Dickhead (I can’t believe I am actually addressing someone as Dickhead on here, couldn’t you have picked a better user name than that), I admit that I am not smoking Camels. I prefer Parliaments and full size cigars myself 🙂

It is interesting that nurses have been taking AZT for 20 years for the same purpose as Truvada is being marketed for today. Unfortunately the patent on AZT run out years ago so no one will do research to see how well it actually works for prevention of HIV. AZT doesn’t cost anywhere near $1100 a month to take (180 pills is currently $143.58 at Walgreens — probably at least a two month supply), if it works just as well the future of HIV prevention could be much brighter than it currently is.

@dickhead

Have to address this separately…”You clearly know a lot more than most disdainers, but it’s like arguing with Birthers – Nobody argues 100% effectiveness for anything, but it sure could be a lot better than it was 20 years ago and the nurses used AZT for the “professional” PEP.”

Since you’re brave enough to waltz into a public form and push your agenda here’s a tip. Read back posts/comments to see where the various players stand. Research meeting/conference regulars as well to find your strongest allies and no matter what…no matter how much you know…assume the next guy or newest face in the door doesn’t have some thing to teach you. They may have hooked into the one detail you’re missing or misinformed on for a whole new or more vibrant picture.

@jilted

Damn…were old fucking farts! read your comment after responding and had to laugh seeing our separate ways of saying..kid yer heart is in the right place but …

Meh we prolly just earned a pat on head for repaying someones patience when we were too young to know better. 😉

@dickhead

Your passionate goal is hampered without more detailed information. Seeking first general then more detailed Truvada information was to understand what the marketing, promotion and advocates were trying to say. Early on the 2012 CDC approval and the supporting studies were sourced so that’s where I looked and found right out front and center the disclaimers and questions by Gilead about vaginal vs anal transmission. Further studies proved the same effectiveness rates for anal and IDU (injected drug use) with the vaginal discrepancy remaining. Looking at the study data for the alternate vaginal delivery routes the frustration of what’s causing this discrepancy is apparent. Hoping the research solved this discrepancy I was all over the 2014 world conference. It sucked finding out the studies only included transexual women and made no reference to heterosexual vaginal rates outside continuing studies for monogamous sero-discordant couples.

For porn use it seems very important to at least mention if not detail this limitation when promoting PrEP/PEP. Performers (regardless of gender or activity preferences) need to know that as use of varied PrEP/PEP applications gain popularity risks may move from reduced/suppressed anal to unknown vaginal effectiveness. This isn’t to discourage PrEP/PEP use but to ensure it’s presented as one of many factors to consider when assessing and responding to STD risks.

Unlike the FSC I include escorting in ‘porn’ and learned escorts negotiate bareback anal requests by untested clients, many insist on oral (lowest transmission risk) and some settle for vaginal with more risk than oral but much less than anal. With effective rates that rival and often surpass the less risky oral choice Truvada is a game changer for those who consider varied activities to mitigate their overall risks.

Peter Acworth of Kink.com has actively promoted Truvada including a Mid-May 2014 HuffPo live with Ciagliarri (sp) that included two advocates (San Francisco and national Non-Profit) focused on advocating Truvada use in porn.

Hopefully this clarifies the difference between someone trying to offer accurate information vs marketing selling points. I’m not selling PrEP/PEP and my vested interest is allowing folks most affected to arm themselves with pros/cons with the glittering promotion offered by pharma and LGBT orgs whose primary focus is reducing MSM HIV rates. LGBT efforts would be laudable if they didn’t treat folks looking to have a rational convo about this issue like they’re Birthers at an Obama convention.

Dickhead,
“Billions of pharma dollars invested in ignorance”
Hate to break it to ya, but Truvada is BIG PHARMA. The producers of Truvada loose their patent in a few short years, so now they are trying to sell their drug to MILLIONS of people before they loose their exclusive rights. As someone who seems to be against big pharma, I would think you would see this for what it is, a huge money grab based on the ignorance you seem to know so much about. Even the Big Pharma compnay that makes this drug says it is ineffective without condoms, even you cant deny that, it is right there in EVERY single peice of literature that the makers of Truvada have ever produced.

As a person who got his first job in a clinical laboratory in 1981, when this HIV/AIDS thing was brand new, and working in this industry ever since, I have seen first hand the evolution of the HIV/AIDS industry. Once in 1982, I stuck myself with a used phlebotomists needle. The next six months of my life were a nightmare.

DICKHEAD, heres some advice, something I also learned the hard way.
You make great points, valid points, that deserve consideration. But you will get nowhere with the way you say it. You can have the best message in the world, but it will fall on deaf ears if you continue to alienate the very people to whom the message is intended. I like what you say, I just dont like the way you say it. And like it or not, your first impression is very important, and you made a bad one. Here’s something else, NEVER underestimate the stupidity of anyone, beleive me, I will never underestimate yours again.

Nothing happens overnite Dick, may I call you Dick? So how is it that the same Big PHarma you rail against, as you say, investing in ignorance, is the same Big Pharma that has created Truvada, and is now trying to sell to people who DONT have HIV? Could it be that youre the one who is buying into the ignorance that the Big Pharma is selling you, that MILLIONS of people spending 14,000 dollars a year on a drug that is only effective if you use a condom. And you are calling others ignorant? Do the math Dick, and see what big pharma is selling YOU dickhead.

My primary interest is to make PEP and PrEP, as well as some awareness of the infectivity impact of treatment, all the more evident to groups long ignorant of these opportunities. And the reason for my interest is that Obamacare is the first breakthrough by which a positive HIV diagnosis does not result in cancelled insurance – and therefor the key to reducing the number of unknown carriers of the virus. At $400,000 from diagnosis to death – which was an NIH number two years ago – the real value of ObamaCare is to convert medical practice from treatment to prevention.

Most assuredly that conversion will not be automatic, and has billions of pharma dollars invested in ignorance. As someone who has known plenty of people with HIV as a life sentence, it is painful to wallow in the margins while universal health care, safe testing, reasonable pre and post treatment options, and the value of compliance are all known plenty well to worry less about the edges.

And, incidentally, I can’t imagine how vaginal transmission is exempt from generalizations about anal or by needles: it is not the location that shares the virus, but, rather, the impact of the virus itself on the antibodies. The better precedents for this level of research are, incidentally, in Canada, where the studies go back much longer, and the “treatment is prevention” mantra is already established.

You clearly know a lot more than most disdainers, but it’s like arguing with Birthers – Nobody argues 100% effectiveness for anything, but it sure could be a lot better than it was 20 years ago and the nurses used AZT for the “professional” PEP.

In the porno industry, incidentally, I’m also surprised that no producer has bothered producing a porno movie on how to use PrEP or PEP to stay safer – if not virginal. And, by the way, it’s inconceivable that people would use PrEP to prevent other diseases or pregnancy: that takes a level of stupidity I find – even in this blog – surprising.

In any case, do whatever you will, since you surely will regardless of improving odds and better health opportunities than ever before.

Big Thumbs Up Lurk!:)

@Dckhead

It’s obvious you have no clue where I stand on the positions in your agenda. First and foremost porn’s turn at being targeted for regulation with teeth has come. This isn’t regulatory agencies bashing or singling porn out it’s regulatory agencies recognizing the validity of the industry and trying to bring it in line with other American industries. In the past 100 years nearly every industry that started out exploiting its workers regulations have been negotiated tailoring standardized American Labor laws for easier compliance as the best way to protect workers and keep employers fiscally healthy. Porn and it’s ancillary industry segments won’t be outsourced like the garment and many service jobs were. Look at jobs w/ migrant workers and intermittent or seasonal for the tax base increase over the past 25 years and any doubts that porn’s time has come are easily dismissed. A year ago I made the bold statement that porn regulation is what will pave the road to legalizing other sex work. Since then speaking with regulators and legislators on a personal level it’s amazing how many are ready for a comprehensive safety standards plan..regulators because it unites their hands…legislators get support and a tax base. The kicker every legislator currently accepting porn support via networking or funding outright said or implied they gain more than they lose if they vote for a comprehensive labor safety plan. Some mentioned this or that agency and where their efforts are and headed..all mentioned Truvada and ACA as a motivator.

In every case where details were offered…Truvada or it’s equivalent will be included as an optional PPE (Personal Protection Equipment) to minimize HIV exposure risks. Employers may choose to offer it and workers who opt out of its use will use a form similar to the mandatory vaccine form..documents that worker was offered vaccine and declines for “personal or medical reasons”

Insurers weren’t happy with the cost of Truvada and FDA approval getting pushed through forced ugly changes to their ACA actuarial tables. Now comes some not so back room agreements that happened to appease insurers who were ready to drop Medicare and Medicaid. They get to chase employers for PPE use of Truvada the same way they get to chase employers for WC injuries and competitor insurers for Auto injuries.

So now maybe you’ll appreciate my stance that Truvada is a great drug but pushing PEP/PrEP numbers and stats as equally applicable to all users is going to earn you a rash of shit from me every time! I’m also going to call you out on including generics and equivalents from international sources as oppositional to your goal of HIV prevention. In porn it’s no secret that many performers use legal and black market antibiotics as a prophylactic to testing, some are already using antivirals as well contributing to disease mutation and drug resistant strains.

When you’re ready to discuss facts as a part of the whole picture vs your microscopic agenda…let me know.

@Laura

TY if the hot air I spout motivates or encourages someone to look into performer safety and step up to the plate in their world and/or take it a step further by negotiating a workable plan with OSHA for independent producers (one others can copy) then my day would be made for sure!

Any performers or independent producers counting on FSC/stakeholders to negotiate with OSHA/Legislators is asking for trouble. Any deal they work out isn’t going to be in independents favor and when it becomes binding you can bet more will come out of performer/independents pockets than FSC/stakeholders. Best way to stick it to FSC is performers & independents working together to negotiate w OSHA for plans that benefit those most affected and have that become the binding regulation…now that would be a great FU FSC 🙂