"he said he had difficulty taking someone my size with a condom on"
humblebrag detected

Gah. I guess I'm now considered the Gay Old Guard now. Yikes.

Anyway, I was there in the late 1980s when gay men were dying in 6 months from this disease. I watched it happening to friends. I totally admit that I'm a bit PTSD about the whole fucking thing. But I find it hard to read about people who are so cavalier about condom use. The idea terrifies me.

While I agree that PrEP is a good addition to the anti-HIV arsenal, it isn't a panacea. It may prevent HIV, but you can still acquire a whole host of other STDs that PrEP doesn't effect at all. And even if HIV is somewhat treatable now, it's still a really really shitty disease. You're still much better using a condom, even if it's a bit inconvenient.

I'm afraid I come down on the side of our dear Reverse Polarity, and I'll add this: PrEP protects against HIV. But what about the next appalling thing out there? As the population grows and the climate changes, we're going to have our hands full of dreadful infections.

Why does Dan never mention Hep C? Still deadly in the west...

Resorting to harsh chemicals like PrEP is not really an answer; see prepfacts.org - they don't know the long term effects.

No man is work getting sick over, much less have long-term health consequences from ill-advised pharmaceuticals.

"PTSD" is a really apt description. It's not only something that befalls people exposed to war, all due deference to them. Those of us who lived through that era did so because we were careful, or sometimes very lucky, or very rarely genetically resistant, but the experience left its marks on us nonetheless, whether through loss of friends or constant fear.

Huh, why didn't Savage come down hard on this guy for violating safe sex protocol? I too remember the 80s when everybody seemed to have all agreed that the way to stop HIV was to stigmatize and even criminalize those who didn't get on the safe sex bandwagon. After all it worked so well with sex workers and IV drug users.

But then after years of failure the obvious lesson finally sunk in: That shit doesn't work. Shaming, name calling, scolding, civil suits, even criminal charges don't change behavior. What works is respect, understanding where somebody is coming from, and meeting them halfway. Marginal improvements in behavior, whether it's from the hard core taking the most risks, or the most timid who only rarely cut corners, save lives.

That's the enlightened, progressive approach that is now standard and mainstream.

Except the same enlightened, progressive thinkers who understand that you can't get people to listen if you go around attacking them are busy using the same stupid Nancy Reagan "just say no" approach to parents today who don't vaccinate. Instead of meeting them halfway and trying to get marginal improvements from the most open-minded sub-group, otherwise smart people are shaming and mocking the very people they want to educate. Threatening them with lawsuits and even jail.

Doctors and schools are being lauded for turning away unvaccinated families. Can you imagine the reaction if a doctor, or a school, announced they would turn away people who didn't practice safe sex? Or turned away HIV+ patients as a threat to everybody else?

When we harassed gay men or IV drug users or sex workers or undocumented immigrants, they went underground, where public health workers couldn't reach them. They didn't trust any busybodies who came around telling them what they were doing wrong. But by scaring or shaming or insulting parents who are already terrified of vaccines you're going to get a different result?

I find the pigheaded arrogance and hypocrisy kind of amazing.

I see this guy (RB's new partner) as a manipulative boundary-pusher, who doesn't like condoms when he bottoms. RB didn't expect to have any trouble using a condom, but then the new guy got into his head, pressuring him to engage in an act which led into bareback anal (whoops), then mentioning problems right when RB was trying to penetrate with a condom, then somehow manipulating RB to go bareback again the next time (even though RB had still intended to use condoms). RB should expect this guy to ignore his boundaries in other areas as well, whenever they interfere with the guy's preferences.

Also: the guy is clearly happy to bottom to casual partners without condoms. He is more likely than most people to be positive for one or several STIs.

And RB mentions his own tests, but not his partner's tests -- does that mean the partner won't provide his test results? Or that RB's gut tells him not to trust the guy's claim to be disease-free? Or that RB is so intimidated by the guy that he doesn't even dare ask him his STI status?

If the sex is really hot and RB knows he's going to keep having sex with the guy, then getting on PrEP is a good idea (rather than trusting to condoms, since that hasn't worked for them in the past). But I would encourage RB to really think about whether this guy is a decent person, or whether the better course might be to just stop seeing him.

The stuff at the CDC that is quoted above is misleading and not exactly accurate.
PrEP is nearly bulletproof protection if taken every day for 5 days before possible infection and for a week after. The reason it is recommended daily for gay men is that so many have sex regularly that every day is the appropriate regimen. Studies show that it is OK to miss 1 or even 2 doses per week.

@5 I agree in principal, but Truvada was chosen for PrEP studies because it has already proven to be well tolerated by many for many years.

@4 HepC is harder the pass through anal sex than HIV. It requires blood to blood exchange. Semen to blood exchange does not pass it.

@2 No one was suggesting condoms for gay sex before HIV. I agree that there are other STIs and I choose condoms even though I hate them. But for someone who knows he is going to slip up, PrEP is a great idea.

Remember that in order to get PrEP one must be tested for everything every three months. Any upswing in other STIs among PrEP users will be easy to track.

@8
+1
Anyone who wants to bareback with a causal partner has and will bareback with others and is the greatest risk there is.

But @LW, Playing with fire?
Big effing DUH!

It's hard to understand how the LW could have any doubt that he is at huge risk. I suppose we should be grateful that he wrote in so that we know the job of education is far from done.

STOP being risky, Risky.

I agree with @5 said, no "once in awhile" guy is worth getting sick over. Seems dumb to have to repeat that in this day & age.

@8 and @9: Yes, the bottom who talks his causal-hook-up tops into not using a condom is far, far more likely to be poz. And someone who refuses such a simple step to protect his health is also a lot less likely to test, start on drugs and continue on drugs to achieve undetectable viral load.

Since this bottom either wants to kill/injury gay guys or doesn't mind that outcome, shouldn't this practice have gotten the moniker "Saddlebacking"?

David--I thought "Saddlebacking" referred to straight kids who took those virginity pledges but thought anal and other forms of sexual activity didn't count.

At any rate, RB's FWB sounds like a manipulative fucker. And RB has ammunition. He can make it clear to his partner that condoms are a nonnegotiable.

@7: false fucking equivalence. I'm not going to catch an STI from someone I pass in the hall or share a class with.

DTMFA. Jesus.

"he said he had difficulty taking someone my size with a condom on"

Really? Because condoms are so thick, right? How fucking stupid are you? This is a Darwin Award waiting to happen.

Huh. Maybe this guy should be concerned about other diseases?

http://slog.thestranger.com/slog/archive…

Thanks Dan, I lived through the epidemic and I have never understood the AIDS activists who oppose the use of PrEP. If we have another arrow in our quiver, we should use it. No one every thought that condoms were perfect. PrEP is wonderful for people in serodiscordant relationships as well as people who are just not going to use condoms for whatever reason.

Seriously LW?

Dan; this change in format,is confusing. And I can't access comments in longer longer threads, on SavageLove.

"The next time, I insisted on a condom; he agreed, but then, as I tried to penetrate, he said he had difficulty taking someone my size with a condom on."
DTMFA
Seriously how could you miss this one Dan? Let's pretend for a moment that LW was a woman and her FWB/BF kept trying get her to have unprotected sex. Nagging and manipulating her like this. LW: this guy doesn't care about you or your health. He's the kind of guy who would remove the condom during sex without you noticing it, if the roles were reversed. Condom use is not something you should have to insist on and certainly not have your partner overhear, when you do insist - DTMFA.
PrEP has serious side effects and is VERY expensive. Many health plans doesn't cover it from what I've heard. LW shouldn't have to take meds that causes kidney damage and bone loss just because his FB doesn't like getting fucked with a condom. Also there are lots of other STDs that PrEP doesn't protect you from.

18: Quite. Very strange answer from Dan.

I'm glad I'm not the only person who picked up on the manipulation of saying "I can't handle someone as big as you with a condom on". Insisting on not using condoms is an automatic dealbreaker for hookups, doubly so when they try to sneakily manipulate me into taking it off.

If the LW doesn't want to risk herpes, gonorrhea, HPV, or chlamydia, he should walk away from this guy and fast.

@12, Danielle: Yes, you're right. that's what Dan selected as the definition of "Saddlebacking" - straight religious kids who thought anal sex wasn't "sex" and prohibited by their virginity pledges.

I'm saying the LW's FWB's behavior would be, in some ways, a better meaning of Saddlebacking because, like Rick Warren, he's out to get gays. Not with his words, books or political actions, but with his likely-infected anus.

Agreed, this guy is manipulative and a big risk for more than HIV.

Definitely dude, if you are likely to be talked out of using a condom then get on Prep. You should really use both condoms and prep together, but if you are only going to use one then we all know that prep is the one you are more likely to be consistent about and is probably going to be more effective to prevent HIV.

But this guy in particular is a high risk individual. He has casual unprotected sex (assuredly with more than just you) and manipulates you into not using condoms. He clearly doesn't care one bit about your health so why on earth are you going back to him?

Condoms and truvada are great because people fuck up and make mistakes that risk their health and these things reduce the risk. But fucking someone who is intentionally trying to get you to act in a way that risks your health is stupid. Accidents happen, and people fuck up. But what this guy is doing is willful negligence.

Can women use Truveda???

@23 - yes

http://www.cdc.gov/hiv/prevention/resear…

(it says "manor woman", but I think that's a typo, not that it's only for women with large houses)

@23: The CDC website shows that possible indications for Truveda include women in a non-monogamous relationships without consistent condom use, if their partner(s) are at risk of HIV, and HIV-discordant heterosexual couples. Also, women who inject illicit drugs and share injection equipment.

Mr. Thrustwell and I were googling and posting at the same time. I puzzled over "manor woman" a moment as well. "man or woman", I'm pretty sure.

@23,
An HIV negative woman can go on PrEP, be impregnated by an HIV positive man, and go off PrEP a week after impregnation—and remain HIV negative.

I'm with the folks who say that the bottom is just being an asshole (ahem); folks who like unsafe practices practice unsafely any time, anywhere, in my experience: run, run fast.

In other news I seem to see a different interface today, probably meaning that the tech savvy youth are getting some practice, but it doesn't seem like an improvement to me: one of the rules of thumb in web design is the fewer clicks to see what you want, the better. It wasn't broken, why fix it.

The anti-Prep people sound an awful lot like the abstinence only people. It's also interesting that most people who concern troll that Truvada doesn't protect against all STDs freely have unprotected oral sex in my experience. Anyway, one tactic is to start with condom only. If you are 100% compliant, then great don't use Prep, but the first time the condom breaks, or you have a momentary lapse of judgment and have unprotected sex, immediately get yourself some Post-Exposure Prophylaxis Truvada and continue it as Prep. Many people are with condoms like they are with diets. The best of intentions until there is a dozen Top Pot donuts in front of you and you didn't have time for breakfast.

This seems to be a bit of a reversal for Dan. Last I heard he wasn't big on the idea of PrEP.

I hope you do a more at-length article about PrEP sometime. There is a LOT of back and forth and misinformation going around, especially in comments sections. I trust Dan Savage to cut through the bullshit to find out whether PrEP is something the average gay guy should be on or not.

@29,
PrEP and PEP are not the same protocol. The PEP regimen is no fun at all from what I've heard. For Truvada alone to work as PrEP, it must already be in the system in sufficient strength to prevent replication. In the studies, those who dropped below 5 doses a week still sero-converted even though they continued taking Truvada after infection.

Confused non-penis-haver, here. Dan has said numerous times that he's sick of whining guys who don't want to wear a condom, who say they can't feel anything with a condom, who then, when the condom breaks inside the person they're fucking, don't even notice.

Yet here he is saying how much better it feels without a condom.

Perhaps as a gal this is beyond me, but ... if you don't notice the difference between condom-fucking and non-condom fucking, how, then, is it that condom-free sex feels so much better?

@ 32 - I think Dan said it as one if the supposed truisms that are usually thrown about concerning bareback sex.

@32, my understanding is that men feel a lot of pressure to maintain a hard erection. The condom adds to that pressure, because if he goes limp and the condom comes off, I gather you're supposed to throw that one away and open a new one.

Anal sex also requires a hard erection (harder than PIV). The condom may feel like altogether too much pressure, especially because there's a pause in the sexy times to get the condom on, when one risks losing one's erection.

Also: It's extra confusing for us women because guys don't like to talk about all the pressure to have a hard erection, since thinking & talking about their anxiety makes the anxiety worse. So they speak about a different kind of annoyance -- not being able to feel skin-on-skin -- because that's less anxiety-inducing, and in fact makes them sound kinda earthy and cool.

"unprotected bareback sex just feels better," as if that is ANY justification, or new news, or as if that's only true with anal sex so therefore it's more okay to coerce your partner into going without protection in this instance than with p-i-v or anything else. this response was the dumbest. also was pretty cavalier about the actual seriousness of actual HIV. not your best, dan.

As the child of a hetero parent who died from complications of HIV, and another parent who has been dealing with the symptoms of HIV for more than 20 years, (yes i said twenty, my father died in 1994, mother was positive before his death), i am fucking appalled by the lack of serious warning from Dan! "Its ok, you might not die right away." Really? Like HIV is comprable to chlamydia? This LW needs a reality check, and apparently Dan does as well. Not to mention other non curable stds. If this guy is lucky enough to avoid HIV, how bout some hepatitis, herpes, and warts?

Anyone else think this letter was just something Dan used as an excuse to make a public service announcement about PrEP?
Because the obvious Dan answer was, of course, Yes, you're playing with fire. DTMFA.

Love Erica P's (@34,35) comments- so true.
Stopping to put a condom on when there's alread anxiety is a huge boner- killer.
And yes, talking about it as being "the condom's fault", makes it easier...but it's still there.

@29: I'm not against PrEP. I'm against idiots (and this guy is an idiot) having sex with manipulative, lying assholes. If people didn't insist on rewarding bad behavior, there wouldn't be so much bad behavior. Or so many people with STIs.

RB definitely needs to see How to Survive a Plague. Duh

RB definitely needs to see How to Survive a Plague. Duh

@34: Do you mean condoms can add to the pressure because getting another one calls attention to the fact that they've gone soft? You're right about the pressure to always be rock hard - porn movies don't help in this respect, and the pressure isn't necessarily just self-inflicted. The biggest issue is simply that condoms do reduce sensitivity (as well as interrupt momentum, if you don't time the application right - right before PIV is actually too late), and once you start to lose the erection it's also more difficult to get it back. Ultrathin condoms are noticeably better, and there are ways to address their shortcomings (one size does not fit all, for instance) but yeah, they do make sex less arousing. That's not sufficient reason not to use them, of course.

@43: Putting the condom on your partner -- with hands or mouth, if you're skilled enough -- is a good way to maintain the sexy momentum prior to penetration. But yeah, condoms are the price of admission if you want to have non-monogamous sex.

Whoa, everyone... just whoa! Dan's advice is spot on, and entirely consistent with a harm reduction approach to public health. I find it appalling that people here would discourage protective measures simply because this dude is not protecting himself in the way you would prefer he does. That's some judgmental, ab-only inspired bullshit.

This advice will help to actually reduce the incidence of HIV. Let's respond to the risks as they actually are in the world, not as we feel they should be, m'kay?

A condom would be better. Maybe this is me being sex-negative - sure, it doesn't feel as good as skin on skin. But the manipulative tactics displayed by the LW's play partner are a huge red flag. His playmate likely says this to other partners. It's his business if he wants to repeatedly put himself at risk - not just of HIV but a host of other diseases out there, like gonorrhea, chlamydia, herpes, syphilis & HPV - but to repeatedly encourage others to do it also seems disrespectful to them.

Sex without barriers feels better. I won't argue that point because we're all adults. But when we have the freedom of playing with multiple partners, whose history/test result status we aren't sure of, it's just smarter to use them than not. Bit of a boner-killer? Yes. Sometimes needs working around? Sure. Worth the risk of alll those ugly buggies? Not to me. Though I guess it may be to the LW & his partner. As a former "Act Up" era activist in NYC & NJ, it's hard for me not to go all Church Lady/pearl-clutcher about that idea. I'd react the same way to a non-monogamous straight couple where one partner was pressuring the other to not use a condom for casual play.

Dan may have assessed that the LW was just gonna go ahead & not use condoms - that he was just repeating excuses maybe Dan has heard too-many times before - & so Dan decided that PreP was the best course of action.