It sounds simple but for a lot of people it’s not a trivial thing to take a pill every day or adhere to a strict appointment schedule to get an injection. I’d imagine that adoption & compliance goes way up if it’s that much easier.
It sounds simple but for a lot of people it’s not a trivial thing to take a pill every day or adhere to a strict appointment schedule to get an injection. I’d imagine that adoption & compliance goes way up if it’s that much easier.
Just to avoid the accidentally missing a dose or the chance interactions (lower efficacy) with dairy and many fiber supplements, this would be amazing.
Would be nice to never need to worry about that or think, hey I missed a dose is it actually true that it doesn’t matter or do I need to wait a full week. Half a week?
My only concern here though, if it’s in your system for 6 months what if you have an adverse reaction or just some unpleasant symptoms.
1. in sex work, "not using a condom" is an "extra" that clients will pay quite a bit for
2. people who "party and play" tend to be in an altered state of consciousness that biases against use of condoms
To me, that is such a weird thing.
People literally paying money for something that can damage them for life and may even kill them.
Though the same can be said of addictive things (smoking comes to mind), is this some form of that maybe?
You could say the same about sky-diving.
They post you're replying to merely points out they're wrong, as there are examples of it not _always_ entailing a premium.
No-one's saying that there aren't examples of risks that do entail a premium.
When somebody else takes a risk for you, you have to pay them more than if they are not taking a risk. We pay soldiers more when they are at war than when they are not. People who want to raise money by selling bonds have to pay a higher interest rate if their credit is worse. Etc.
Prostitutes would consider unprotected sex more risky, and thus charge more.
We all choose to take risks all the time and often pay for the privilege, sometimes explicitly seeking out the thrill of a risk.
I'm guessing what makes this specific scenario weird for you is more likely that this risk doesn't seem worthwhile to you relative to what you get from it (and I agree with that - I've never had an appetite for taking risks with STDs)
i'm confused. are we acting like we don't full-well know that using a condom sucks for everyone involved? it's like wondering why people didn't like using a face mask during covid: because it sucks. that, of course, is independent from whether it's prudent, but if something sucks, it's no surprise when people avoid it, right?
What do you mean "acting"? We all know it reduces the sensitivity. That's the trade off. You feel less pleasure, and your fucking doesn't get to kill you.
> it's like wondering why people didn't like using a face mask during covid: because it sucks.
Similar analogy. It sucked, but that was a similar trade off. It sucks a bit, but there's less chance it'll kill you or you'll kill others.
> it's no surprise when people avoid it, right?
I think those people would have to be fucking morons, but sure, morons exist.
As someone who took the condom off in a risky situation recently, there’s no comparison between the on and off feeling. It’s like licking a piece of candy vs crushing it with your teeth and sucking it all at once.
With consent yeah?
Preventative:
1. Gardasil 9 (vaccine against 9 strains of HPV, prevents genital warts and cancers caused by HPV)
2. Monkeypox vaccine
3. Meningitis ACYW vax
4. Meningitis B vax (35% effective against gonorrhea)
5. doxyPEP (two pills of doxycycline taken after sex, 90% effective against syphilis, 80% chlamydia, 50% gonorrhea)
6. PrEP (prevents HIV infections)
7. and the usual suite of vaccines against the rest like hepatitis A/B, mumps etc
Treatment of the bacterial ones (which transmit through oral too):
1. syphilis - butt shot of penicillin 2. chlamydia - 1 pill of an antibiotic 3. gonorrhea - a week of doxycycline pills or one butt shot of ceftriaxone
Remaining: HSV. Half of the population has it, so no big deal. Condoms dont prevent it either.
As for hepatitis: even though it requires blood contact and as such is not necessarily considered an STI, hepatitis c is curable these days thanks to DAAs taken over the course of 8-12 weeks. a/b have vaccines.
Worse still--large scale casual sex is a great way to introduce new, novel and un-contemplated STDs into the population. STDs are opportunistic that way, just ask Mr. triple-resistant Gonorrhea.
It's decidedly not the way I want it to be, but that's just how it works. For casual sex to be safe I think its more like "Hi, please spit into this tube so we can get busy" and red means HIV, Green means Monkeypox, comprehensively.
Actually it appears the 9-polyvalent HPV vaccine protects against multiple cancers but insurance won't pay for it once your outside the age window.
* originally he said "throat cancer" at the advice of his agent!
[edited: wityl pointed out I’d typed HSV for some reason]
There is no vaccine, it doesn't cause cancer (that we know of, at least not like HPV), and spreads via skin contact on the genital area.
Since fluids are not required for HPV or HSV and it's present on the area that a condom won't cover, condoms aren't effective for either.
See also: Wrestlers' "Herpes gladiatorum" which is just HSV-1. Which demonstrates how HSV-1 survives for transmission far more easily or broadly than just genital contact. Is there "HSV-2 gladiatorum"? Apparently it's usually HSV-1 but probably yes - neither HSV-1 or HSV-2 are really location specific.
In the early days of AIDS (wasn't called HIV back then) the recommendation was to use a condom or dental dam (depending on the hardware of the recipient). That's how I learned what a dental dam was. Later it was suggested that plastic food wrap would work (the jokes just write themselves).
Sadly the ubiquity of paper toilet sheet covers in US bathrooms dates back to the 80s due to straight paranoia over AIDs + widespread and overt anti-gay prejudice, so every time I see one of those dispensers I grit my teeth.
Reminds me of the early days of COVID (not the anti-gay part, but the weird practices when nobody really had yet a good theory of what's going on).
The reason for the reversal in terms is treatment options. When HIV was first found, there were no treatments so AIDS was inevitable. Nowadays, medication can permanently prevent HIV from progressing to AIDS, so AIDS is much less common than HIV.
You might be thinking of “GRID” (gay related immuno deficiency), the original name of AIDS when it was believed it only affects gay people. Once the virus causing the illness was identified it was called HIV.
Personally I’d say that’s a pretty good tradeoff: fear, stigma, and death for a different problem that’s more an annoyance than a mortal threat right now.
Preventatively using antibiotics is a horrible idea, for one it increases the risk of creating resisitant strains, and we are already running out of antibiotics (especially broadband ones). Moreover, antibiotics in general are known to mess with you gut biome whose importance we are just beginning to understand (we know it plays a role in many physical and mental illnesses for example). Then there are the side effects which for doxycyline include diarrhea, increased risk of bowel cancer, higher sensitivity to the sun (and associated risk of skin cancer).
If loopdoend’s doing this, it feels like a good bet that there’s a doctor in the mix judging that it’s medically appropriate for them.
Suppose you’re immunocompromised. Wouldn’t it be worth the diarrhea to avoid infections your body couldn’t fight off?
Suppose you’re in a situation where you’re having lots of opportunities for infection. Whether you can or can’t control that situation, the end result is the same: you know your body is going to be challenged by infectious disease frequently in a way that most people’s bodies aren’t. Isn’t it plausible that the infectious agent may have less opportunity to evolve if you didn’t contract it as frequently?
Different forms of therapy might be both individually and collectively optimal for people in different situations. What’s right for a person who isn’t at risk isn’t the same as what’s right for a person who is at risk.
The overuse of antibiotics is mostly in farm animals, which represent 73% of global antibiotics use, and 90% of American antibiotics use.
This is how you end up with super STD's
lol what
https://www.cdc.gov/hiv/risk/condoms.html "condoms are highly effective in preventing HIV"
https://pubmed.ncbi.nlm.nih.gov/9141163/ 1997, "reexamination of HIV seroconversion studies suggests that condoms are 90 to 95% effective when used consistently"
https://www.cdc.gov/hiv/prevention/condoms.html "Most condoms are effective in preventing HIV and certain other STIs"
https://www.cdc.gov/hiv/risk/prep/index.html
>PrEP reduces the risk of getting HIV from sex by about 99%.
Last I checked 99 was greater than 95.
Why not just save money and not install those ECP brakes on your vinyl chloride freight train?
Why not just use one unshielded Raspberry Pi on that spacecraft instead of a 3-of-5 quorum from the output of 5 identical engineered-for-space systems?
Using/requiring condoms AND being on PrEP helps me live my best life with less fear-based inhibition and cognitive load.
In case of a pill perhaps negative side effects.
I have no clue how often a person in high HIV risk has sex or behaves.
It should be fine to ask that question
It is. I interpreted the parent post as a neutral question, and I intended my reply to involve playful analogizing. I'm sorry that it didn't reach you as such through the side-channel-impoverished medium of text.
This is like saying to someone killed in a motorcycle accident why didn’t you use a car. It’s a reductive, unempathetic and frankly unproductive take. Please think before asking this again.
Edit: lmao touched a nerve? I will never understand why folks here get so prudish when we talk about sex... "Just wear a condom!" is remarkably insensitive, as though 100% of HIV transmission is your own fault, and not, say, someone else who has bad intentions.
We all know exactly at a individual level what to do and not. We can keep asking "Why not just use a condom?" and see how far that gets us, or actually understand psychology and use patterns and work with what people actually do (good or bad).
Same can be said about (illicit) drugs, why not just not do drugs? Simple!
It is actually simple. Just not easy. Same with losing weight - consume fewer calories than you burn.
moreover, condoms can have numerous issues like tearing or stealthing
there's a few good injection sites (upper arm, buttock, thigh or even pecs) and after I was shown once how it's done, I can do it myself. it's also essentially painless.
For what it’s worth you might want to try a weekly dose if you haven’t. Most do better on it.
I'm Hypogonad and I'm on self administration of sub q injections twice a week and it's quite annoying. My urologist told me it's best to split it this way since more frequent injections avoids a "crash".
I would like to have less frequent injections if I could!
The most common - Testosterone Cypionate should be best used twice a week to avoid the "crashes" - if you care about keeping your levels relatively stable. Other forms of Testosterone have different half-lives and should be taken at differing schedules.
I never saw the point in subq shots for TRT. They are less effective, and are recommended solely for patient comfort and compliance. If you can manage a twice-weekly deep IM injection, I personally have had great results with that once I learned the locations. Nearly as painless as subq and better more consistent results.
Overall it doesn't matter a whole ton unless you are doing it for specific performance enhancing reasons. Being off "optimal schedule" a few days isn't going to make a meaningful difference for most.
I don't see why I change and my doctor essentially said the same.
Both graphs are 200mg per week. Green is dosed at once every 7 days, while the blue is broken into 7 smaller doses per week. (I haven't included axis and such, because it's really just the shape I'm trying to highlight)
As you can see, more frequent dosing results in steadier levels.
When administering your testosterone once per week, you will have to make one of a couple trade offs:
1) Dose high enough that you are above the level you want to be by the end of the week. This avoids the "crash" you mention, which will consist of both low-testosterone (low-libido, fatigue, etc) and low-estrogen[1] (joint pain, etc) side effects. Dosing higher means you shift the whole graph up, and you will be at supra-physiological levels of testosterone and estrogen, and the high estrogen side effects are no fun: nipple sensitivity, emotional fluctuations (think crying at the sight of puppy pictures), gynecomastia (development of breast tissue), horrible back acne, etc.
2) Dose on the lower side to avoid avoid high testosterone/estrogen side effects. This shifts the whole graph down, and now you're below where you want to be by the end of the week, and you now feel more like you did before you started TRT.
3) Somewhere between the above two options, and add an aromatase inhibitor (like anastrozole) to minimize high estrogen levels. You'll still have excessively high testosterone though... and you'd really be better off avoiding the high testosterone peaks instead of adding another drug to the mix.
I used to go into a clinic once a week for an intramuscular injection of testosterone cypionate. In order to not feel like shit the last two or three days of the week, I had to up my dose such that my back broke out in a constellation of acne, and probably negatively impacted my health in other more meaningful (but less obvious) ways.
Now I inject testosterone propionate every night. I managed to lower my dose so that I'm always hovering right around where I want to be, instead of bouncing all over the place.
That's another benefit of increased injection frequency: you can lower the total amount of testosterone injected per week while staying within therapeutic range.
1: Your body produces estrogen by aromatising testosterone. More testosterone and/or more aromatase -> higher estrogen. Less testosterone and/or aromatase -> lower estrogen.
Ideally they'd break down at a constant rate (they don't, but close enough) leading to steady levels despite levels of the prodrug steadily diminishing. This makes once a week dosing of testosterone cypionate (for example) viable for many, but not all, as you've discovered.
Dosing less but more often helps minimize the uncertainty/variability in breakdown/conversion, thus being more reliable at the cost of convenience.
https://www.nhs.uk/contraception/choosing-contraception/how-...