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Top, Cut, Bareback, PrEP

Jun 23, 2018

Hey,I take prep daily. I had been taking Prep for 8 days before engaging in bareback sex, I barebacked several bottoms with me being top. I cum inside them. I am circumcised.

Despite taking Prep and being cut, I still have the fear of getting HIV. Given my situation, Could you please advise me the possibility of acquiring HIV?

Also, I am curious about what chance does a bottom who takes Prep daily have in contracting HIV? Suppose he got barebacked and the tops were HIV positive?

Response from Mr. Jacobs

Hi there,

Congratulations on starting PrEP and taking control of your sexual health. After 8 doses, you now have the maximal protection PrEP can offer for anal sex.

I understand your fear, it's hard to wrap the mind around the fact that this blue pill is offering more protection from HIV than a latex condom. But that is exactly what the science and data has been showing us reliably for the past 8 years.

Now let's break down the details of your situation. Even without PrEP or condoms, as a circumcised top, your risk of acquiring HIV are less than 1% (https://www.poz.com/article/HIV-risk-25382-5829). When you add 8 doses of PrEP to that, your risk drops so close to zero it's incalculable. You would be more at risk of getting struck by lightning than getting HIV in this scenario (https://www.weather.gov/safety/lightning).

If a bottom is using PrEP as prescribed, and they are being topped by partners with detectable HIV, their chances of acquiring HIV are still nearly zero (https://www.robertmgrant.org/project/has-prep-ever-failed/). We currently only know of two people in the world out of approximately 315,000 who have acquired HIV with verified adherence to PrEP (http://www.thebody.com/content/80972/has-anyone-gotten-hiv-when-they-were-on-prep.html). That is significantly less than 1%. And as you may know, if someone living with HIV has an undetectable viral load for six months or longer, then they cannot transmit HIV to to their partners (http://www.thebody.com/content/80813/hiv-undetectable--untransmittable-uu-fact-sheet.html?ic=7001).

I hope this information allows you to gain a realistic perspective on the HIV risks (or lack thereof) in this scenario, and allows you to experience the kind of sexual encounters and pleasure you wish to enjoy.



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