AIDS/HIV | Truvada

HIV Activist Rails Against PrEP, Plus Magazine Destroys His Arguments

Robert Brandon Sandor

Robert Brandon Sandor is an HIV activist, the owner of poz4poz and HIV-UB2, and is the creator of a series of regular serosorted play parties in NYC and other gay meccas. He recently wrote an opinion article for Gay San Diego wherein he slammed PrEP as a viable means for HIV prevention. The only problem is that his opinion piece appeared to be almost entirely devoid of factual information, so Todd Heywood at HIVPlus Magazine took the time to fisk Sandor's piece and dismantle his claims with cited facts.

For example, since PrEP supporters encourage people to use condoms and the pill together Sandor begs the question whether it's condoms or PrEP that accounted for lower HIV transmissions in the iPrEx study. Heywood countered with a statement from the study that stated, in part:

Given that high-risk sexual behaviors were still quite common, and given that condom use was the same in both the Truvada and placebo groups, it is highly likely that Truvada, and not just condoms, had a lot to do with how effectively the pill prevented new infections.

Sandor, who is HIV+ himself, also claimed that there is no need to take medications for prevention as "Safe Sex Serosorting" sex parties, and serosorting in general, already help to prevent the transmission of HIV. The Journal of Acquired Immune Deficiency Syndromes found that "The protective effect for serosorting we found was not statistically significant." What's more, the CDC itself states in bold, authoritative letters, "CDC does not recommend serosorting as a safer sex practice," because

(1) too many MSM who have HIV do not know they are infected because they have not been tested for HIV recently, (2) men’s assumptions about the HIV status of their partners may be wrong, and (3) some HIV-positive men may not tell or may misrepresent their HIV status. All of these factors increase the risk that serosorting could lead to HIV infection.

Both articles are worth a read for a more comprehensive understanding of the issues and arguments around PrEP.

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Comments

  1. This also why HIV+ people will remain stigmatized. A few bad apples spoil the lot.

    Posted by: Sam | May 1, 2014 7:54:01 PM


  2. Wow. I remember when Brandon was hot. Dude is no longer f*ckable anymore, and it ain't just because he is a Truvada denier.

    Posted by: peterparker | May 1, 2014 8:03:38 PM


  3. The body doesn't like it when you add chemicals to it. Gay men have been manipulated by Big Pharma into taking drugs. Avoid Truvada and avoid HIV drugs. Just say no to Big Pharma.

    Posted by: petey | May 1, 2014 8:20:17 PM


  4. Jimbryant I mean Petey what then do you recommend I take to keep my viral load undetectable? Please let me know cuz I am all ears.

    Posted by: Derek | May 1, 2014 9:12:35 PM


  5. "Sandor, who is HIV+ himself..."....I stopped reading right there.

    Posted by: wheelie81 | May 1, 2014 9:36:49 PM


  6. How about just stopping having anal sex instead? That's the only reason STDs ravage a part of the gay community. If everybody would just "limit" himself to fellatio, mutual masturbation, intercrural sex, etc. etc. the epidemic (of everything, not just HIV) would END overnight. And there'd be no need of condoms either.

    Posted by: Pandion | May 1, 2014 9:37:55 PM


  7. @PANDION: No, sexually transmitted infections can still be transmitted through oral sex, it is less likely, but it would still happen. The way to curb infections in all communities is simply effective condom use and adequately educating people on being able to identify infections early on so they can seek the appropriate treatment before potentially transmitting to anyone else. Condoms are needed regardless, intercural and mutual masturbation are safe yes, but fellatio still carries the risk of infection, most commonly that of:
    -gonorrhea
    -genital herpes
    -syphilis
    There is also a smaller risk of contracting chlamydia through oral sex. No sex is completely safe, use protection.

    @PETEY: how about we leave recommended treatment for diseases such as HIV to the health professionals? Since we actually study for a number of years and base our practice on scientific evidence.

    Posted by: Student RN | May 1, 2014 10:52:38 PM


  8. If these medications had been available in the 80's, hundreds of thousands of gay men would still be alive today.

    If these medications had been available in the 80's, and a gay man who isn't a doctor was telling other gay men not to use them, HE wouldn't be alive today.

    Posted by: Bill | May 1, 2014 11:10:45 PM


  9. Anal sex is not the cause of STD's. Anal sex is a conduit, not the cause.

    If there is no STD-related pathogen in your body, the conduit (anal sex) is not important or relevant. You can thus have as much anal as you wish without worrying about catching an STD. No condoms needed.

    However, you still need to be concerned about E Coli bacteria that can enter the bliod of the bottom ir the urethra of the top. E Coli exist ib everybody but only become infectious if they move fron their natural residence. E Coli do not cause STD's, however.

    Posted by: petey | May 1, 2014 11:11:40 PM


  10. @Student RN: "It is less likely". Indeed. It's much, much lower risk than straight vaginal sex. There is an inconvenient truth here that few want to acknowledge, i.e. that anal sex is exceptionally dangerous, 10x worse than vaginal sex. And condoms are not enough to make it safe, most obviously because people don't seem inclined to use them, even after decades-long campaigns to promote their use.

    Posted by: Pandion | May 1, 2014 11:14:00 PM


  11. Pandion,

    Actually, the vagina is a source of HIV infection through a woman's menstrual blood. Women's vaginas are worse than anuses.

    Posted by: petey | May 1, 2014 11:39:35 PM


  12. Jimbryant/Petey didn't you get banned from Queerty for spouting the exact same garbage? We miss you there, honest we do.

    However, you are the epitome of a sad, warped, ignorant, issue riddled troll. Waddle back under the bridge from which you came please.

    Posted by: Derek | May 1, 2014 11:51:25 PM


  13. Petey

    The scientific studies that have been carried out on HIV transmission rates do not agree with you.
    In fact, there is at least one study that claims receptive anal sex *with a condom* has a statistically higher risk than receptive vaginal sex without a condom (0.18% vs 0.08%). This is because condoms can break.

    Posted by: Pandion | May 1, 2014 11:52:14 PM


  14. Pandion is correct. Studies invariably show that protected receptive anal carries a higher HIV risk than receptive oral, and unprotected anal an an exponentially higher risk.

    In fact, researchers who have set out to quantify the risk of oral transmission have had trouble doing so because there's not much evidence that it happens at all. Look up the Page-Shafer study.

    With vaginal sex, the numbers can vary greatly because of factors like concurrent infections and menstruation, but it's certainly far less risky than anal -- including anal between a man and a woman.

    Posted by: smith | May 2, 2014 12:22:10 AM


  15. If you use condoms correctly every single time you do anal AND you do it with a trusted partner after testing together outside the window period AND you are prepared if one breaks, then you should be fine. Being on top also helps. Personally, I just avoid anal altogether. It doesn't do much for me.

    Posted by: smith | May 2, 2014 12:27:08 AM


  16. I'm now at half a century, and I have to say, I don't have HIV because I consciously chose not to.

    I did it, you can do it too.

    It really IS that simple. I didn't miss-out on anything that was more important than my own health.

    I can't even remember all the names of the people I've known who chose otherwise.

    Posted by: ToddyOutWest | May 2, 2014 12:27:12 AM


  17. Anal sex is is not exclusive to men. Women have anal sex all the time. Combine a woman's anus with her menstruating vagina and you end up with 2 conduits for HIV transmission

    Posted by: petey | May 2, 2014 12:31:10 AM


  18. Toddy, beautifully said. HIV is a choice.

    Posted by: petey | May 2, 2014 12:40:08 AM


  19. If you structure your life around loveless sex with multiple partners, you will eventually get sick, if not with HIV, then with other STIs, mental and mood disorders. This peculiar way of life, first foisted upon us by a hostile society but then embraced by a bunch of urban males in the 1970s, is catastrophic if practiced in the long term.

    So don't play on that toxic playground. Walk away from it, with its exploitation, its coldness, and its never-ending burden of finding workarounds for the myriad problems that it causes. Join your gay brothers and the rest of the human race and structure your sex life around love and relationships. It is vastly more likely to lead to a happy, healthy life and you won't have to take Truvada, sero-sort, or worry about whether your Grindr hookup is going to shank you.

    Posted by: Sevia | May 2, 2014 2:32:42 AM


  20. I chose to put any thing I desire in my ass, repeatedly with great vigor. In doing so, I am SO glad that my moans of satisfaction, blocks out the constant howling of self important know it all finger wagging trolls; about their overly justified fear based logic, for having a facsimile of life experience.

    Posted by: booka | May 2, 2014 2:33:17 AM


  21. What about the other MST? Truvada doesn't prevent everything. I don't see the reason on why taking a medication when you're not ill. Serosorting it's like to play to the russian roulette and mixing different HIV strains can produce some more resistant one.

    Posted by: lukebrux | May 2, 2014 3:05:01 AM


  22. Comparing transmission rates between women and men and vaginal and oral leaves out the fact that most heterosexual men who do not dabble in homosexual activities have near zero chance of having HIV because transmission from a woman to man is VERY difficult (though certainly possible under the right circumstances). So statistically speaking, unsafe sex for a woman with a presumably straight man carries lower risk than other activities mentioned. Biologically speaking, transmission through anal sex is far higher than through vagina sex. Menstruation has minimal impact because there is not necessarily a place for infected blood to re-enter the bloodstream. You understand how a woman's period works right?

    The best protection is condom use. Period. Those of us who don't have enough sex to take a pill daily and who actively use condoms when we do have sex do not need to preached to by either side of this debate. If men do not want a drug inside of their body, it is their choice to not do that. By all means, if you want to and do and it can help prevent HIV transmission, go right ahead. I support you.

    Posted by: Samwell | May 2, 2014 10:09:57 AM


  23. Grammar nitpick:

    "Begs the question" does not mean, "Raises the question." Instead, refers to a kind of circular reasoning: X leads to Y because of Y. "PrEP leads to lower HIV infections because fewer men become HIV+ when having sex with men on PrEP." That's begging the question.

    Yes, yes, I know. Everybody uses it that way, so clearly it means that. But just as "irony" doesn't mean self-awareness mixed with snark, "begs the question" doesn't mean what people use it to mean and it's sad we've forgotten that.

    Posted by: Rrhain | May 3, 2014 12:17:28 AM


  24. @SAMWELL: Your claim that men don't get HIV from women is trivially proven false. Just look at Africa. As the World Health Organization points out, three-quarters of all HIV transmission is through heterosexual sex. Next comes IV drug use. It is only in the West that the primary transmission vector is male-male.

    HIV is a straight disease.

    Posted by: Rrhain | May 3, 2014 12:19:33 AM


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