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He also notes that having patients at risk for HIV on Pr EP gives them more opportunities to see the patient since it is a biomedical prevention.

It allows them to treat STIs and other problems more efficiently while counseling for any other risk behaviors.

This applies, obviously, to someone who has already been diagnosed as HIV positive, and who has controlled replication of the virus. When I ask guys if they’re undetectable, it’s one question in a series. Today, so much of this is done electronically, on Grindr and Scruff and Jackd and all these applications and online connections, that communication can actually be easier than being face-to-face.

What it means in a social context is that this person, in theory, is the least “infectious” they can be, biologically. Derek: For the most part, they appreciate that I’m bringing it up.

But today, in two renowned doctors debated whether a man should be on Pr EP. Kenneth Mayer, Beth Israel Deaconess Medical Center in Boston and medical director of the Fenway Institute says yes. Howard Libman, also of Beth Israel Deaconess, says no.

In this case study, the 45-year-old man has an HIV-positive husband who he has been with for 11 years. X already has begun Pr EP and the couple says it has greatly improved their sex life. X says he only has missed two daily doses of Truvada as Pr EP in 18 months. Here are excerpts of their arguments, which shows how two very qualified doctors reach opposite conclusions.

To join, couples had to say up front that they sometimes don’t use protection—meaning no condoms, and the HIV-negative partner could not be on a daily Pr EP, or pre-exposure prophylaxis, regimen.You need years of practice, and sometimes you need tips from someone who knows what he is doing. The tips in this slideshow progress from beginner bottoms to more advanced bottoms, so if you are just beginning your magical bottoming journey, the advice at the beginning may be more useful to you than those in the back. Those who are sensitive regarding frank discussions about sex are invited to click elsewhere, but consider this: If you are outraged by content that addresses sex openly and honestly, I invite you to examine this outrage and ask yourself whether it should instead be directed at those who oppress us by policing our sexuality. And feel free to leave your own suggestions for sex and dating topics in the comments. Follow me on Twitter @Bad Alex Cheves and visit my blog, The Beastly Ex-Boyfriend.The first rule of gay sex applies to bottoms of all calibers: watch what you eat.Derek brings his perspectives as a San Francisco-based registered nurse specializing in HIV and an outspoken past Pr EP user with HIV-positive and HIV-negative sex partners.

In this Q&A, Derek and Zachary offer their takes on what “undetectable” means, and their advice for how to talk about it with hook-ups, dates, and other important people in your life, whatever your HIV status. The first meaning is very clinical: Doctors aren’t able to find a detectable amount of virus when they screen you at regular check-ups. ” Asking the viral load question triggers a series of follow-up questions that help gauge where he’s at and how he takes care of himself.

“The most common response I get from disbelievers is that positive men use ‘undetectable’ as a way of getting people to sleep with them without a condom,” says Tyler Curry, an editor with the new group HIV Equal, who has written about his frustration with gay men still ignorant about what it means to be undetectable.

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