and also a study in the New England Journal of Medicine:

Antiretroviral chemoprophylaxis before exposure is a promising approach for the prevention of human immunodeficiency virus (HIV) acquisition.

http://www.nejm.org/doi/full/10.1056/NEJMoa1011205

there is some important medical news that --I hope-- will have important implications for hobbyists and responsible providers.

There is a new study which shows that the faithful use of a combination of retro viral medications in high risk men cuts the risk of aids by 90%,  I have always (tho many of my colleagues feel this is not a good thing to do from a public health point of view) pretreated myself with a combination of meds that treat syphilis, gonorrhea, herpes, and chlamydiae  when planning to see someone either professional or friend (and, of course I use safe sex to the degree possible and get tested regularly when active in a non monogamous setting.)  I was never sure this is effective and I knew that none of these helped with AIDS. Now there may be a pretreatment that blocks the transmission of aids.

This may be of particular interest to professions providers and those of us hobbyists interested in skin to skin oral genital or oral anal contact or even deep kissing.

Let's hope.

That is, offerring a brief course or up to 30 days of anti-retrovirals after a potential or known blood borne pathogen exposure.

Last week'w issue.  There have been articles in the popular press as well. There was a front page story in yesterday's (Wednesday's)  New York Times.

“Now there may be a pretreatment that blocks the transmission of aids”

Their already exist a much cheaper and safer pretreatment (condom use) that can essentially eliminate the risk of HIV transmission in the USA heterosexual population:

Pre-treatment with antiviral for approximately a year is REPORTED to cut the risk of aids by less than a factor of 2 (not 90% or a factor of 10) at an annual cost of greater $12000/year and significant side effects like kidney injury as measure by creatinine levels. Prolong use of antiviral greater than one year in this study can expect to further increase the incidence and severity of side effects.  Unlike your short-term ( week or so) self pre or post prophylactic medication for syphilis, gonorrhea, herpes, and Chlamydia the antiviral must be taken daily for as long as you are sexual active. In contrast pretreatment by using condoms cuts the risk by factor of greater than 20 at a cost of approximately $1/ sexual act and does not require daily application.

The study was done on a very high risk population, men and transgender women who HAVE SEX WITH MEN in countries with a much higher prevalence of HIV than USA.  The USA HIV heterosexual transmission risk with use of condoms alone conservatively assuming a 1% prevalence, 1/500 transmission rate for unprotectected coital sex with an HIV partner, and condom protection of 95% is approximately 1 million/sex act. From a public health point of view it makes no senses to unnecessary subject hundred of thousands of heterosexuals to the considerable financial and side effects to prevent 1 additional HIV infection than one can achieve with condoms alone.

There is a good reasons you’re your colleagues feel it is not a good thing to pre or post self medicate yourself for STDs from a public health point of view. Perhaps you should elucidate them to make your post more balance.

The CDC recommended BRIEF antiretroviral POST-EXPOSURE prophylaxis following a KNOWN high risk exposure to HIV such as infected blood from needle sticks, sexual assaults by HIV infected person. This is quite different from PROLONG antiretroviral PRE-EXPOSURE prophylaxis for UNCERTAIN exposure to HIV that is being suggested by OP or what is reported in NEJM.  I doubt the CDC would recommend what the OP has suggested. In fact the CDC states the most effective methods for preventing HIV infection are those that protect against exposure to HIV. That is the use of condoms.

“You say the decrease in risk was not 90%; that is true if you look at the whole treatment group among whom the risk was cut in approximately half, but among those men in the group who faithfully took the meds, they was a decrease in incidence of 90%.”

Need to consider also confounding factors.  For example subjects who faithful took their meds also probably faithful use condoms as all (including the placebo group) were instructed to do.  Also the >90% effectiveness was for subjects that had detectable study-drug level which may reflect differences in  metabolism rate of the antiviral as much as how faithful the drug was taken .  The point is that taken as a whole the prolong daily prophylactic antiretroviral treatment is not a good, practical or cost-effective way to reduce the risk of HIV transmission in the US heterosexual population.

“Condoms work well, but there are large groups for whom it is not feasible (prisoners, men and women who find themselves unable to insist on condom use) but there is a larger group exposed who could benefit: those who enjoy skin to skin oral/genital oral/anal contact or deep kissing are exposed to transmission of HIV.”

This is not what you were suggesting in your original post as indicate by the following quote from that post

“This may be of particular interest to professions providers and those of us hobbyists interested in skin to skin oral genital or oral anal contact or even deep kissing.”

The risk of HIV transmission from deep kissing, oral–genital contact or skin to skin contact is a factor 10 to 100times less than that for protected penile-vaginal and penile-anal sex which is already very low as I pointed out before. Do you really think individuals who are unable to insist on condom use will be able adhere to the required prolong expensive antiretroviral regime. Are you suggesting that the public should foot $12,000/yr bill for antiviral treatment of male inmates to prevent a few HIV transmission? Beside studies indicate that the risk for becoming infected in prison is probably less than the risk outside prison because sexual contact and injection-drug use are prohibited in jails and prisons.

Wohl AR, Johnson D, Jordan W, et al. High-risk behaviors during incarceration in African-American men treated for HIV at three Los Angeles public medical centers. J Acquir Immune Defic Syndr 2000;24:386--92.

Mutter RC, Grimes RM, Labarthe D. Evidence of intraprison spread of HIV infection. Arch Intern Med 1994;154:793--5.

Brewer TF, Vlahov D, Taylor E, Hall D, Munoz A, Polk BF. Transmission of HIV-1 within a statewide prison system. AIDS 1988;2:363--7

Thanks for your comment, but there are a few points to be made.

You say the decrease in risk was not 90%; that is true if you look at the whole treatment group among whom the risk was cut in approximately half, but among those men in the group who faithfully took the meds, they was a decrease in incidence of 90%.

I am not advocating this for HIV, but simply suggesting there may be a good affordable and practical pre treatment in the future.  

Condoms work well, but there are large groups for whom it is not feasible (prisoners, men and women who find themselves unable to insist on condom use) but there is a larger group exposed who could benefit: those who enjoy skin to skin oral/genital oral/anal contact or deep kissing are exposed to transmission of HIV.

Finally, my pre treatment routine is not expensive and involves a few pills for 24 hours and --while I use condoms for intercourse, I enjoy other activities that do expose me to risks of easily preventable disease.  Tho for the moment I am monogamous, that will surely not last and I will appreciate the safety of my routine when I am back.