Let’s Talk About PrEP.

img.phpThis is a blog about health and fitness. And when it comes to your health, being proactive against disease and affliction is of paramount importance.

And that’s why I want to talk about PrEP.

And before anyone else mentions it, no this is not a sponsored post. This is an honest and open conversation that our community needs to be having.

First things first, PrEP is short for “pre-exposure prophylaxis,” and it involves the practice of using drugs like Truvada to prevent HIV infection. For high risk communities (i.e., sexually active gay or bisexual men), some doctors are prescribing this treatment to reduce risk of HIV infection. When taken as recommended, studies show that it can be up to 99% effective.

So is PrEP right for you? That’s something that only you and your doctor can decide. There’s a lot to consider, including risk factors, side effects, the fact that PrEP doesn’t guard against other STDs and, unfortunately, price. Truvada is expensive (roughly $1,500 per month) but it can be covered by insurance and there is a co-pay assistance program.

It’s estimated that about 500,000 people in the United States are potentially good candidates for PrEP. But according to PBS New Hour:

The drug’s manufacturer, Gilead Sciences Inc., says that in reviewing records from about half of U.S. pharmacies that dispensed Truvada between January 1, 2012, and March 31, 2014, it found that only 3,253 people had started the PrEP regimen during that period.

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HIV infections in the United States.

So why has PrEP been so slow to catch on?

There are probably a number of factors. For one, a lot of people don’t know about PrEP. It isn’t currently being actively marketed and, for whatever reasons, people don’t seem to be talking about it. There’s also a layer of stigma. I’ve heard PrEP referred to as the “slut pill.” People who proactively prioritize their health shouldn’t be shamed; they should be celebrated and emulated.

At a certain point, we need to recognize that condom campaigns and HIV education aren’t enough. HIV infections continue to rise. We need a new tool and PrEP could be part of the answer.

At the end of the day, gay and bisexual men are at high risk for HIV infection. And here is a treatment that dramatically cuts that risk. For me, it’s as simple as that.

What do you think about PrEP? Let me know in the comments below.

 

About Davey Wavey

Davey Wavey is a certified personal trainer and YouTube sensation with more than 250 million video views. For Davey's fitness tips and secrets, sign up for his free monthly newsletter - or download any of his affordable and effective workout programs.

Comments

  1. To me the issue with PreP is that like antibiotics if over used will cause HIV to develop a resistance (tested when you convert to find compatible drugs). If this happens a whole class of drugs stop working on it. Imagine HIV version of MRSA. Do we want to risk that?

    • My daily work is at an infectious diseases unit at a hospital. I can put your mind at ease about resistance. No, you cannot develop resistance to Truvada if you are not infected. Resistance is something that occurs in the hiv-virus, so if you don’t carry the virus, you will not become resistant to the drug.

    • As someone in science who has read all of the literature about PrEP, including the original reports for Truvada as both an anti-HIV and a preventative, and as someone who is on PrEP, I feel it is important to underline when and how HIV can become resistent to Truvada and the class of drugs that contain Truvada’s active ingredients. HIV becomes resistent to medications when exposed to them in doses that are not enough to inhibit HIV function or kill cells with HIV. When HIV is exposed to low concentrations of the drug, the weak versions of the virus die, but the hardier ones do not and replicate, so when they are exposed to higher doses of the drug they are unaffected and become considered “resistent”. This kind of exposure happens when you’re starting a drug, stopping a drug, or if you miss doses, with both PrEP and actual HIV treatments. So with PrEP, they do thorough screening to make sure you’re negative before you start, they check your adherence to dosing schedule throughout, and they also have recommended windows during which they advise avoiding sex or unprotected sex when starting and stopping PrEP, so as not to expose your body to the virus while the drug still remains in your system. Something that is super important to realize is that if you stop taking PrEP, and end up HIV positive at somepoint after the Truvada is out of your system, you can still take Truvada and the whole class of drugs containing its components. HIV is not resistent to the effects of the Truvada/it’s component drug class, simply because your body has been exposed to it while you were negative. Similarly, HIV cannot become resistent to Truvada unless you miss the dosing regiment. in the original case studies, the percentage of people who became positive admitted to being negligent with their adherence to the dosing regimen.

      So really it becomes a matter of how well can you remember to take a pill daily, and if it’s worth it to you to make that effort.

      I know that I have had a very close friend end up HIV positive while in a monogamous relationship, not because either of them cheated but because his partner and him were tested together, but his partner fell into that time frame where he had a false negative reading and they didn’t know. I choose to take it because I don’t want the same thing to happen to me, and I recommend the same thing to pretty much anyone I know who is able to make the effort to remember that daily pill.

  2. I just can’t help but feel there hasn’t been enough research done to find out exactly why so few people have started this regimen. For me, the biggest and most influential reason for me not to start this regimen is cost. My insurance doesn’t cover the drug and the cost is just too much when compared to the low level of protection of the drug – and by that I mean that it is only effective against HIV – and using condoms, which are much easier to get, more cost effective and protect against much more than HIV alone. Also, I am in a monogamous relationship. While we do have sex, it is nowhere near the amounts we were both having when we were single.

    And I don’t buy into the whole “slut shaming” aspect of this. Men, in general, are going to fuck whoever they want whenever they want, damned be the consequences. Why else are we continually seeing rising cases of new infections? Bottom line – men don’t care if they are called sluts or worse; our brains are not wired that way. When it comes to sex, for the most part, men think with their dicks and not their brains.

    That said, one would think that in the face of this on-going epidemic, Gilead would choose to dramatically lower the cost of this drug to make it more available to those who are most at risk instead of trying to line their pockets, since this is a combo of drugs that have already been on the market for years.

    I really don’t consider this a “miracle” drug, because while it does protect against HIV when taken as prescribed, it does not protect against the myriad of other STD’s/STI’s. I am fearful that many gay men will start this regimen with the mindset that they can fuck as many people as humanly possible with no regard to the other diseases that can be sexually transmitted and could very well turn out to be fatal. But I guess as long as it’s not HIV, it’s ok, right?

  3. I agree that the stigma is awful and needs to be fought with reason and kindness at every opportunity. My issue is the price—if, like me, you don’t have health insurance, you can’t afford this medicine. Healthcare in America has a long way to go.

  4. I’ve been HIV+ for almost 10 years and on meds and undetectable for 9 years. My boyfriend of 2 and a half years is on PrEP for about 5 months. Because of the PrEP, my stress over the chance of infecting him has gone down significantly. For us, being on PrEP is not about him being a “slut” or anything like that. It’s about protecting him from getting infected.

  5. I have been on PrEP for over a month now and am glad I started it. I am in no way a slut and I don’t have unprotected sex, but I do like having the peace of mind that comes with taking it. Condoms break all the time and unfortunately some men take condoms off during sex without informing their partner, PrEP puts me at ease know if either happens I have another form of protection.

  6. In the studies done on PrEP, is the reduction in risk reported in relative or absolute terms? Absolute risk is far more telling than relative risk. One must account for the marketing tricks used by the pharmaceutical industry when analyzing drug-related research.

    Cost is definitely a big issue; no developed country in the world has more income inequality than America. We may be the richest country, but income inequality is so large here, our standards of living are one of the lowest in the developed world.

    Committed relationships where only one person is infected is something I didn’t consider before. That position makes this drug worth the effort.

    However, drug resistant HIV is terrifying. I know that mother nature creates anti-bacterial and anti-microbial substances that bacteria and microbes CANNOT adapt to (with essential oils for example). Perhaps we should take a lesson from her.

  7. When the guys using Truvada to bareback their way through their city/state/region without taking into account what incredible recklessness they’re showing realise that isn’t the intent of the drug, then there won’t be a stigma. But that’s not going to happen, Davey. There are guys here in Phoenix who’ve made a show of destroying condoms and then going to the local bathhouse and offering to take as many raw loads as they can handle, because “hey I’m on PrEP!” So fucking reckless. If there’s a second wave of the deaths we suffered in the 80s due to the hubris of taking Truvada, then we deserve it.

    Want to use it responsibly? I’ve no issue with that, but it’s not happening. Wake up Davey.

  8. I’ve been on PrEP for about 2 months. Without my insurance and the co-pay program there’s no way I’d be able to afford it. Cost is a major obstacle. I guess the manufacturer really doesn’t understand that to some people $1,500 a month is their rent, and others have more important things they can put their money to than a pill. While I truly understand putting your health first (and obviously I do since I take it and I’m not a slut and I use condoms), if the manufacturer wants more people to use it the price needs to be more realistic as does the process for obtaining it, and the communication about what it is and does. My Dr. had to write a justification to the insurance company. Why? So I could protect myself from a potential infection that could cost them even more money down the road? Absolutely ridiculous. Basically comes down to greedy drug and insurance companies who want to keep their investors happy and make insane profits instead of doing the right thing and actually helping people with the drugs they create.

  9. Rafael Sá says:

    I’ll be honest, I didn’t heard about it, but even if I had, I still wouldn’t be so sure about the use. The thing, as you mentioned is the lack of information. Maybe if I had access to the research explanations and see the logic through it I wouldn’t feel exposed to the virus. The problem is the small guarantee that the prep really works, I’m mean condoms have its risks, but we already trust in it because we can see the results. For prep it would take a while to find out if it worked or not and that is what really freight people, at least is what frights me

  10. I have been taking PREP now for almost 5 months. I haven’t had any major side effects. For me it’s worth taking. I don’t like condoms, I don’t use condoms. I’m very open about that fact. There are so many gay men out there that actually aren’t open about that and say they practice safe sex but are having bareback sex all the time. It has just become more common. PREP is 99% effective, scientific studies have shown that. Also if you have sex with an HIV Positive person that is undetectable the chances of you getting infected are very slim. I sleep with who I want and enjoy life. My first 3 month supply cost me $590 out of pocket. Now I pay $50 for every 3 month supply because I met my deductible. I did have to go to 3 doctors to get the Rx for PREP. The first doctor didn’t know much about it. The second doctor says he only gives it to people that live with an HIV positive person in a relationship. He said he would rather see me get HIV which is treatable than take Truvada and possibly have a side effect of cardiac arrest or kidney failure. The third doctor agreed with me because I have random sex (i.e. sex parties, etc) and bareback, I need to be on PREP. Everyone needs to take care of themselves and make choices they are comfortable with. I’m happy with my choices.

  11. I’m a Public Safety worker (Police Officer)….and this would be a miracle for my department to provide to me. Public Safety workers….police….fire fighters…paramedics….EMT’s….we all face a daily risk of exposure through our work and our dealings with the public, and the situations are always volatile and chaoitic. It’s not like a doctor’s office or hospital where you have time to ‘glove up and scrub down’ before you start doing what you have to do. I’ve found myself in many situations where I’ve had to provide first aid to a stabbing victim, or get an bleeding person out of a wrecked vehicle, or any other number of crazy scenarios that can happen involving blood and body fluids. Just last week I had to wrestle a guy into custody who was cut-up and bloody because he got high on PCP and punched a plate-glass window. I was completely covered in HIS drug-addict blood after I had to save HIS life after HIS crazy actions! I can’t tell you how many nights….weeks…months….I have worried about “what if this time I got something”. This PreP would be a miracle for all of us who risk our health and safety for the rest of the community! Unfortunately, cost is the barrier….it’s just too expensive. They pay for everything else…hepatitis….TB…..but not HIV.

  12. Davy: if there were not a profit motive for companies then life saving or enhancing drugs would never get developed. Researchers don’t work for free, studies and reams of data and reports have to be generated, filed, defended and cost recovery from failed research efforts, which far out number successes, have to be realized and legal teams have to be paid to defend against a plethora of law suits which no industry has more of then the pharmaceutical. There are numerous expensive (and inexpensive) life saving drugs available… But not because people work for free. Hard reality.

  13. I TOTALLY agree with you Davey. I have had this conversation and your line below is almost exactly what I say:

    “At a certain point, we need to recognize that condom campaigns and HIV education aren’t enough. HIV infections continue to rise. We need a new tool and PrEP could be part of the answer.”

    Ultimately with HIV infection rates still the way they are in this country what we have historically been doing IS NOT WORKING. Good on you for addressing this issue. So many young gay members of our community follow your posting and I think truthfully they may not even know about this option. When I spoke to my doctor about this drug she hadn’t heard of it! My doctor!

    I’ve been on it for about 6 months now and the peace of mind alone is worth the cost.

    Keep up the good work

  14. After carefully reading the side effects of this drug, I would prefer to be in a monogamous relationship without a pot belly or buffalo hump. It isn’t theoretical that Gilead has tapped into another market to sell their drug and create a panacea of wellness, perhaps a false sense of security. While California is purported to be #2 in a Syphilis epidemic, it does show that condom usage has made a steep decline as the “great imitator” makes it’s way through the population, many not knowing they have Syphilis, or HPV or hepatitis B, etc. It’s possible that gay marriage may have an impact on multiple sex partner hiv transmission, so that is potential profit loss for pharma. I’m familiar with “foreward-looking statements.” Here are the side effects taken from Gilead’s Truvada webpage, read it carefully:

    What is TRUVADA?

    TRUVADA is a prescription medicine used in 2 different ways:

    to treat HIV-1 infection in adults and teenagers (12 and older). When used for the treatment of HIV-1 infection, TRUVADA is always used together with other HIV-1 medicines.
    to help reduce the risk of getting HIV-1 infection when used together with safer sex practices. This use is only for adults who are at a high risk of getting HIV-1. This includes HIV-negative men who have sex with men and who are at high risk of getting infected with HIV-1 through sex, and male-female sex partners when one partner has HIV-1 and the other does not.

    TRUVADA does not cure HIV-1 infection or AIDS. Ask your healthcare provider if you have questions about how to prevent getting HIV-1 or passing HIV-1 to others. Always practice safer sex and use condoms to lower the chance of sexual contact with body fluids. Never reuse or share needles or other items that have body fluids on them. If you are taking TRUVADA with other HIV-1 medicines to treat HIV-1, you must keep taking TRUVADA to control HIV-1 infection and decrease HIV-1 related illnesses.
    IMPORTANT SAFETY INFORMATION

    What is the most important information I should know about TRUVADA?

    TRUVADA can cause serious side effects:

    Too much lactic acid in your blood (lactic acidosis), which is a serious medical emergency. Symptoms of lactic acidosis include weakness or being more tired than usual, unusual muscle pain, being short of breath or fast breathing, nausea, vomiting, stomach-area pain, cold or blue hands and feet, feeling dizzy or lightheaded, and/or fast or abnormal heartbeats.
    Serious liver problems. Your liver may become large and tender, and you may develop fat in your liver. Symptoms of liver problems include your skin or the white part of your eyes turns yellow, dark “tea-colored” urine, light-colored stools, loss of appetite for several days or longer, nausea, and/or stomach-area pain.
    You may be more likely to get lactic acidosis or serious liver problems if you are female, very overweight (obese), or have been taking TRUVADA for a long time. In some cases, these serious conditions have led to death. Call your healthcare provider right away if you have any symptoms of these conditions.
    Worsening of hepatitis B (HBV) infection. If you also have HBV and take TRUVADA, your hepatitis may become worse if you stop taking TRUVADA. Do not stop taking TRUVADA without first talking to your healthcare provider. If your healthcare provider tells you to stop taking TRUVADA, they will need to watch you closely for several months to monitor your health. TRUVADA is not approved for the treatment of HBV.

    If your healthcare provider has prescribed TRUVADA to help reduce the risk of getting HIV-1 infection, you should also know:

    You must be HIV-negative before you start taking TRUVADA to reduce the risk of getting HIV-1. You must get tested to make sure that you do not already have HIV-1 infection. Do not take TRUVADA to reduce the risk of getting HIV-1 unless you are confirmed to be HIV-negative.
    Many HIV-1 tests can miss HIV-1 infection in a person who has recently become infected. If you have flu-like symptoms, you could have recently become infected with HIV-1. Tell your healthcare provider if you had a flu-like illness within the last month before starting TRUVADA or at any time while taking TRUVADA. Symptoms of new HIV-1 infection include tiredness, fever, joint or muscle aches, headache, sore throat, vomiting, diarrhea, rash, night sweats, and/or enlarged lymph nodes in the neck or groin.
    Just taking TRUVADA may not keep you from getting HIV-1. You must continue using safer sex practices while you are taking TRUVADA to reduce your risk of getting HIV-1. To further reduce your risk of getting HIV-1:
    Get tested for other sexually transmitted infections. Other infections make it easier for HIV-1 to infect you.
    Get information and support to help reduce risky sexual behavior.
    Have fewer sex partners.
    Do not miss any doses of TRUVADA. Missing doses may increase your risk of getting HIV-1 infection.
    You must stay HIV-negative to keep taking TRUVADA to reduce your risk of getting HIV-1:
    Know your HIV-1 status and the HIV-1 status of your partners.
    Get tested for HIV-1 at least every 3 months or when your healthcare provider tells you.
    If you think you were exposed to HIV-1, tell your healthcare provider right away.
    If you do become HIV-1 positive, you need more medicine than TRUVADA alone to treat HIV-1. TRUVADA itself is not a complete treatment for HIV-1.
    If you have HIV-1 and take only TRUVADA, your HIV-1 may become harder to treat.

    Who should not take TRUVADA?

    Do not take TRUVADA if you also take:

    Medicines containing emtricitabine or tenofovir disoproxil fumarate (ATRIPLA, COMPLERA, EMTRIVA, STRIBILD, VIREAD).
    Medicines containing lamivudine (Combivir, Epivir, Epivir-HBV, Epzicom, Trizivir).
    Medicines containing adefovir (HEPSERA).

    If your healthcare provider has prescribed TRUVADA to help reduce the risk of getting HIV-1 infection, do not take TRUVADA if:

    You already have HIV-1 infection or if you do not know your HIV-1 infection status. If you are HIV-1 positive, you need to take other medicines with TRUVADA to treat HIV-1. TRUVADA itself is not a complete treatment for HIV-1. If you have HIV-1 and take only TRUVADA, your HIV-1 may become harder to treat.

    What are the other possible side effects of TRUVADA?

    Serious side effects of TRUVADA may also include:

    New or worsening kidney problems, including kidney failure. Your healthcare provider may do blood tests to check your kidneys before and during treatment with TRUVADA. If you develop kidney problems, your healthcare provider may tell you to take TRUVADA less often, or to stop taking TRUVADA.
    Bone problems, including bone pain or bones getting soft or thin, which may lead to fractures. Your healthcare provider may do tests to check your bones.
    Changes in body fat can happen in people taking HIV-1 medicines.
    Changes in your immune system. If you have HIV-1 infection and start taking HIV-1 medicines, your immune system may get stronger and begin to fight infections. This may cause minor symptoms such as fever, but can also lead to serious problems. Tell your healthcare provider if you have any new symptoms after you start taking TRUVADA.

    The most common side effects of TRUVADA are:

    In people taking TRUVADA with other HIV-1 medicines to treat HIV-1 infection, common side effects include: diarrhea, nausea, tiredness, headache, dizziness, depression, problems sleeping, abnormal dreams, and rash.
    In people taking TRUVADA to reduce the risk of getting HIV-1 infection, common side effects include: headache, stomach-area (abdomen) pain, and decreased weight.
    Tell your healthcare provider if you have any side effects that bother you or don’t go away.

    What should I tell my healthcare provider before taking TRUVADA?

    All your health problems. Be sure to tell your healthcare provider if you have or had any kidney, bone, or liver problems, including hepatitis virus infection.
    If you are pregnant or plan to become pregnant. It is not known if TRUVADA can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking TRUVADA. If you are taking TRUVADA to reduce the risk of getting HIV-1 and you become pregnant, talk to your healthcare provider to decide if you should keep taking TRUVADA.
    If you are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed. HIV-1 can be passed to the baby in breast milk. Also, the medicines in TRUVADA can pass into breast milk, and it is not known if the medicines can harm the baby.
    All the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. TRUVADA may interact with other medicines. Keep a list of all your medicines and show it to your healthcare provider and pharmacist when you get a new medicine.
    Your healthcare provider may need to check you more often or change your dose if you take any of these medicines with TRUVADA: didanosine (Videx EC), atazanavir (Reyataz), darunavir (Prezista), or lopinavir with ritonavir (Kaletra).

    You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.FDA.gov/medwatch, or call 1-800-FDA-1088.

  15. I feel very lucky to live in the state of Washington, who has started a program to cover your cost up to 100% if your insurance doesn’t cover it. I have been in PrEp for 9 months and has cost me zero.

  16. Good for you Davey for discussing this. PrEP is something that definitely needs to be talked about more. I’m from Minneapolis where this is becoming more and more used by high risk groups and is being talked about more but we are behind a little bit compared to other larger cities where this has caught on better such as Chicago and San Francisco. There is stigma associated with it and we need to look to ourselves to help change that stigma and not judge or label those who choose to use PrEP. Everyone is responsible for their own sexual health and should be proactive about taking whatever steps they see fit as an individual. Thanks for the blog.

  17. I’d rather wear a fucking condom than destroy my liver..

  18. The problem with HIV is that it blindsides us to other STDs in the same way cancer does to heart disease and diabetes, (which are responsible for more morbidity and mortality.)

    There are a host of other STIs out there, some, like HPV, potentially fatal (and in men highly under-diagnosed. Truvada will do nothing to protect you from catching these. A condom, on the other hand, is highly effective in preventing the transmission of these bugs.

  19. david rushton says:

    A few facts are wrong here

    -It’s 85% effective against HIV (not 95%)
    – it’s 0% effective against other STD’s some of which can lead to increased exposure to HIV

    Condoms when used effectively are 95% effective against HIV and most other STDs.
    Embracing PrEP leads to increased risk taking in our community.

    As a student who can’t afford PrEP- my health is put at risk by guys who choose not to use safer protection. This is increasingly happening and guys are using prep as an excuse.

    • Some terms are getting mixed up here. “Efficacy” is how well a particular method works on an individual level at preventing a certain thing. “Effectiveness” is how a particular method words at a group or population level at preventing a certain thing.

      When taken daily, PrEP has 99% efficacy in reducing HIV infections. When taken four days a week — missing three days — we’re talking 92% or more efficacy in reducing HIV infections.

      The best numbers for condoms, when used, are also around 99%. When a condom isn’t used? 0% efficacy in reducing HIV infection.

      PrEP has an 84% effective rate of preventing new HIV infections. That’s at a population level. That’s when you throw people who take PrEP, who miss a dose, or who have some other problem into the mix. You are looking at everyone in that case.

      Condoms are 70% effective in preventing new HIV infections. Again, that’s a population measure, looking at everyone and a host of successes and failures in condom use.

      On an individual level, PrEP and condoms work about as well at preventing new infections. On a population level, PrEP works better at reducing new infections than condoms do.

  20. Here’s what I think: Condoms cost a lot less than PrEP and cover all STDs. Condoms are also easier to obtain.

  21. Shannon says:

    I am not going to claim credit, since I didn’t do the research, but I found this comment on the PBS site you linked to in your article. Its quite an interesting read:

    Terry Michael • 2 months ago
    This article is an blatant advertisement–posing as a news story–for Gilead Science’s toxic chemotherapy. If you would like to know the truth about Gilead, Truvada, the confirmation biased “clinical trials” that led the FDA to approve it for the scam know as “PrEP,” this will explain it: “AIDS War Profiteering with PrEP”: https://dl.dropboxusercontent.com/u/31816360/AIDS_War_Profiteering_with_PrEP_by_Terry_Michael_Nov2014.pdf

  22. Hello, I really appreciate posts which contain interesting info and which I am always eager to read! Great site!

  23. Adam Lynn says:

    I just want to say BRAVO Davey for bringing this topic to light! I’ve been on PrEP Since July 2014 and it’s one of the best decisions I have ever made. I have finally been able to have sex without living in constant fear of the HIV virus. Even with protection you always wonder, what if the condom breaks? What if I get drunk or roofied at a bar one night and someone fucks me without a condom and I’m too out of it to know or stop them? Because I have friends who are HIV positive because of condoms breaking and I know plenty of friends who have been roofied in gay bars. When guys ask me why I chose to take PrEP I tell them for several reasons. To protect my health and the health of anyone I have sex with. To be part of the solution to stop the spread of the HIV virus in my lifetime. But perhaps the biggest reason for me is deeply personal. My Uncle Bob was gay and died of the AIDS virus on Valentine’s Day 1986. I remember that day and the days after perhaps more clearly than any other from my childhood. My uncle has a very contentious relationship with a lot of my family but they still deeply loved him. My grandmother was absolutely devastated over his death. I remember for years after his death growing up no one talked very much about Uncle Bob. Aside from a picture in my grandmother’s bedroom it was almost like he never existed. When I came out to my mother at 19 she was finally the first family member to open up to me about Uncle Bob and the fact that he was gay. My mother has been and ER nurse for over 30 years now and she told me her greatest fear for me was getting HIV and ending up like my Uncle Bob. With PrEP I have finally been able to help her put that fear to rest. I like to tell people that I take PrEP to honor the memory of my Uncle Bob. He and entire generation died of this virus and they would have rioted in the streets if this drug had been available during their lifetime. HIV took my uncle away from me when he should have been there for me. He should have been there for me at age 17 when I began to realize what my feelings towards guys meant. He should have been there at age 19 when I came out first to my mother and then my father. He should have been there at age 25 when I discovered I was a kinky submissive bottom. He should have been there for some of the most important moments of my life as a gay man and he wasn’t. He wasn’t because HIV took him away from me. So it’s in his memory that I pop that little blue pill every morning. I like to think if I could spend just a few minutes talking with him today he would tell me I’m doing the right thing and that he was proud of me.

    So Davey, thank you. Thank you for bringing this issue up to your fans and readers because you are absolutely right. We have a deafening silence in the LGBT community on the topic of PrEP. I hope people like you can help us change the world one pill at a time.

  24. Excellent article Davey! HIV should not be taken lightly. One of my favorite statistics is that 20% of gay men in American cities are HIV-positive! Be safe out there guys 🙂

  25. My primary care physician didn’t feel like she knew enough about PrEP, so she referred me to the infectious disease specialist. He didn’t know much about it but was willing to do the research and after 3 appointments and 3 1/2 weeks I got my prescription. THEN had to wait another 2-3 weeks as Truvada is only filed by specialty pharmacies. I was lucky, my ACA Blue Cross/Sheild plan covered Truvada and at the time I’d already met my out of pocket spend, so Truvada was free. Just realize that many communities and Doctors may not know about PrEP and it may take some doing to get started on it.

    As for the stigma, it’s very similar to the early days of the birth control pill. People looked at women who wanted to be on the pill as women who wanted to sleep around. The same is true for PrEP. While, yes, people who have many partners, especially those who don’t use condoms 100% of the time should consider going on PrEP. However, seeing how so many people also get infected by a spouse/partner being non-monogamous, there’s something to be said for using Truvada even when you are in a committed relationship (That’s likely a trust issue on my part though).

    The fact of the matter is that the protection rate from HIV for someone who doesn’t use condoms 100% of the time is much less than the person who never uses condoms, but consistently takes their Truvada pill. NOTE – Even when on Truvada, every piece of literature and the doctors strongly encourage continued use of condoms every time.

  26. it’s not right to ask me and my insurance to pay for someone’s $40,000 prep medications.
    If you can’t pay for your meds you do not get them.I don’t want to jeopardize true medications for my life for those who just want to have sex

  27. That is one big list! Links to the best tech blogs, and all in one place!! WOW!!
    This post is like a gateway to awesomeness.
    Good compilation. Thanks

  28. Thank you for highlighting this game-changer, and for confronting the social stigma waged against those who chose to use it.

    Not only is PrEP not a “slut pill,” there are many HIV-negative people in committed relationships with an HIV-positive person, and PrEP allows them a sense of security they haven’t had before. What a shame that even my fellow gay men are quick to presume the sexual morals of those who are taking pro-active steps to protect themselves. (By the way, I’ve always heard a slut is someone having more sex than you are.)

    Initial research suggests that using PrEP does not change your sexual behavior. If you didn’t use condoms before using PrEP, you’re not going to start, and those who have been using them are likely to continue.

    But, for the sake of argument, let’s say that people using PrEP are all engaged in risky sex, including many young gay men still negotiating their sexuality and being experimental. Shall we deny them PrEP and hold them in judgment instead? Is living with a chronic illness the rest of their lives just the “wages of sin?” What a breathtaking attitude. If we learned anything from the 1980s (I was there, it wasn’t pretty), it is that when we judge and shame the sex lives of others, the only thing that wins is HIV.

    Of course PrEP isn’t the final answer. The magic cure ain’t coming. ButPrEP is a valuable new tool that must be embraced for those who do their homework and decide it is right for them. While moralists fiddle, our community burns.

  29. Nice article Davey, even if it was written almost 6 months ago, is still relevant. I think Truvada isn’t available in my country (Mexico) yet but I like to follow on news regarding it as it seems like a nice addition to Safe Sex Culture.

    One thing I’ve realized is that people seem defensive about this ‘slut shaming’ thing. Honestly, I’ve seen on the internet guys refering to themselves as ‘Truvada Whores’, yeah…they aren’t helping the cause.

    Some fellows have made very sound statements: Truvada, as a PrEP, is to be used along with a condom in order to minimize the risk of STD infection. Also, you need utmost discipline to take it every day without fault. I’m all in for PrEP use along the common forms of protection, Truvada alone just doesn’t cut it.

    So, if a guy comes to me asking if he wants some bareback assuring me not to worry because he’s on Truvada I will still ask him to wear a condom (I’m not naive, some dudes lie to get what they want and even if they aren’t there’s still the risk they have missed a dose) If they don’t want to put on a rubber I just walk away.

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