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- Aug 23, 2013
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PREP is basically a "pill" just like birth-control which you take to prevent from contracting HIV if exposed to the virus. My doctor suggested it to me since I have a legit HIV scares after having dealt with a false positive back in 2019. Also, despite the fact that I am not usually considered to be in the risk-group (heterosexual male), the mere fact that I have many new partners (I do use condoms... but you know... sometimes)... the odds start going in my disfavor. So, we decided to opt for PREP.
The system works likes this. There are two ways to take it. Either 1 pill daily or... 2 pills 24hours to 2hours prior to intercourse, as well as 1 or 2 pills post-sex (not sure exactly how many post-sex). I am opting for option two, because I only want to take them when I feel the girl is in a risk-group or if she gives me the chills (and happens to be hot). This gives me the option to add another layer of protection whenever I feel this is warranted.
Anyway, I will keep you guys updated on how it goes!
I will be the only straight guy that I know off who will be on PREP. The doctor has never prescribed it to a straight guy before. Love being the first one.
---
UPDATE (06.05.2022)
So I went to see the specialist at the hospital. The doctor was a liberal gay-guy. He was super open minded and was on prep himself. He made tons of inappropriate jokes which I loved. He told me he was into chemsex and did worse things than I did. Good way to make me feel very at ease. But more importantly, he had both the theoretical knowledge but also the practical in-field knowledge, by being in a hiv risk group himself, and taking the meds himself. Obviously not a KJ. It was like a doctor from a different planet.
Beside prescribing prep, he prescribed condoms as well as lubes for me. So I now get those for free at any pharmacy. He also suggested i take the hpv vaccine and prescribed it for me. I always wanted to take it, but many GP's declined for stupid reasons (not recommended for people over 25).
Now onto prep:
There are two ways to take prep.
1. Take prep daily: 1 pill every day of Truvada: 200 mg of emtricitabine and 245 mg of tenofovir disoproxil (as fumarate). It takes 1 week before becoming protected. You need to take 1 pill every day +/- 2 hours.
2. Prep on demand - or prep 2-1-1: 2x pills 2-24 hours before sex, then 1 pill 24h later (+/- 2 hours), and another 24h after that (+/- 2 hours). Protection is granted after 2 hours of taking prep. Basically here you start with 2 doses in one go, and after the initial intercourse, you take 2 doses over two days to end it. But if you want to be protected for 3 intercourses over three days you just do: 2x first day, 1 pill second day, 1 pill third day, then to end the protection you need to take pills for two more days without having intercourse. If you want to be protected 4 days instead of three, repeat the same process, just add one more pill one day. Let me know if you want more clarification.
I opted for the second option. The first option grants more efficacy, with a 99% chances of blocking HIV (higher protection condoms). The other option (the on demand/2-1-1) is more controversial. Some claim it is at good at daily prep (99%), other research claims it is only 86% efficient. The latter option is not yet recommended by the FDA in the US, but will soon be (specialists in the US that are up to date may still prescribe PreP according to the 2-1-1 model). The 2-1-1 model is recommended in many other countries, including all of europe. The 2-1-1 ("on demand") option only works for men, and not for women because it takes longer for the meds to enter the vaginal tissue. This option is also not recommended for post-op transsexuals yet.
There is also another drug aside from Truvada that can be used as Prep. That med is called Descovy and is more often recommended for women but also works for men. Currently it has only been recommended to be used daily and not on demand (the 2-1-1 model), but research is being conducted for that option. The composition of Descovy is different to the one you find in Truvada, so if you are intolerant to Truvada, you have another option. Descovy is approved in Europe, but not in the US (but the CDC and the FDA are currently evaluating it).
MIND YOU: PREP Protects you, but not your partner against HIV contamination. It also doesn't protect you against other STI's (chlamydia, syphilis etc), with the exception of HSV-1 and 2 (Herpes).
To get prep, they will need to test your kidneys. This is done through a simple bloodtest. Truvada is a rather safe med with low side-effects, but of course like any other meds, it can attack your kidneys (like tons of other meds). It happens very rarely. They do this test to add an additional layer of safety.
You will also need to test for hiv before taking prep, and then keep doing so every 3 months. Why? Because although there has been only 3-4 cases of people catching HIV from taking prep despite taking it properly (which may make prep look bad, but it is not, it actually protects better than condoms statistically speaking!). Also sometimes people doesn't take it properly (people are stupid), or they take a break because they think they are not at risk (more common in people chosing the 2-1-1 on demand strategy).
The issue is, if you get HIV and you take prep, you risk creating resistance to key retroviral drugs (HIV MEDS). In other words, your HIV develops resistance to key meds. The HIV infection thus becomes much harder to treat. As the doctor said "you will have to go from having to take 1 pill a day, to 4 pills a day" in addition to risking getting a worse prognosis. To dodge these issues, an HIV test is prescribed every 3 months, which is as often as I test myself ANYWAY (testing for HIV while on prep is much less scary trust me!). Any sexually active person should test oneself at least 3 times a year (so why not make it 4). The doctor will also prescribe you all the tests (including oral STD tests which many GP's fail to perform - yes you can catch and transmit oral chlamydia, syphilis and gonorrhea).
Your specialist will also ask you if you are vaccinated for HEP A and B, as well as HPV. If your are not, he will recommend it and prescribe it to you. I already took the 3 doses of HEP A and B, but not the HPV shot. I guess I will take it in the next coming weeks (on less thing to worry about). Taking Prep with Hepatitis is way more complicated because the meds may interact with the HEP meds as well as the disease itself.
In all honesty, today was one of my greatest experiences with the French healthcare system.
You may not have enough sex to be a candidate for PREP and you may not end up in as much weird shit as I do. But if you one day happen to end up like me, or if you live in a high risk community or a high risk-country, visit prostitutes, bang men occasionally (Bisexual) or transsexuals, then I hope this post will serve you. If you know anyone in a risk group (prostitute, gay, transsexual etc...) then I am sure they will benefit from this info and I hope you will spread it to them. This will be your contribution to the war against HIV. Thank you for helping us in this fight!
---
UPDATE (08.05.2022) - ABOUT PEP (POST-EXPOSURE PROPHYLAXIS)
So someone messaged me (will keep the person anonymous) asking if one could use PREP (preventive meds) as PEP (post exposure prophylaxis - i.e. a treatment you take after a potential exposure in order to not get HIV after potentially having been exposed to it).
THE CLEAR ANSWER IS: HELL NO!
Truvada (200 mg of emtricitabine and 245 mg of tenofovir disoproxil) is not the med they give you for PEP. They give you a different cocktail and a much stronger one for 28 days. You will have a close follow-up by a specialist. Why not just use Truvada? Because it is simply not strong enough to work as PEP. What are the consequences of taking Truvada AFTER you have been exposed to HIV? Well, you risk developing resistance - the HIV strain becomes resistant to Truvada. This totally sucks. So not only does Truvada not work as PEP, but it makes things worse.
Been exposed to HIV or fear that you have been? Here is a quick guide:
1. Call your closest emergency room (also at night) or if during the daytime, call your GP.
2. Go to the clinic, hospital or whatever that offers PEP.
3. Get there are SOON as you can. PEP is only given within 72h post-exposure. After that it is not working anymore. The sooner you do it, the more chances of it working.
4. You will meet a specialist (only specialists can prescribe PEP) - and talk 100% the truth to him. This is very important.
5. Take the meds as prescribed. Not shortcuts! Take them at the time the doctors tells you to take them. Important too,
6. After 28 days, you will take a blood test to test for HIV... and you will have to do it again 3 months later. If first test is good, you are most likely ok. If second test is good, then you are ok.
UPDATE (11.05.2022) - TESTING PROTOCOL FOR PREP
As part of the protocol (in France, but I think it is similar in most countries), you need to do bloodwork to get the first month, and after that test yourself every 3 months if you want to keep the prescription.
The test serves two purposes:
1. Test kidney function and liver function to make sure you tolerate the med
2. STI testing. This is because you cannot take PREP if you have HIV (it can generate resistance and the last thing you want is an HIV that is resistant to certain antiretrovirals). However, because many people on PREP have condomless sex, they also test for STI's in order to make sure that you don't end up becoming an STI bomb.
If you are curious or if you intend to get PREP, you will most likely have to take the following tests. I advice you to take those tests the same week or the week before seeing the specialist, so that you can have them ready for your appointment. This will facilitate the process and help you get the prescription faster.
Below is a list of the tests you will have to take (this is the guidelines for France, but I assume they are the same elsewhere).
* Hepatitis B
* Hepatitis C
* Gonorrhea: urine, throat, and anus* (your ass yes)
* Chlamydia: urine, throat, and anus
* Syphilis
* Creatin (Plasma)
* ASAT
* ALAT
They test your ass because most people on PREP are GAY-men, and they are not going to make guidelines for the little majority of heterosexual freaks like us.
Hope this helps.
Best,
Teevster
EDIT: If you live in the US and lack or have problems with your health insurance, than do not despair. Gilead (the producer) offers help to get it cheaper for you. If you live in the US, visit this link.
The system works likes this. There are two ways to take it. Either 1 pill daily or... 2 pills 24hours to 2hours prior to intercourse, as well as 1 or 2 pills post-sex (not sure exactly how many post-sex). I am opting for option two, because I only want to take them when I feel the girl is in a risk-group or if she gives me the chills (and happens to be hot). This gives me the option to add another layer of protection whenever I feel this is warranted.
Anyway, I will keep you guys updated on how it goes!
I will be the only straight guy that I know off who will be on PREP. The doctor has never prescribed it to a straight guy before. Love being the first one.
---
UPDATE (06.05.2022)
So I went to see the specialist at the hospital. The doctor was a liberal gay-guy. He was super open minded and was on prep himself. He made tons of inappropriate jokes which I loved. He told me he was into chemsex and did worse things than I did. Good way to make me feel very at ease. But more importantly, he had both the theoretical knowledge but also the practical in-field knowledge, by being in a hiv risk group himself, and taking the meds himself. Obviously not a KJ. It was like a doctor from a different planet.
Beside prescribing prep, he prescribed condoms as well as lubes for me. So I now get those for free at any pharmacy. He also suggested i take the hpv vaccine and prescribed it for me. I always wanted to take it, but many GP's declined for stupid reasons (not recommended for people over 25).
Now onto prep:
There are two ways to take prep.
1. Take prep daily: 1 pill every day of Truvada: 200 mg of emtricitabine and 245 mg of tenofovir disoproxil (as fumarate). It takes 1 week before becoming protected. You need to take 1 pill every day +/- 2 hours.
2. Prep on demand - or prep 2-1-1: 2x pills 2-24 hours before sex, then 1 pill 24h later (+/- 2 hours), and another 24h after that (+/- 2 hours). Protection is granted after 2 hours of taking prep. Basically here you start with 2 doses in one go, and after the initial intercourse, you take 2 doses over two days to end it. But if you want to be protected for 3 intercourses over three days you just do: 2x first day, 1 pill second day, 1 pill third day, then to end the protection you need to take pills for two more days without having intercourse. If you want to be protected 4 days instead of three, repeat the same process, just add one more pill one day. Let me know if you want more clarification.
I opted for the second option. The first option grants more efficacy, with a 99% chances of blocking HIV (higher protection condoms). The other option (the on demand/2-1-1) is more controversial. Some claim it is at good at daily prep (99%), other research claims it is only 86% efficient. The latter option is not yet recommended by the FDA in the US, but will soon be (specialists in the US that are up to date may still prescribe PreP according to the 2-1-1 model). The 2-1-1 model is recommended in many other countries, including all of europe. The 2-1-1 ("on demand") option only works for men, and not for women because it takes longer for the meds to enter the vaginal tissue. This option is also not recommended for post-op transsexuals yet.
There is also another drug aside from Truvada that can be used as Prep. That med is called Descovy and is more often recommended for women but also works for men. Currently it has only been recommended to be used daily and not on demand (the 2-1-1 model), but research is being conducted for that option. The composition of Descovy is different to the one you find in Truvada, so if you are intolerant to Truvada, you have another option. Descovy is approved in Europe, but not in the US (but the CDC and the FDA are currently evaluating it).
MIND YOU: PREP Protects you, but not your partner against HIV contamination. It also doesn't protect you against other STI's (chlamydia, syphilis etc), with the exception of HSV-1 and 2 (Herpes).
To get prep, they will need to test your kidneys. This is done through a simple bloodtest. Truvada is a rather safe med with low side-effects, but of course like any other meds, it can attack your kidneys (like tons of other meds). It happens very rarely. They do this test to add an additional layer of safety.
You will also need to test for hiv before taking prep, and then keep doing so every 3 months. Why? Because although there has been only 3-4 cases of people catching HIV from taking prep despite taking it properly (which may make prep look bad, but it is not, it actually protects better than condoms statistically speaking!). Also sometimes people doesn't take it properly (people are stupid), or they take a break because they think they are not at risk (more common in people chosing the 2-1-1 on demand strategy).
The issue is, if you get HIV and you take prep, you risk creating resistance to key retroviral drugs (HIV MEDS). In other words, your HIV develops resistance to key meds. The HIV infection thus becomes much harder to treat. As the doctor said "you will have to go from having to take 1 pill a day, to 4 pills a day" in addition to risking getting a worse prognosis. To dodge these issues, an HIV test is prescribed every 3 months, which is as often as I test myself ANYWAY (testing for HIV while on prep is much less scary trust me!). Any sexually active person should test oneself at least 3 times a year (so why not make it 4). The doctor will also prescribe you all the tests (including oral STD tests which many GP's fail to perform - yes you can catch and transmit oral chlamydia, syphilis and gonorrhea).
Your specialist will also ask you if you are vaccinated for HEP A and B, as well as HPV. If your are not, he will recommend it and prescribe it to you. I already took the 3 doses of HEP A and B, but not the HPV shot. I guess I will take it in the next coming weeks (on less thing to worry about). Taking Prep with Hepatitis is way more complicated because the meds may interact with the HEP meds as well as the disease itself.
In all honesty, today was one of my greatest experiences with the French healthcare system.
You may not have enough sex to be a candidate for PREP and you may not end up in as much weird shit as I do. But if you one day happen to end up like me, or if you live in a high risk community or a high risk-country, visit prostitutes, bang men occasionally (Bisexual) or transsexuals, then I hope this post will serve you. If you know anyone in a risk group (prostitute, gay, transsexual etc...) then I am sure they will benefit from this info and I hope you will spread it to them. This will be your contribution to the war against HIV. Thank you for helping us in this fight!
---
UPDATE (08.05.2022) - ABOUT PEP (POST-EXPOSURE PROPHYLAXIS)
So someone messaged me (will keep the person anonymous) asking if one could use PREP (preventive meds) as PEP (post exposure prophylaxis - i.e. a treatment you take after a potential exposure in order to not get HIV after potentially having been exposed to it).
THE CLEAR ANSWER IS: HELL NO!
Truvada (200 mg of emtricitabine and 245 mg of tenofovir disoproxil) is not the med they give you for PEP. They give you a different cocktail and a much stronger one for 28 days. You will have a close follow-up by a specialist. Why not just use Truvada? Because it is simply not strong enough to work as PEP. What are the consequences of taking Truvada AFTER you have been exposed to HIV? Well, you risk developing resistance - the HIV strain becomes resistant to Truvada. This totally sucks. So not only does Truvada not work as PEP, but it makes things worse.
Been exposed to HIV or fear that you have been? Here is a quick guide:
1. Call your closest emergency room (also at night) or if during the daytime, call your GP.
2. Go to the clinic, hospital or whatever that offers PEP.
3. Get there are SOON as you can. PEP is only given within 72h post-exposure. After that it is not working anymore. The sooner you do it, the more chances of it working.
4. You will meet a specialist (only specialists can prescribe PEP) - and talk 100% the truth to him. This is very important.
5. Take the meds as prescribed. Not shortcuts! Take them at the time the doctors tells you to take them. Important too,
6. After 28 days, you will take a blood test to test for HIV... and you will have to do it again 3 months later. If first test is good, you are most likely ok. If second test is good, then you are ok.
UPDATE (11.05.2022) - TESTING PROTOCOL FOR PREP
As part of the protocol (in France, but I think it is similar in most countries), you need to do bloodwork to get the first month, and after that test yourself every 3 months if you want to keep the prescription.
The test serves two purposes:
1. Test kidney function and liver function to make sure you tolerate the med
2. STI testing. This is because you cannot take PREP if you have HIV (it can generate resistance and the last thing you want is an HIV that is resistant to certain antiretrovirals). However, because many people on PREP have condomless sex, they also test for STI's in order to make sure that you don't end up becoming an STI bomb.
If you are curious or if you intend to get PREP, you will most likely have to take the following tests. I advice you to take those tests the same week or the week before seeing the specialist, so that you can have them ready for your appointment. This will facilitate the process and help you get the prescription faster.
Below is a list of the tests you will have to take (this is the guidelines for France, but I assume they are the same elsewhere).
* Hepatitis B
* Hepatitis C
* Gonorrhea: urine, throat, and anus* (your ass yes)
* Chlamydia: urine, throat, and anus
* Syphilis
* Creatin (Plasma)
* ASAT
* ALAT
They test your ass because most people on PREP are GAY-men, and they are not going to make guidelines for the little majority of heterosexual freaks like us.
Hope this helps.
Best,
Teevster
EDIT: If you live in the US and lack or have problems with your health insurance, than do not despair. Gilead (the producer) offers help to get it cheaper for you. If you live in the US, visit this link.
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