Boyfriend on PrEP - hurting on Truvada

[loscang]

Hi everyone

I guess that I have a very percular problem... I am hiv positive for going on 4 years now.

My very awesome boyfriend of 2 years (hiv neg) has been on PrEP for over a year now and he is a great and strong soul for doing that for us to be safer together.

The problem is that he seems to be very sensitive to the Truvada.  His digestion, muscle pain, severe sunburn and photosensitivity is affecting him a lot. He doesn't readily admit that but I know that he is hurting.

He was shirtless outside this morning for 2 hours in early morning sun and is in agonising pain from severe sunburn.  Second time in a month. He used to tan white to brown so easily before the Truvada and now he goes incredibly red in zero time. Literally an observable difference in his skin tolerance even his mother and brothers noticed he no longer tans.

I am aching from guilt... I am destroying this man I love because of his daily pill to be with me.

 

[mecch]

I think you should go into some of the logical leaps you are making in your rationale of what is going on.

First of all, PrEP is not NECESSARY for a serodiscordant couple to have a sex life with little to no risk.  It might be recommended for a couple trying to conceive.  Otherwise, it seems entirely OPTIONAL.  So if, IF, PrEP is not sustainable - for its claimed side effects on your BF, why does he stay on it?    You could go on HAART and if you are undetectable, thats another assurance of very low to no risk.  Also, there are plenty of couples who simply used condoms for protected sex, thus taking risk out of the coupling...

If you feel guilty, I think you should discuss that. Also, you should discuss some of the other options, if he decides he doesn't want to be on PrEP..... 

[Ann]

Loscang, if you're on meds and have been undetectable for more than six months, with no other active STIs, your partner being on PrEP is a bit of overkill, particularly if you are usually bottom.

Hiv is much more difficult to transmit from the receptive partner to the insertive partner at the best of times, and if you're undetectable it's very unlikely to happen when you bottom.

And if you also use condoms in tandem with an UD VL, then there is really no reason for him to be on PrEP.

If you don't use condoms and he stops PrEP, you'd mainly need to use condoms when you're topping, to be on the safe side.

Does your partner get regular bloodwork done to check his kidney and liver functions? If he isn't, he should be having this done.

And has he discussed how he's been feeling with the prescribing doctor? Again, if he hasn't, he should. Patients taking PrEP need regular monitoring and visits to the prescribing doctor.

One more question - is he on any other meds? If he is, there's always the possibility that the culprit isn't Truvada but something else. It's easy to automatically attribute problems to hiv meds because of all the bad press they've gotten over the years where side effects are concerned.

Hope you get this sorted out to your satisfaction. I think the first step is to have him book an appointment with the prescribing doctor to discuss these problems. Good luck!