Author Topic: Truvada PrEP (Read 15463 times)

Mightysure · « **on:** February 26, 2014, 02:20:57 pm »

Hello all

I am an HIV negative guy who is thinking about PrEP for several reasons, the main reason is that I met a nice guy who is someone I could see myself with but he happens to be positive. Even though I know about HIV transmission, undetectability, and consistent and correct condom usage, I have lingering anxiety about having sex with him. I thunkt more than anything Truvada will give me practice of mind.

So I have two questions. Does anyone have any tips on how to get over anxiety about sero-discordant sex and for anyone taking Truvada or its component drugs has any warnings or tips? I would greatly appreciate any feedback

mecch · « **Reply #1 on:** February 26, 2014, 02:41:49 pm »

I had serodiscordant relationships when I was HIV- and my boyfriends HIV+.
I got over anxiety about it by knowledge that sex with condoms prevents transmission. Some of these partners were not on medicine and two were before there was HIV treatment and two died of AIDS. I never had condom breaks, I think that would have freaked me out.
Today of course an HIV+ parter might easily be on effective treatment and consistently undetectable. Wouldn't that lower anxiety. Secondly, there is POST-exposure treatment available. Also gives peace of mind. Plus - good old condoms.
Yes there is PREP available now. If your partner is undetectable and you want to have condom protected penetration, I would think that PLUS PREP would be overkill.

I would think the PREP would be interesting if the idea was to do without condoms completely, with an undetectable partner, and just to be super super duper sure.

Generally, my gut reaction to your post is to work though the ways to lower anxiety without the need for PREP. iF you really cannot work towards that, with some time and application, I would say that PREP, with condoms, and undetectable viral load, is overkill and a sign that someone really can't be comfortable in a sero-discordant relation. Just an opinion mind you. And I obviously don't know the particulars.

mecch · « **Reply #2 on:** February 26, 2014, 05:31:20 pm »

OH, P.S. - here's an interesting discussion of PrEP:

http://blogs.poz.com/marksking/2014/01/the_fury_of_the_prep.html

AusShep · « **Reply #3 on:** February 28, 2014, 05:01:45 pm »

I've been in a sero-discordant relationship for almost 20 of our 22 years. I don't think the fear ever goes totally away. I think I'm actually more concerned than my partner though.

If you can get it covered by your insurance (get the copay assistance too), I'd say to go for it since you're worried. Continue to practice safer sex, it'll probably give you both more peace of mind. Also, PrEP can be safely stopped after confirming you're still negative if you decide it is no longer necessary or have any lingering side effects.

Mightysure · « **Reply #4 on:** February 28, 2014, 08:51:47 pm »

Thank you for your input. I've read all the pros but never really got the cons or the opinion of someone who doesn't see it as a crucial thing. I have general anxiety anyway, but I just have this phobia, which is odd b/c I've slept with ppl who've said they were negative but I don't know if they were or not and I had no reservations then.

Cost wouldn't be an issue. My co-pay would be 45 dollars per month w/o co-pay assistance. I just don't want to miss out on a good guy b/c of my hang ups about a virus that they have under control and they aren't really infectious. I don't know, but thanks for your input. It will give me something to think about.

mecch · « **Reply #5 on:** March 01, 2014, 11:56:11 am »

Its not crucial thing. Because you have options, such as I layed out.

If you are going on it to solve your anxiety issues, maybe the anxiety issues need other attention - like behaviour therapy of whatever. Have you had sex with this person? Is your idea you will need PrEP before you start sex with him? If so, I'd say its the anxiety ,and not all that rational. But you know that. And we are not always rational are we. Its human.

That said, I don't see much harm in taking PrEP if its the only way you'll dare have sex with him. Maybe after awhile you will chill and decide you don't need the PrEP to keep having sex. Or maybe the relation won't last, for whatever reason.

Nothing ventured, nothing gained.

A little vocabulary correction - HIV is not "infectious" -- it is not an "infectious disease"! It is transmissible. Maybe that little distinction might help?

Mightysure · « **Reply #6 on:** March 01, 2014, 04:30:09 pm »

Sorry if I offended you meech. But in the US, doctors who specialize in HIV care are called infectious diseases doctors. At least in my area. Thats why I used the term.

But no. I've never had sex with him yet. Its not the most important thing bc I like who he is as a person. I think its just one of those things where the more you think about it, thr more anxious you become. So I'll try, when the tiime comes, to treat him as I would anyone else whose status I dont know. Thanks for all your input and i like how supportive and helpful this site is

wolfter · « **Reply #7 on:** March 01, 2014, 04:48:50 pm »

I guess I too better inform my specialist that he is in fact; a transmissible disease specialist.

I still believe HIV/AIDS is considered an infectious disease.

sorry to the OP, hopefully you garner some great insight without further chastising by our regular know-it-alls.

within these forums, you'll find numerous threads about this topic.

best of luck
wolfie

mecch · « **Reply #8 on:** March 01, 2014, 05:07:35 pm »

You didn't offend me. I was a dunce! I was thinking of "contagious" of course.

Just do what you have to do to go forward. And be frank with this person.

I suffer with anxiety so over life have to find all the workarounds so it doesn't get in the way of actions.

Good luck!

AusShep · « **Reply #9 on:** March 01, 2014, 06:34:17 pm »

Infectious Disease is the correct Internal Medicine sub-speciality name although many HIV specialists aren't Board certified in infectious disease or even internal medicine and not all ID docs specialize in HIV, but none of this really matters...

PrEP is really a numbers game. The odds of transmission may be very low in your described situation, but they're not zero. PEP is not 100% effective, and neither is PrEP.

One can play the numbers/cost game all day long and debate how many millions may be spent for each prevented infection that could have been spent elsewhere. But in the end, if you're one of the unlucky few, you'd probably want to have had the extra 98-99% protection from PrEP. It's one of those things you just have to decide for yourself.

As someone who got HIV in one of those long shot (literally) ways. I sure wish PEP and PrEP were options available for me to consider and use 20 years ago.

Mightysure · « **Reply #10 on:** March 03, 2014, 12:56:58 pm »

I just had a consult with an ID doc and from.our discussion and the feedback.here, PrEP isnt right for me. If im doing things to where PrEP is needed, then im exposing myself to other infections. And if I do become positive while taking it, there is a strong chance that strain will.become resistant to that entire class of ARVs. And that's a bigger danger than becoming positive. So no PrEP for me. I'll just work on my anxiety issues and proceed from there. Thank you all. Everyone has been a big help.

magneticlove · « **Reply #11 on:** April 06, 2014, 07:59:13 pm »

I've been on Truvada for PrEP for about two months now, since I'm in a serodiscordant relationship with a positive man (I'm a negative woman). Even though he's undetectable and on meds, I wanted the extra layer of reassurance. We hate condoms and will not use them faithfully, and we both like the freedom of not being worried about him ejaculating in me. Also, we want to have a baby at some point, so Truvada is good on that note, too.

I had a few weeks of nausea in the beginning, but overall, I'm thrilled with my choice. I have to get tested in about a month, and I'm not worried about it AT ALL, knowing that both he and I haven't missed any doses of either of our meds.

JohnD99 · « **Reply #12 on:** April 29, 2014, 11:47:13 pm »

To the Original Poster:

I may have a unique viewpoint to add to this discussion. I am HIV negative and was put on PEP (not PrEP) after an exposure to HIV. I can tell you with the most enthusiasm I can possibly muster, that I would not recommend PrEP over other alternatives in a million years.

The PEP regimen I was put on was Combivir and Kaletra. Granted its not this "new fandangled" Truvada that everyone is recommending, but my understanding is that Truvada isn't really that much different than Combivir (AZT+3TC). I became extremely, extremely sick while on them, and even though I only did a 30 day course, I have continued to have unexplained health problems, neuromuscular problems, immune system dysfunctions (similar to autoimmunity), severe fatigue, and a host of other symptoms that just wont seem to abate. I am now at the 2 year mark. Around 1 year 6 months I did get significantly better. Unfortunately I got influenza A and everything that was wrong before that, came back. I believe I have experienced some sort of chronic inflammatory immune condition. Doctors are stumped.

I wouldn't in a million years recommend putting these drugs in your body if you don't need to. And I personally am extremely offended that the potential side effects and long term ramifications of this class of drugs is so understated by the medical community. My own health problems and the horror stories about AZT are why I want to get my friend who does have HIV off of AZT as soon as possible.

I really dont think these drugs should be given to any individual unless it is needed. I was reading that Truvada is becoming a "party drug" now and my jaw about hit the floor. In any case, just wanted to share from the viewpoint of another HIV negative person who *has* taken some of these medications. I can also mention that I have been in contact with several individuals who have also struggled with long term health damage as a result of PEP.

mecch · « **Reply #13 on:** April 30, 2014, 06:03:36 am »

JohnD99,
In my opinion, your experience of side effects is very individual.

It is contradictory to the majority of HIV+ people, these days, who take the latest molecules and do not have much in the way of side effects. So what's your theory, antivirals have minimal, to no, side effects for HIV+ people, but destroy the health of HIV- people? Hmmm.

People on Truvada as PrEP often say there are no side effects.
So again, your experience may be by far the exception to the rule.

Furthermore, you were only on your drug for 30 days. And it was not Truvada.
Again, its not uncommon for anyone starting antivirals to have an adjustment period.

Reading these columns over the years, I have seen people report their experiences with PEP (Post-exposure...) like yours. So, 30 days, its not a good sample of time to extrapolate to being on HAART for awhile. And, people on PEP are often extremely stressed out, anxious. Often nervous wrecks. This does not help the body one bit. My experience is that stress and HIV drugs can be troublesome.

If doctors "are stumped" I recommend you push further for answers. Maybe they are providing answers that you are rejecting? (Is there not a psychosomatic element to your experience?)

I find your comments potentially fear-mongering, or ignorant, in the context of this forum:

" And I personally am extremely offended that the potential side effects and long term ramifications of this class of drugs is so understated by the medical community. My own health problems and the horror stories about AZT are why I want to get my friend who does have HIV off of AZT as soon as possible."

If you live in a country were people commonly take AZT, that is a pity. It is a political and financial challenge. I am thinking that in many countries now, whee PReP is being rolled out, AZT is not one of the molecules.

I agree with you there needs to be a dialogue about the advantages and disadvantages of PrEP, and yes its a bit unusual to be on medicine to avoid a disease when there are other ways to avoid it. But it is a method that may be a good solution for some people, what do you think? And there is plenty of dialogue about these choices.. The "medical community" isn't ignoring anything and isn't pushing anyone into anything.

Mightysure · « **Reply #14 on:** May 01, 2014, 04:27:03 pm »

I've been going back and forth with it. There are strong arguments on both sides. I've been meeting some nice guys who are poz and it just makes me want to ask my doctor for it even more.

jessie_tr · « **Reply #15 on:** May 04, 2014, 06:46:31 pm »

Resistance caused by PrEP is extremely unlikely. There were only two people who had emtricitabine resistance in the active arm of the iPrEx study (and one in the placebo arm), and it only happened to people who it turned out were actually positive before starting PrEP but were still in the window period of the test used. (They used an RNA test for enrollment for the trial I just finished being in, NEXT-PrEP, to make that much less likely to happen.) No one, not a single person, who became infected after starting PrEP in iPrEx had any resistance.

(You can verify this here: http://www.niaid.nih.gov/news/QA/Pages/iPrExQA.aspx)

Jeff G · « **Reply #16 on:** May 06, 2014, 09:45:08 am »

Hi Jessie . I removed your post from the living with HIV forum . As a HIV negative person you are only allowed to post in the someone I care about forum . Thanks

jessie_tr · « **Reply #17 on:** May 06, 2014, 10:11:33 am »

All I did was link him to the largest ASO in Ohio, how is that not useful information? No one else in the thread had offered that info.

And the description of the forum says "For HIV+ individuals and their friends & family" and the rules say "The Living With HIV forum is open to those who are infected with or directly affected by HIV." Seeing as how I have positive partners and (chosen) family, I would think I'd fall under those categories. Especially if I'm just offering objective, valuable info.

Jeff G · « **Reply #18 on:** May 06, 2014, 10:40:47 am »

I read your reply in the other thread yesterday and let it stand but I took it down today after a member complained about it . I agree the welcome thread needs to be edited to make it more clear who is and is not allowed to post there .

This is also a part of the living with welcome thread ...
The Living With HIV forum is open to those who are infected with or directly affected by HIV. Our Moderators reserve the right to interpret who is "affected" on a case by case basis with a view to preserving the good order of these forums.

I removed your post only after getting a complaint from our positive members so lets please move past this and not have any hurt feelings over it . Thanks for your understanding .

Mightysure · « **Reply #19 on:** October 29, 2014, 04:20:37 pm »

I know this isn't the proper section but I can't post a new topic in Am I infected.

Went for STD screen Monday and was told it would take two days. I called and no results today which would have been two days. I know I'm probably worrying for nothing but that doesn't mean there's something wrong, does it?

Jeff G · « **Reply #20 on:** October 29, 2014, 04:26:39 pm »

Quote from: Mightysure on October 29, 2014, 04:20:37 pm

I know this isn't the proper section but I can't post a new topic in Am I infected.

Went for STD screen Monday and was told it would take two days. I called and no results today which would have been two days. I know I'm probably worrying for nothing but that doesn't mean there's something wrong, does it?

Just call back and ask them ... there is not much light we can shed on what goes on at your doctors office . Are you still dating a person living with HIV ?

Mightysure · « **Reply #21 on:** October 29, 2014, 04:39:41 pm »

I did and they said nothing has come back yet. I just know people who've tested positive and had that line fed to them while they waited longer for their positive result. I know no one knows for sure what's going on I guess I would just like some reassurance that it doesn't signal a problem.

And no, that person and I are no longer on speaking terms.

Jeff G · « **Reply #22 on:** October 29, 2014, 04:49:16 pm »

I am sympathetic to your anxiety but there is not allot we can do for that as much as we would like too . As a HIV negative person who is not in a relationship or a caregiver to a person with HIV there is not currently a forum you to post in except AM I INFECTED . Its a paid subscription after 3 post . You know how to use the forum and how HIV is transmitted so I cant see a need for you to purchase anything . We offer some one I care about and AM I INFECTED as a service to the community but we are primarily a support group for people living with HIV . Please feel free to read the forum but as of now you really should not be posting . I am wishing you the best .

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Author Topic: Truvada PrEP (Read 15463 times)