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Is PrEP Right For YOU?
About the information covered here...
This page is a comprehensive overview about PrEP (Pre-Exposure Prophlaxis) or commonly called Truvada and Descovy. I, Robert Brandon Sandor believe that you deserve to know as much as possible about PrEP so you can make the most informed decision for yourself. PrEP is nothing new and it is not for everyone, as you are about to learn here. So take your time reading this and share it with a friend, partner or trick so you can begin a discussion...and understand the role you play in HIV Prevention.
Lets start by answering these two questions using GOOGLE and your cell;
(How many people are living in America?)
(How many are HIV?)
Why is it important to know the population of America and how many are living with HIV (are HIV+)? Because, BEFORE you consider taking PrEP, you must know where America stands on the war against HIV, and knowing that there are more than 320 million Americans living HIV FREE TODAY brings the "need" for PrEP in perspective.
It offers you a better understanding of where we are at, and how we achieved this monumental success. Are there any HIV-negative Support Groups at your local HIV Agency or Organization? Online? Sex Parties or Hook-up Sites? No. Therefore, more than 320 million Americans are HIV FREE TODAY because of behavior, social and sexual. As an HIV+ gay man living with HIV since August 1983, I THANK YOU for doing your part to remain HIV-negative. I congratulate you on a job well done, you have proven that HIV HAS BEEN STOPPED.
Quick Facts About PrEP...
* PrEP (TRUVADA) is a vital HIV Prevention medication that thousands of HIV+ people (gay and straight) rely
on to help keep HIV in check.
* PrEP alone is not going to keep you HIV-negative, Truvada / Descovy (PrEP) and condoms are
recommended. Just ask the HIV experts, professionals and your doctor.
* Taking PrEP includes MORE frequent medical visits and blood tests, all requiring you miss more time from
work or school. It also INCREASES your medical costs not to mention the extra costs to the HIV+
community for lack of getting Truvada for their medical needs.
But is PrEP RIGHT for YOU?
Here are some questions to consider. If you answer "YES" to ANY of them, PrEP might be a good thing to discuss with your doctor, family, partner (boyfriend or husband) and sex buddies.
* Are your MAIN sex partners HIV+? In other words, do you seek sexual encounters with HIV+ people (gay, bi-
sexual or straight) only?
* Are you a bottom or versatile bottom and only bareback (sex without condoms) with HIV+ people only or with
people who do not know their HIV status?
* Have you been treated for chlamydia or rectal gonorrhea recently?
* Have you or your sex partner(s) been in prison?
* Are you a heavy party drug user or drink heavily before or during sex?
* In BDSM role playing, has your sex partner(s) forced you against your will to have sex with someone who is
HIV+ or HIV Status Unknown?
WHEN is PrEP not right for you?
* When you do not know your HIV status.
* Don't think you can keep a daily medication regimen for years to come.
* Just plan to take it for short periods, such as a weekend of partying.
* Have weak kidneys or liver. (see side effects)
WHAT is PrEP?
PrEP means that you take a drug before you are exposed to something that causes an infection. In this case, an HIV-negative person (you) who might be at risk for HIV (you choosing to have unsafe sex - sex without condoms - with an HIV+ person) would take the pill TRUVADA to help prevent infection. The US Food and Drug Administration (FDA) approved Truvada for PrEP back in July 2012, however, more than 300 million HIV-negative Americans chose not to chance it. Why? Because PrEP is NOT just about taking a pill every day for years to come.
IF you decide to take PrEP, you'll need to see your doctor at least every three months for routine healthcare and HIV testing. This means you'll need to talk about your sexual activity and sex partners, if you have safe sex or bareback, STD's, the side effects of Truvada and so on. In the end, this means MORE doctor visits, lost time from work or school, refills, co-pays and changes in your daily routine and medical expenses. Ask your local HIV agency, organization, expert, professional or doctor if this is not true.
But MORE importantly and putting ALL this aside, more than 320 million HIV-negative Americans are asking: If I'm HIV-negative NOW and NOT taking PrEP, what did I do wrong? The answer: NOTHING. You did nothing "wrong" in fact you are doing everything correct - that is why you are HIV-negative TODAY without PrEP.
WHAT are TRUVADA'S side effects?
The short-term side effects noted in PrEP studies included headaches, weight loss and stomach problems like nausea, diarrhea and stomach pain. If you like taking laxatives, you'll enjoy PrEP. In studies for HIV treatment for HIV+ people, Truvada affects the kidneys, bones and liver.(see side effects link above) Changes in bone density were also found, ask your doctor or HIV agency. As for long-term side effects, HIV-negative people with weak kidneys or liver disease must not use PrEP. (PrEP and HEP-C)
WHAT are DESCOVYs side effects? https://www.descovy.com/prep/clinical-trial-efficacy-results
1) You must be HIV-negative before and while taking DESCOVY for PrEP, 2) 7 out of 2670 people taking DESCOVY® tested HIV-positive during the clinical study.† ,3) Common side effects in people taking DESCOVY for PrEP are diarrhea, nausea, headache, fatigue, weight gain and stomach pain, 4) BONE LOSS: LUMBAR SPINE (DESCOVY) 159 PEOPLE +0.5%, HIP BONE (DESCOVY) 158 PEOPLE +0.2%, 5) DESCOVY may cause new or worsening kidney problems, including kidney failure. Your healthcare provider should do blood and urine tests to check your kidneys before and during treatment with DESCOVY. If you develop kidney problems, your healthcare provider may tell you to stop taking DESCOVY.
WHAT tests will you need to take?
Before you start PrEP: 1) A thorough and HONEST talk about your sexual behavior and if you bareback. 2) An HIV antibody or antibody / antigen test and possibility a test to detect HIV directly. 3) Tests for Hep B, liver and kidney function and STD's.
WHILE YOU ARE TAKING PrEP; you'll be required to do the following:
1) Make regular medical visits every 3 months, 2) Routine HIV tests to verify if you are still HIV-negative. Or, if you become HIV+ to seek treatment, 3) Someone in your doctors office or clinic should talk to you about side effects, how to take PrEP daily and your sexual and party drug behavior - sex partners, party drug use and if you had safe sex or not. You'll also need to get STD tests done every 6 months or sooner.
WHY should you get tested for Hep B BEFORE starting PrEP?
Both drugs in Truvada work against Hep B. Therefore, it's important to know if you currently have Hep B before starting PrEP. If the test shows that you do have Hep B, then get a routine vaccine. You can take PrEP at the same time you are being treated for Hep B. However, if you have active Hep B disease and stop PrEP suddenly, it can cause dangerous or fatal liver problems. Your doctor would have to monitor your care more often as a result.
"THE TALK"
What should you disclose to your doctor... What are the results of your most recent HIV tests? Do you need to TEST AGAIN because of a recent "high-risk" behavior? How often does your doctor want you to be tested and what tests are required? Are you being tested for STD's, Hep B and offered treatment when needed? Where do you go for extra treatments? How often will you need to disclose your sexual and party drug behavior? What are the test results of your kidneys, liver and bones? Where would you go for treatment? Are there any DRUG INTERACTIONS between Truvada (PrEP) and any other medications you need or might need in the future? Can you STOP taking PrEP if you wanted to? WHY do you need to take PrEP every day? What if your HIV+ sex partner does NOT have his / their HIV treatment under control? What if you get infected with HIV while on PrEP? Can you sue someone? What if your HIV+ sex partner(s) is resistant to Truvada? ARE YOU STILL REQUIRED TO HAVE SAFE SEX (wear condoms, have safe sex if you bottom)?
WHO pays for PrEP?
YOU DO. Period. End of discussion. Your local HIV agency, organization, "expert", "professional" AND your doctor will all tell you that "PrEP is free or you can get it at a discount." This is NOT true, you pay full market value in the end and this is how: 1) You might pay for PrEP through an insurance provider, this is called an INSURANCE PREMIUM. Your premiums go up every time you need more services or medical care.The more people needing a medical treatment, the insurance provider raises the cost, this is Economics 101 and The Law Of Supply and Demand. 2) You might have PrEP paid for by an HIV related national or international "non-profit" organization.
But where does THEIR funding come from? YOU the tax payer or through your donations. If you do not pay your taxes or cut your donations, they WILL cut services to you - the community. They will NOT cut their annual bonuses or salaries. (ask them to show you their accounting data). 3) Don't have medical insurance? Don't qualify for Medicaid? Don't worry - the drug maker (Gilead) will be glad to pay for your PrEP treatment. But for a price. Only $3,600 a year. What about co-pays, lab tests, doctor visits, treatments for the side effects, lost time from work or school and other PrEP related costs like: transportation to and from medical visits?
BEFORE you consider taking PrEP, please consider this...with the current debate in Washington regarding the overall issue of the concept of American Health Care, and the desire for some to eliminate and change American Health Care, will any funding you get for your daily PrEP treatment be available next month?
CONCLUSION: IS PrEP Right For YOU?
Only you can answer that question, I wish I could answer it for you but, I can't - I'm HIV+ since 1983 and never had the opportunities you have today with your HIV-negative status. However, I can tell you this: 1) As you have learned above just by using your cell phone and GOOGLE, you have learned that there are more than 320 million Americans living HIV FREE (are HIV-negative, just like you) and not taking PrEP. Why is that? Because of your current choices and behavior. You are doing something correct otherwise you would not be HIV-negative TODAY. 2) You have learned that there are published research studies proving that even IF you took PrEP, that 70% of HIV+ gay men do NOT have their HIV in check or might be resistant to Truvada which still puts you at risk. 3) PrEP is expensive and someone, somewhere at some time pays full market value. Period. This is the basic rule of Supply and Demand.
YOUR VOICE MATTERS - Join the conversation locally or write an OpEd in your local / national LGBTQ publication (POZ magazine, The New York Times or other). Join the discussion on FACEBOOK / TWITTER YOUTUBE / INSTAGRAM CONTINUE: 10 TIPS FOR ONLINE LGBTQ NETWORKS (best viewed on your cell)
RELATED ARTICLES:
"HIV PrEP Is Available, But Why Aren't People Taking It?" (Daily Maverick, Dec. 2019)
"Cost of HIV Prevention Drug Discouraging People From Doing PrEP Theraphy" (Healthline, Apr. 2020)
"SURVEY: Gay - Bi PrEP Users Finds 1-10 Share Meds" (POZ Magazine Oct. 2020)
"A behavioral cascade of HIV seroadaptation among US men who have sex with men in the era of PrEP and U=U" (YALE Research, Nov. 2020)
"Big Increase In Recent PrEP Users Among New HIV Cases, Largest UK Clinic Reports" (NAM AIDSMAP, Jan. 2022)
STORE: "SAY NO TO PrEP"
