PrEP?

[wardell]

what is PrEP I have noticed a lot of guys on Grinder have their HIV status as Negative, on PrEP what is this?

 

[slimjim]

I didn't know but Google has just told me this:

Pre-exposure prophylaxis (or PrEP) : when people at very high risk for HIV take HIV medicines daily to lower their chances of getting infected.

 

[luvmuslmen]

Pre-Exposure Prophylaxis. For guys who are having bareback sex or having sex with someone that they know is HIV+, they take Truvada to prevent the virus from taking hold. They take it either a day or two before sex, or take it for about 4 or 5 days after having bareback sex with someone whose status is not known. There are some bareback studios that are supposedly giving it to their performers, rather than making them get tested. Not a smart move by the performers, imo. They also use it for people who are in relationships with an HIV+ partner, but for this, it's used long term, to prevent infection.

 

[jeansGuyOZ]

The official line from AIDS organisations is that PrEP is one more tool in your collection to reduce the risk of contracting HIV. It's been known for many years that it's best to use a condom if your partner's HIV status is positive or unknown, but some guys find it difficult to be strict with themselves about this. They have been out partying all night, they have had a few drinks so they are not thinking completely rationally, they don't have a condom to hand and they think "I'll risk it just this once". If you are that sort of guy, like I said, PrEP is one more option to protect yourself.

PrEP is not to be confused with PEP (Post-Exposure Prophylaxis). I'd assume that everyone here knows already about PEP, which has been around for years, but perhaps I shouldn't make those assumptions. PEP is emergency medication that you take after you think you may have been infected (say for example you were being fucked and the condom broke). Obviously there has never been a series of controlled double-blind tests with some subjects on PEP and some not, to prove that PEP works, but it's believed that it works since there has been no known case of someone becoming HIV+ after such an incident, if they went on PEP. It has to be taken as soon as possible after the potential infection; 72 hours is the absolute maximum. If you are in this situation, most cities should have a PEP hotline; get on the phone straight away and they'll tell you where to go to get PEP.

 

[topdog]

Just to expand on what everyone has said, PrEP prevents the HIV virus from taking hold should it get in to your body. It's not surprising that you haven't heard a lot about it. It has only been approved for about two years.

There is a wealth of information on PrEP at the CDC website.

At the same time it has left a lot of AIDS prevention organizations flummoxed because it's arrival means that condoms and abstinence are no longer the only two options for reducing the risk of HIV transmission to people who are currently HIV negative. If you have a lot of emotion invested in one of those methods (like the Catholic Church is tied to abstinence and the AIDS Healthcare Foundation is tied to condoms) then PrEP being available can feel like a threat.

The ultimate medical goal since AIDS was discovered has been finding a vaccine that will prevent the virus from spreading. PrEP is not a vaccine, but it is functionally a step in that direction. With a vaccine you take in once (or every few years) and the HIV virus can't live in your body and make you sick. With PrEP, you get that same preventative effect, but only as long as you take the medication. So, just like HIV+ people have to take their medication (the same pill, by the way) to keep the viral levels down, HIV negative men on PrEP have to take their pills every day as well - as long as they are sexually active with a possibly HIV+ partner.

The FDA recommends PrEP for anyone having sex with multiple partners without a condom, and for couples where one person is positive and the other isn't.

In their own ways, PrEP and condoms are equally effective - but they are such radically different approaches you have to take a lot of your own environmental and behavioral factors in to consideration.

What they have in common is that they only work as long as you use them according to according to directions. Some people are really inconsistent in taking pills and some are inconsistent with carrying and properly using condoms. Also PrEP is expensive in the US (though ususally covered by insurance), while condoms are relatively cheap. PrEP only protects you from HIV, while condoms protect your from multiple sexually transmitted diseases.

I will just finish with this personal story. My nephew is in his mid-20s, gay, and sexually active. I love him dearly, but he is not the most responsible person in the world. Sometimes. Last time we visited we were talking about politics and health care and he was telling me about how much he appreciated his own doctor who proscribes him PrEP.

Inside I just breathed a huge sigh of relief! I didn't have to worry about whether he was using condoms and being responsible - as long as he took those pills he was at least safe from the killer that took away what seemed to be half my generation of gay men. I was ready to throw him a party.

That's what PrEP can do. With one prescription, it can make parents and uncles sleep a lot sounder knowing that particular angel of death will pass by their children.

 

[kwhotboi]

I have been on PrEP ever since it first became available because I prefer it bareback.
My Dr recommended it to me and gave me a prescription which my insurance fully covers.
Now I have all the BB sex I want without worrying about HIV status. I love the freedom.

 

[newage]

PrEP is great but it is not full proof---few strains are resistant. Furthermore, there are not sufficient studies on the long term effects on several organs of the body...the ones i'd worry about the most are kidneys and liver. My favorite of the program is people who are on it get tested regularly per protocol so they are genuinely safer pool who may/may not know their status on stds/hiv. All of that goes out the window if you aren't adherent to the medication though.....

 

[Mike_hawk]

Just to be clear, Doctors still suggest condom for other STD's and PREP only protects you 90% from HIV.
Every three months you have to see your doctor for a barage of tests and they only prescribe 3 months worth so you have to come back and see them regularly.
You have to take it regularly, preferably same time everyday, to keep your viral load steady, stopping means you're more susceptible to the virus.
Not all insurance give full coverage, mine has almost $600 co-pay. but there's a lot of programs to help for the co-pay, even GILEAD offers $3500 annually per patient.
I think most prescription nowadays has an effect on kidney and liver that's why it's part of the tests.

For those interested, here are the program to help you with co-pays. Once you exhausted a program, you could contact another to help you.

AbbVie Patient Assistance Foundation for Norvir and Kaletra 800-222-6885
Advancing Access Program 800-226-2056
BMS3assist Co-Pay Assist for Atripla, Evotaz, Reyataz and Sustiva 888-281-8981
Boehringer Ingelheim Cares Foundation Patient Assistance Program 800-556-8317
Bristol-Myers Squibb Access Virology Patient Assistance Program 888-281-8981
Good Days Program 877-968-7233
Johnson & Johnson Patient Assistance Foundation, Inc. Hospital Access Patient Assistance Program 800-652-6227
Merck Connect 800-489-5119
Patient Advocate Foundation 866-512-3861
Serostim Patient Assistance Program 877-714-2947, opt. 2
Truvada for PrEP 800-226-2056
ViiV Healthcare Patient Assistance Program 844-588-3288

 

[Mike_hawk]

Pre-Exposure Prophylaxis. They take it either a day or two before sex, or take it for about 4 or 5 days after having bareback sex with someone whose status is not known. .

I'm sorry but this is misinformation. You take PREP, everyday, regularly, you don't stop,to keep your viral load steady otherwise it's just a placebo and stopping makes you more vurnerable to the virus.

 

[SoleLove]

^^ No. It is not misinformation. I was told (and I also got it from gay health publications) that those who only occasionally (several times a year) or very occasionally (a few times a year or less) have sex may take Truvada before intimacy and after intimacy over several days. In such cases, there is no need to take it 365/366 days a year!

In cases where the individual has sex on a more frequent basis, especially bareback sex, they may want to take it everyday.

Protected www.prepineurope.org/en/faqs/does-prep-work/intermittent-prep/

Protected www.aidsmap.com/Intermittent-PrEP-may-be-a-robust-strategy-for-anal-sex-vaginal-much-less-certain/page/2986809/

 

[tonka]

I think you guys are talking past each other. If you have HIV, you need to take your meds every day.

If you have great self control (and are negative), and plan you life well...you can take your meds as you describe.

Health professionals are rightly skeptical of this second group. Young guys party. Young guys drink and do other things. And naughty fun happens. If you rely on taking your meds after the fact, you might be in trouble.

So if naughty fun might happen to you, maybe take your meds every day.

^^ No. It is not misinformation. I was told (and I also got it from gay health publications) that those who only occasionally (several times a year) or very occasionally (a few times a year or less) have sex may take Truvada before intimacy and after intimacy over several days. In such cases, there is no need to take it 365/366 days a year!

In cases where the individual has sex on a more frequent basis, especially bareback sex, they may want to take it everyday.

Protected www.prepineurope.org/en/faqs/does-prep-work/intermittent-prep/

Protected www.aidsmap.com/Intermittent-PrEP-may-be-a-robust-strategy-for-anal-sex-vaginal-much-less-certain/page/2986809/

 

[bluemount]

http://anon.projectarchive.net/?www.gmfa.org.uk/prep
This gives the current 2018 UK view

 

[thejackson5]

I'm surprised you've found out so late about PrEP. I know a bunch of people taking it for at least 2-3 years now.

 

[kwhotboi]

PrEP is still evolving so check with Dr to make sure you are on the latest available drug.