PrEP For Sex

Ten Reasons This Little Blue Pill Could Save Your Life


It was once unimaginable: taking a pill once a day that could prevent you from getting HIV. If gay men had heard of it a decade ago there would have been jubilant dancing in the streets. It would have been a freaking miracle.

That miracle is now a reality. It is known as pre-exposure prophylaxis (PrEP), and it comes in the form of a little blue pill called Truvada. It can literally save your life, blocking the transmission of HIV from 90 to 100 percent of the time. Combined with other prevention practices–condoms, serosorting–it has the potential to cute the rate of transmission dramatically. So where’s the dancing?

Instead, there are a few outspoken PrEP critics making all kinds of noise, including iconic AIDS activist Larry Kramer, who called those taking PrEP “cowards” for not using condoms, and AIDS Healthcare Foundation head Michael Weinstein, who referred to PrEP as a “party drug.” In both cases, their level of discourse says as much about them — and their long AIDS history rooted in fear tactics and grief — as it does about this modern medical strategy rooted in research and science.

Somewhere along the last thirty years, the heartache of dealing with HIV has jaded us to good news. We’ve had our hopes raised and then dashed by promising developments many times before. But whatever our hesitations, they do not lessen the very real facts about PrEP.

So let’s take a moment to list ten reasons for a little dancing…

1. PrEP works

In study after study of thousands of couples who did not use condoms consistently and one of them was HIV positive, PrEP has been shown to reduce HIV infection by rates of 90% and above. Ignore the naysayers who use smaller efficacy figures; they are using data that included people in the study who chose not to take the drug at all. Most research has put PrEP efficacy at the same rate or higher them condoms, and one National Institutes of Health (NIH) study found it to be 99% effective when taken every day.

Consider that figure for a moment: 99% effective. When it comes to 50,000 new infections in America per year, mostly among gay men, that figure could mean the end of the epidemic as we now suffer it. But even if it turns out to be closer to 90 percent, how can that not be a huge step forward for the community as a whole.

SFAF-2013_11x17poster_BLACK_GAY2. PrEP is an easy regimen to follow

When was the last time you were in the heat of the moment and couldn’t find a condom? How about the withering effects of a rubber once you got it on? Those are dangerous scenarios that are the perfect environment for HIV infection. Now imagine taking a pill each morning, when sex isn’t even on your mind. Yes, the pill should be taken each and every day for maximum protection. The benefits are worth it.

The Centers for Disease Control (CDC) has stated that inconsistent condom use is as dangerous as never using one at all. Sooner or later, the odds catch up with you. If you are not using a condom each and every time you have sex, why not consider an additional level of protection? There’s little to lose and lots to gain.

3. PrEP protects us all, regardless of how promiscuous you are (or are not)

Much has been said about PrEP giving license for people to become barebacking sluts. The fact is, most HIV infections occur within a “primary relationship,” meaning a lover or regular fuck buddy. New infections generally are not the result of guys gone wild (although there’s plenty of examples of that, too). They often occur among trusting people or simply by accident. And don’t people in positive/negative relationships deserve some additional piece of mind? God forbid monogamous couples might want to enjoy sex without a barrier between them.

Most HIV infections are the result of a singular event. Someone got drunk or trusted the wrong person or fell in love or said yes when they should have said no. We’re human, we make mistakes, we are afraid of rejection. These are factors that confound the message of “use a condom every time,” or else everyone would.

And you might be at greater risk yourself than you believe. In a recent British survey of sexually active gay men about their sex lives and whether PrEP might be right for them, the vast majority of those surveyed met the criteria for PrEP use (80%), based on their reported risk behaviors. Surprisingly, an almost equal number (78%) did not believe their risk to be high enough to warrant using the drug. That disconnect between real and perceived risk is the perfect scenario for HIV infection.

Meaning, a lot more gay men are candidates for PrEP than realize it. When we limit those at risk for HIV to people we consider sluts, we might be ignoring our own vulnerabilities. Take a hard look at your actual sexual repertoire and ask yourself: Do you always know your partner well? Do you sometimes forgo a condom, top or bottom? Honest answers might help you think twice about rejecting PrEP.

4. We’ve been down this road before

Fifty years ago, a different medication was approved. It caused an uproar because people thought it would lead to casual sex galore. But women taking The Pill have long since proven they can protect themselves from pregnancy and not become whores in the process.

By the way, there were plenty of people who railed against The Pill half a century ago because they thought it was too expensive or not studied enough or believed women should just always make their partners use condoms (as if they had that ability). Sound familiar? No wonder half of the initial prescriptions for PrEP were written for women. We might learn something from their willingness to take control of their own bodies.

truvada-doc5. PrEP puts the power in your hands

Speaking of control, PrEP offers the ability to for you to take charge of your own protection without relying on your partner to know their status or use a condom every time.

6. This isn’t as simple as a battle between condoms and PrEP

Feeling threatened that PrEP equates to men throwing out condoms is a false argument. People choose to use condoms now or they don’t. A Truvada prescription doesn’t really change that equation.

We are dealing with a gay population in which condoms are not used consistently among more than half of us. This figure has remained virtually unchanged since condom use among gay men started being measured in the 1980’s. PrEP didn’t create this situation. But it sure can help it.

Fortunately, many of us do use condoms each and every time. For those of us who do, PrEP may not be warranted. That’s great. But simply dismissing men who don’t always use condoms as sluts doesn’t do much to solve the problem. If you think they deserve to be infected because of their condom habits and deny them a new tool to prevent it, you really should check yourself. We can use every tool available to prevent 50,000 new infections every year, or we can have a useless moral debate.

7. Truvada has shown few serious side effects.

Truvada has been used by people living with HIV for many years and has a favorable safety and side effect profile. That’s exactly why it was the first drug chosen for clinical testing for PrEP. Although we can’t say what the long term effects might be for people who are negative, it is believed that they may tolerate it very well over the long term because their bodies are not also fighting HIV. Very few side effects have been reported among HIV negative men using Truvada as PrEP. Obviously, one would rather not take the medicine, all things being equal. But when considering side effects, you also have to consider the alternative in many cases: Treating HIV with Truvada.

8. PrEP has become much more affordable for most gay men.

Insurance companies have woken up to the financial advantages of PrEP and are covering it in most plans (although it sometimes takes coaxing from your physician to point out the benefits). Gilead, the maker of Truvada, also has a fairly generous patient assistance program to cover co-payment or for those who are uninsured. Virtually everyone has access who wants it.

Of course, this does not account for those who do not have access to health care at all, which often includes young gay black men, one of the most vulnerable segment of our community. Check out the new video below produced by the National Minority AIDS Council, which focuses on young gay men of color and their attitudes around PrEP.

9. If you’re considering PrEP you are in very good company

The World Health Organization (WHO) has endorsed the use of PrEP. They join a growing chorus of advocates and agencies, including the CDC, the NIH, the New York City mayor (who included the widespread use of PrEP in his call for an end to AIDS), ACT UP, and virtually every major AIDS service organization in the United States. Informational sites about PrEP are springing up everywhere, but our favorite and most comprehensive is PrEPWatch.

10. Like it or not, we’re all in this together

Okay, so maybe taking a medication that is also used by your HIV positive friends may not make us all soul brothers. But there is something mutually supportive about negative men stepping up and choosing to do everything in their power to remain that way.

These facts about PrEP often unleash a torrent of anger from those who think we should all just use condoms, every single time, period (gay men have been suddenly seized by the woeful spirit of the moral majority for some odd reason). We wish more guys would use condoms consistently, too. But wishing is not a very dependable HIV prevention strategy.

If there’s one thing we have learned from years of dealing with the virus, it’s that when we argue over what people “should” be doing, the only thing that wins that argument is HIV.

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  • BarLackey

    A few reasons –

    1. 90% is NOT a 100%.
    2. There other many other things to worry about besides the transmission of HIV. Hepatitis and all its variant varieties much?
    3. At last check, this was a VERY expensive regimen. Who’s going to underwrite this for the poor and indigent?

  • Black Pegasus

    I haven’t been sexually active since my last relationship ended many moons ago. So this drug isn’t of any interest to me. But I can see this drug as something sexually active gay men may want to consider. Anything that can assist in reducing your exposure to HIV is worth a try. I’m negative and I intend on staying that way.

    Btw : you can test yourself in the privacy of your own home with the Oraquick HIV test kit. You can buy it at any drug store or you can order it online if you’re paranoid. It only takes 20 minutes for your results after swabbing the inside of your mouth with the test strip.

  • bbg372

    There are so many things wrong with this article, I do not know where to begin.

    1. It is not known if PrEP works. The 99% efficacy figure is not a study finding, but a statistical estimate based on a number of debatable assumptions. None of the studies of the efficacy of Truvada as PrEP controlled for risk reduction, condom use, or the HIV status or viral load of the sex partners of the participants. Any of these controls could be prevent seroconversion independently of the effects of Truvada.

    2. PrEP is NOT an easy regimen to follow. Only 18% of the participants in clinical trials, individuals who were highly-motivated to follow the regimen and received their medication for free, were able to maintain levels of the drug in their blood that was consistent with daily use.

    3. There is no evidence that PrEP creates a herd immunity to HIV infection.

    4. We have been down this road before. There is a correlation between the availability of hormonal birth control and a rise in sexually transmitted infections. This is because women stop using a barrier method of birth control such as condoms, which also prevent STIs, when they start taking birth control pills. See any social networking application or dating site for evidence that gay men are doing the same with regard to Truvada.

    5. One could substitute “condoms” for “PrEP” in this statement and it would be just as true. This is not an argument for PrEP, it is an argument for any number of risk reduction strategies.

    6. See number 4.

    7. Truvada has shown no serious side effects in clinical trials with a median duration of 1.2 years.

    8. PrEP is becoming more affordable for some gay men. Anecdotally, I work for an LGBTQ social service agency and Truvada as PrEP is $3,500 a month under my group insurance plan. And it is currently less affordable for most black and latino young men ages 13–24 who are most at risk for HIV infection and represent more than half of all new HIV infections.

    9. The World Health Organization also recommends compulsory male circumcision because there is some evidence that it reduces the risk of HIV infection through vaginal intercourse. The point being that people at risk for HIV should examine the available evidence for Truvada as PrEP and make a decision that is best for them, regardless of which organizations or individuals are purporting its benefits.

    10. We are all in this together, and if one can take a pill correctly and consistently daily, then he can use a condom correctly and consistently situationally just as easily.

  • Billy Budd


    Truvada can cause serious, life-threatening side effects. These include lactic acidosis (buildup of lactic acid in the blood) and liver problems.

    Other possible side effects of Truvada include:

    New or worsening kidney problems, including kidney failure.
    Bone problems (bone pain, softening, or thinning [osteopenia]).
    Changes in the immune system (immune reconstitution inflammatory syndrome [IRIS]).
    Changes in body fat (lipodystrophy).

  • deltabadhand

    Gretchen, stop trying to make PrEP happen! It’s not going to happen!

  • BeachGuy2014

    Use condoms, cheaper and no side effects.

  • tazz602

    PrEP has already happened, we can debate the studies, statistics, side effects, etc, etc – but bottom line is, this is the first REAL preventative measure we have had since we were first blind-sided by HIV. Whether men choose to use them with condoms or not, that is their choice because there are other STIs out there. But as the article clearly points out, this is a god send for monogamous sero-discordant couples, and they do exist. I will probably wait for a real vaccine, but it’s nice to know that this is an option if I find my self single and dating regularly again or whatever.

  • out91394

    ok, a bit of info I am HIV pos and have been taking truvada for about 4 yrs now. Guess what no serious side effects in fact no side effects at all. I have been undetectable for over 6 yrs now meaning I am probably healthier than most naysayers, if you want info on truvada ask those of us taking it aka no brainer.

  • Billy Budd

    In MY opinion, if you hate condoms or doesn’t have self discipline to use them, it is better to stay away from penetrative intercourse and satisfy yourself with kisses, body contact, blowjobs and toys. It is a compromise, but it is better than poisoning your system with drugs.

  • BeachGuy2014

    I agree Billy Budd.

  • Tackle

    @bbg372: @Billy Budd: Thanks for posting the info about PrEP not being as effective as once thought, and very possible side effects…

  • bbg372

    @tazz602: It is scientific illiteracy that this is a debate at all, but let us not overstate the importance of Truvada as PrEP.

    Abstinence, non-penetrative sexual contact, correct and consistent condom use, etc. are all preventative measures. Truvada as PrEP is simply another one.

    Condom use is just as effective as Truvada as PrEP for serodiscordant couples, and there is a low risk of HIV infection from partners with an undetectable viral load.

    Truvada as PrEP is a potentially promising risk reduction tool, but it is not the be-all-and-end-all of HIV prevention that it is being made out to be.

  • breal

    I remember the first time I saw Larry Kramer on TV and I thought what a jerk. However, over the years I realized he was just ticked off for the way he had been treated and how is friends and our community was being treated. I understand his anger now. And he is right, safe sex and awareness of HIV infection are the most effective fight against HIV infection, which means condoms and not engaging in high risk behaviors. Of course, some people will not take the advice. And for positive individuals today, they sure wish they had this drug available years ago. But can’t they just wish they used a condom? or wish at the time there was a better understanding of unsafe sex?

    Today there was an article about how the HIV infection rate in this country has plateaued. It had nothing to do with prevention medication and everything to do with awareness, safe sex, and yes Larry Kramer and even Mark King who wrote this article.

    I am cynical for on reason or another. But this drug is about profit. Condoms and Awareness are about solutions. Get tested, know your status. Practice safe sex.

    And the BS about not knowing your partners status, well then your partner isn’t really a partner at all. Ask the question, ask for proof. No matter if your relationship is open or closed, protect yourself. Because the drug companies don’t give a f***.

  • breal

    oh and you gotta love the guy in the banner ad at the top of this article. Because if you take the take the drug it’s likely you will have sex with a some musclebound stud, not need to know his status and not get HIV from him.

  • tardis

    I read this does major liver damage.

  • bbg372

    @breal: I am concerned about the possible profit motive behind the recent push for HIV-negative men to take an HIV treatment drug as a means of prevention.

    The first patents of the active ingredients in Truvada expire in July 2017. At this time, other companies may begin producing Truvada under other names, including generics. This means that Gilead Sciences, the makers of Truvada, have a three year window in which it can exclusively produce and market the drug in which to maximize profits.

    As an HIV treatment drug, the consumer base for Truvada is limited to those persons infected with HIV. And as new infections plateau or decrease, strains of HIV become resistant to the drug, and persons currently living with HIV pass away, this consumer base continues to shrink.

    The only way to increase the consumer base of the product is to market it to HIV-negative persons as a means of prevention. This would add 50 years of profits over the lifetime of HIV-negative persons taking the drug for prevention to the 25 years of profits over the treatment lifetime of HIV-positive persons after diagnosis.

    If the drug fails to work as prophylaxis, the company can claim that the consumer did not properly adhere to the regime or was exposed to a strain of HIV that is resistant to the treatment. The company can plausibly deny responsibility, and has a new consumer for its other newly patented HIV treatment medications.

    Trusting a for-profit pharmaceutical company that its drug which has not been properly, rigorously, or thoroughly investigated will prevent HIV infection is like trusting a one-night stand whose safer sex practices are unknown and who has not been recently tested that he is HIV-negative. So why not bareback?

  • Tackle

    @tardis: I read the same thing about liver and kidney damage. And heard people giving testimony about Truvada usage, damaging their kidney and or liver. However they were dismissed by the AMA who is controlled by Big-Pharma and Big-Pharma themselves as the most likely culprit to the liver or kidney damage, was an already pre-existing medical condition.
    I believe this is how they get around this without admitting how dangerous this drug can be.And it seems like their main motive is profit, with gay men being used as Guinea pigs…

  • robirob

    It comes down to trust. Trust in the pill, trust in the pharma industry, trust in yourself (to take it on a daily basis and be ok with the potential side effects, still using condoms, etc.), etc.

  • Random

    I’m curious how PrEP will, if at all, have any impact on HIV disclosure laws. There’s a sense that the goal posts are moving if a pill to supposedly prevent HIV infection becomes widely available. The view may well start to take hold that if you’re not taking PrEP then you weren’t reasonably doing all you could to remain negative and therefore must shoulder the responsibility for your infection.
    The fact that the (female) pill is used as a comparison in this article is interesting as the pill was seen as a turning point for women in that in meant that SHE could take control over her life, even if her husband refused to wear a condom.

    I’m playing devil’s advocate here rather than stating my own view, but I do think this could well be the start of a shift in the dynamics of safer sex which, up to this point, generally, places the burden of responsibility on the person with an HIV diagnosis.

    • Random

      “Ten Reasons This Little Blue Pill Could Save Your Life”

      It’s interesting that the article uses the language of ‘AIDS as a killer disease’, which is something the medical profession has shied away from for well over a decade now, and view HIV as a chronic health issue rather than a deadly concern. That such emotive language is being used, makes me suspicious that the writer has ulterior motives.

  • Ihadtosayit

    My situation is simple: I am a top that prefers to use a condom; therefore if you want to use PrEP as the bottom…you go right ahead…that works for me…

    Thank you!!!

  • Kieru

    @out91394: It is GREAT that Truvada is working for you. Your success and lack of appreciable side-effects while using the pill however, is not indicative of what another persons experience will be. The pharmaceutical’s website is quite upfront and honest that Truvada carries with it the risk of SERIOUS side-effects:

    That’s always been the downside to ART; all of the pills carry with them the risk of liver and/or kidney damage, a risk that only worsens when taken over a prolonged period of time. I imagine your doctor takes a blood draw to check liver and kidney functions at least once a year. That’s why.

  • Kieru

    I find the timing on this article very disturbing. This article is very much pro Truvada, spouting all the talking points such as the 90 – 100% effectiveness rate despite a Queerty article only TWO DAYS OLD discussing how that percentage was made from a statistical estimate and NOT based on actual study results.

    At the end of the day Truvada is in a very gray area.

    The numbers their marketing team are relying on to sell this pill as PrEP are under question. If you’re relying on Truvada to prevent HIV that’s a pretty big deal. Especially if you’re relying on Truvada in lieu of condoms.

    And as I mentioned in response to @out91394 – all ART pills carry with them the risk of damage to the kidneys and/or liver (among other side-effects). As with all ART these risks increase over prolonged use. And like any medication some people will be more susceptible to this sort of damage and others less so.

    You should never base your taking a pill on an article promoting or decrying it. Speak with your physician and gain some insight onto how the drug might interact with your physiology.

  • Ben Dover

    Mark King’s articles can be very strange sometimes. I wonder if he tends to see *all gay men* as former meth addicts like himself so therefore he always downplays, or totally ignores, the well-documented side effects of legitimate drugs.

  • BeachGuy2014

    Going to stick with condoms. No side effects and cheaper.

  • vive

    I think it is a good article. The overwhelmingly negative response was to be expected given the usual suspects who make a habit of commenting on these sites.

    It is quite clear that the anti-PrEP crowd will stop at NOTHING in their campaign. Their tactics:

    1) Moral shaming of PrEP users – do you realize there was a time earlier in the epidemic when guys having sex with condoms were morally shamed?

    2) The FALSE “Truvada is poison” scare tactics. PrEP includes careful medical monitoring every 3 months and any side effects have been rare, mild, and reversible. Certainly none of the lactic acidosis and liver problems everyone shouts about have even been seen in PrEP users.

    3) The FALSE “don’t bother because you can’t afford it” tactics. Even most uninsured people can get PrEP almost for free.

    4) The FALSE assertion that condoms (95%) are more effective than PrEP (99%+). The opposite is true, with correct use. So who are the real irresponsible ones?

    5) The CDC and WHO (both of which recommend PrEP), and Big Bad Pharma conspiracy theories. Never mind how many lives have been saved by these organizations and by HIV drugs, they just have it in for gay people and like nothing more than hook us on poisons (rolleyes) to make money. This is so bad that Gilead isn’t even marketing this drug for PrEP, despite the extra lives such marketing could save, because it knows it would be attacked by the kooks.

  • joey

    i’m on tenofovir (Viread) for hep b, ive read it offers the same protection alone, im not sure id trust it though..not right now anyway. i have been on the med for well over a yr now and there are zero side effects. the doc says its very rare for any side effects

  • Alejandro

    From my recent Facebook post:

    Howdy folks! I’ve been on PrEP since winter. It’s an HIV prevention regimen, a once a day pill of a drug called Truvada. It was approved for HIV prevention by the FDA in 2012, it’s use recommended by the CDC recently, and increasingly recognized by government and community health organizations as an effective tool to curb the spread of HIV, now at a plateau of 50,000 new cases a year in the US.

    I’ve experienced no physical side effects. I’ve received no negative feedback from friends or strangers. I’m very public about being on it, including constantly talking about it and posting information on Facebook, listing it on Grindr and similar profiles. (Grindr is a mobile app for meeting other gay men, with a reputation for being about hookups. Similar to things in the straight world like Tindr or, well, the entire planet.) A common slur is to accuse someone on the drug of being a whore, only interested in promiscuous sex without condoms. Oh no, a human who enjoys sex and people who don’t always or ever use condoms?! That’s never happened in the history of gay people, straight people, rocks or clouds!

    I encourage people on Grindr, Facebook, etc. to ask questions, and I get at least a few people every week who do. I link them to good intro articles from folks like the recent NY Mag pieces like this one:

    I’m also participating in an adherence study through UCSD (and available in LA too). Basically, I receive a text reminder every day to take my pill. It’s fun since the I chose the text contents and they’re either humorous or history and sports trivia.
    I’ll put together a story for soon enough. I hadn’t yet since it’s been nothing but positive but maybe we need to hear about that side too!

    Photo Caption: What Can’t You Do on PrEP?!*
    *PrEP does not guarantee your ability to summit Mt. Whitney, nor does it ensure that others appreciate you choice of neon green spandex fashion. PrEP doesn’t protect against other STI’s, splinters, hurtful words or rainy days. Please remember that while PrEP provides protection against HIV, it will not resolve your emotional issues regarding your parents, dead friends, or ended relationships. But if you wanna talk about it, I’m more than happy to chat.

  • gaypalmsprings

    I’m a #truvadawhore – you can be, too. Why is everyone so afraid?

  • gaypalmsprings

    @BarLackey: 99%, not 90%.

  • Alejandro

    Oh, the last paragraph refers to an accompanying photo of me at the top of Mount Whitney, decked out in neon green hot shorts and headband

  • cformusic

    use a condom..simple

  • queerT

    Let’s see, pioneering AIDS doctor and co-author of How To Have Sex in an Epidemic OR meth addict with a history of slander, exaggerations, misinformation, and flat out dangerous lies? I’ll thin I’ll go with Dr. Sonnabend, one of those “few outspoken PrEP critics making all kinds of noise” over an actor and blogger. And get your story straight Mark. “Take Truvada or you’ll die of AIDS” Is that your message? All this time you’ve being saying HIV isn’t a death sentence but now your title claims a pill will save your life. I guess melodrama is only ok when you use it to further a pet cause.

  • Stache99

    @deltabadhand: “stop trying to make PrEP happen! It’s not going to happen!”

    Sorry to break it to ya toots but it looks like it’s already happening more and more.

  • Stache99

    @queerT: Most of the medical community seems to be on Marks side. You’ll always find desenters in everything though. Will know more in 5 years as it becomes more widespread.

  • Ms Urethra Johnson

    I don’t want a SLEAZY SLUT for a boyfriend / life partner.
    You can have safe threesomes, organized group sex, you know, like real adults / couples do… You can be kinky and safe…BDSM,FF,CBT…wrap yourself in kinky rubber, chemical gloves, etc…
    No need to be depraved sex whores…HUGE turnoff…
    Wear a damn condom…pull it off…magic…clean dick.
    Indeed COWARDS…Selfish cowards…lazy…slutty…SCUM…proud of spreading other diseases?
    You can be a conscientious / considerate slut or an irresponsible sexual terrorist, your call…Nuf said…

  • vive

    @queerT, seriously, so PrEP is the last refuge of meth addicts? Are you actually listening to yourself? What about the CDC recommending PrEP, The WHO recommending PrEP, ACT-UP endoring PrEP, the New York Department of Health recommending PrEP, my own doctor recommending and prescribing PrEP to me, etc., etc.

  • vive

    @Ms Urethra Johnson, condoms are 95% effective. PrEP is 99% effective. So who is the sleazier slut now?

  • Chevelter

    My friend, a dentist, was stuck accidentally with a dirty needle and put on PrEP as a precautionary measure, and had the side effect of bad diarrhea the entire time.

  • Ben Dover

    @vive: I see your points. A lot of the negativity (pun intended) has moralistic roots. PrEP seems perfectly appropriate for SOME people in SOME situations. From what you’ve said about your situation, you seem to be one of them.

    But there IS some nuance in the objections and it’s not all merely the moralistic clucking.

    What many people object to is a rather mindlessly upbeat, propagandistic tone as in this article.

  • LorrieFludd

    How about just stop sleeping around and stick with one sexual partner.

  • vive

    @joey, tenofovir alone confers some protection against HIV infection already (there are studies that you should look up) but it may not be as effective as the Truvada-combo (AFAIR the percentage protection was a bit lower than for Truvada). It may be a good idea to ask your doctor if you could get on Truvada instead, so you get the benefit of PrEP in addition to your HEP-B therapy. It is done sometimes.

  • vive

    @LorrieFludd, many guys get their HIV from their one sexual partner.

  • erikwm

    2 reasons I won’t be taking PrEp:

    1. Kaiser Permanente won’t pay for Truvada as PrEp.
    2. I can’t afford it if my insurance doesn’t pay for it.

    Caveat: I’m not basing this on my own personal experience. However, an online petition states Kaiser categorizes Truvada as a specialty drug and requires a co-payment of $400 a month, which is in addition to one’s monthly premium.

    $4800 a year is an awful lot of money to spend when condoms have kept me negative at a fraction of the cost since I became sexually active 16 years ago.

  • ashersea

    Who is the model in the “Are you PrEped?” ad? I can’t get over his chest.

  • BeachGuy2014

    Will stick with condoms. Cheaper, cleaner, no side effect, don’t have to worry if some guy took his pill consistently!

  • gaypalmsprings

    @Chevelter: Post-exposure is PEP, and pre-exposure is PrEP. Your dentist got PEP, not PrEP.

  • Teeth

    This would have been really helpful a few years ago, but now that we are all HIV=, we really don’t need it.

  • LorrieFludd

    @vive: Then these guys need to improve their judgement and stop getting into relationships with unfaithful people. Wait to have sex until later in the relationship. Get to know your partner before getting serious.

  • vive

    @ericwm, there is a copay assistance program by Gilead that reduces my copay to $10 a month.

  • vive

    @BeachGuy2014, the point with PrEP is you don’t have to worry if the other guy took his PrEP consistently. It is sufficient that you take yours consistently.

    And with condoms, don’t you worry about the possibility of fluids like precum getting on the outside of the condom? Has nobody ever started trying to put on the condom inside out and then flipped it over when they realized their mistake (as happens almost half the time) and do you always keep an eye on this and throw the condom away when they do that? Have you never had a condom break? And have you never worried about whether your gums were 100% intact during oral?

    Let’s be honest, condoms are far from foolproof.

  • kjoemurphy

    PrEP is indeed effective. While the 99% number is an estimate based on an evaluation of an earlier study, it is a fact that for those that adhere to the daily regimen of it, the medication provides a range of protection between 92-99% (everyone reacts to medication differently). While this is not perfect, it is important to realize that there is no way to have sex that is 100% free from potential exposure or infection and this applies to any number of sexually transmitted infections (including those that can be transmitted even WITH condoms like genital herpes, syphilis, and HPV). Regardless, the level of protection provided by PrEP is technically higher than that of condoms, which often break, are used improperly, etc. In terms of adherence, the trials had low adherence for any number of reasons — including the fact that the drug’s efficacy hadn’t been proven, so participants had less motivation to take it. They did not know if they were taking the real drug or the placebo either, which diminishes motivation as well. In demonstration projects out of San Francisco, Miami and Washington, DC, a large majority of participants adhered to the medication enough to provide over 92% protection from HIV.

    Either way, we should encourage people to take any steps they can to protect their own health, not shame or stigmatize their decisions or sexuality. Your determination to take PrEP is personal and there is no right or wrong answer. If you choose to utilize it, there are any number of ways to pay for it, including private insurance, Medicaid and Gilead’s PrEP assistance and co-pay assistance program, which covers up to $200 of your co-pay each month. I have an HMO (cheapest form of coverage available) and my co-pay is $35/month. With Gilead’s co-pay program, I pay nothing.

    We should be kinder to each other, supporting others in protecting their health without judgment. If anyone is reading this article and questioning whether they should really consider this strategy, please know that you can get support and from a number of places and check out and for more info.

  • Random

    I know people who’ve taken Truvada and felt lousy; weak all the time and as if they were slowly being poisoned. They came off it and within days, felt completely normal again.

  • rikard

    you say “few side effects”, but fail to mention even one. you say “much more affordable” but you don’t even HINT at what the cost will be. journalism has become much more suspect than advertising. at least there are standards for truth in advertising.

  • Patrick

    I have had mixed feelings over this prevention method since it came to light. Multiple flaws with this approach; cost, long terms health consequences, following regime properly (you miss a dose or fail to take it at the same time and the effectiveness diminishes) , start up side effects can be ugly and more intense if there is no virus to fight.

    On the flip side, I see where the excitement is coming from. Being in my early 20’s at the height of the epidemic and losing a larger chunk of my family of choice I “get it” but a pharmacological approach to protecting one’s health is not always what it seems to be.

    Finally, let’s face it the drug companies fingerprints are all over this push for PrEP. We have shown, time and time again, That we can take care of ourselves let’s not surrender this very important, if not life saving decision over to them. What if it has some other unexpected effect i.e. – leaving a person more vulnerable to some other infection/disease. What do you think the large pharmaceutical companies response would be?

  • gaym50ish

    I don’t see 90 percent as being a significant advantage, seeing as how a healthy person can have sex thousands of times with no protection at all and not be infected. I am not arguing for going without protection, but taking an anti-viral drug if you’re healthy seems pretty drastic to me.

    According to the CDC, the risk each time one receives anal intercourse is 138 infections out of 10,000 occurrences, whereas receiving infected blood will transmit it 9,250 times out of 10,000.

    So you’re not improving your odds much by poisoning your body with a serious drug.

  • gaym50ish

    Nobel Prize winner Dr. Luc Montagnier, who is credited with discovering the virus, has said, “We can be exposed to HIV many times without being chronically infected. Our immune system will get rid of the virus within a few weeks, if we have a good immune system. It’s important knowledge which is completely neglected.”

    With any drug, you don’t get something for nothing. They say the side effects are mild, but it’s often not just the immediate side effects that are the most serious — it’s the long-term effect on your health. Taking a strong drug could work against having a healthy body and a healthy immune system.

  • Random

    I don’t get why the pro-PrEP brigade are so vehemently vocal. I mean, they’ve made their decision and that’s their preoperative, but to try and force it on others is quite patently absurd. If anything, they sound worryingly like Big Pharma shills, although I don’t see them successfully persuading anyone with their overly optimistic statements of efficacy and low incidence of side effects.

    • Stache99

      @Random: Actually I believe it’s the opposite. I’ve been hearing non stop from the no on PrEP crowd. I’d like to hear more from people actually on it.

  • Random

    @Stache99: Well, obviously, at this stage, the people who aren’t on it easily outnumber those who are. But that also means the pro-PrEP responses stand out a lot more and some are bordering on the hysterical. If you’re comfortable you’re doing the right thing, that wouldn’t be happening but right now, it’s all a bit thou doth protest too much.

  • kjoemurphy

    @Random: v ehement proponents? Just look at this string of comments. The opponents are much more vehement that the proponents, turning to personal and hurtful attacks on those that choose to take PrEP and relying on second-hand misinformation to support their position. @Stache99: As a PrEP user myself, I can tell you that for me, the side effects were very mild and short lived — mostly stomach upset. Everyone reacts to meds differently so it might be different form someone else, but for me, the entire experience has been great.

    The reason that we are “pushing” is to inform. Less than half of all gay men reported using a condom the last time they had sex, and this number is SIGNIFICANTLY higher than the proportion of heterosexuals. We can live in a fantasy world where we just hope that folks will get the message and start using condoms, but that hasn’t worked for the last 30 years, and with infections actually RISING among gay men, we can’t afford to do that.

    @Patrick: The long-term health effects of PrEP, which after 10 years of study with Truvada don’t appear to be negative, would be a lot less troublesome than contracting HIV. In terms of adherence, this question always makes me curious, as the CDC has demonstrated that condoms are also not adhered to and that only using them sporadically is almost as problematic as not using them at all. I appreciate your points, and the measured tone of your comment. Just wanted to respond.

    @rikard: General side effects include diarrhea, headaches, etc. There is a very small risk of kidney problems and bone density issues, but these are very rare and so far have cleared up when they stop taking PrEP. In terms of cost, you can’t answer this easily, which is probably why you don’t hear it often. It depends on insurance coverage and quality. Private insurance covers it, but depending on your plan you may have a co-pay that’s as low as $35 for me or several hundred for some others. Gilead has a copay assistance program that will cover up to $200 of this each month. They also have another program that is income based that will cover about &800 each month.

    No one is arguing that PrEP is a panacea or for everyone. We simply want to get the word out to folks that this is an option, it is safe, it is accessible and it works. I’d also point out that there is only one drug being used for PrEP (Truvada) and Gilead — the company that makes it — is NOT marketing it. They did this to avoid any perception that they were pushing meds on healthy people in an attempt to make big profits. Instead, they are providing grants to nonprofit groups to engage in education around PrEP in communities with high HIV infection rates. These grants are closely monitored to ensure that they educational materials are factually/scientifically accurate and do not cross the line into marketing (for example, grantees are not allowed to actually even mentioned the name of the drug itself, Truvada).

  • Random

    @kjoemurphy: ‘second-hand misinformation’? Hmmm…those kind of comments don’t help your argument at all. People don’t need to experience things directly to have their own valid opinion of them; recreational drugs are a good example here. Like I’ve said above, people should be content with their own decisions, but trying to force PrEP down others throats won’t work.

    • kjoemurphy

      @Random: Neither does your hyperbole. I am content with my decision, as I”m sure you are with yours. No one is saying that PrEP is right for everyone, simply that it is an option. And I’ll stop educating people about my actual lived experiences with PrEP when people who have never used it stop talking about how bad it is. I have science on my side — your illicit drugs example is actually terrible, since PrEP is FDA approved and endorsed by the CDC and WHO, while last I checked all 3 oppose the use of recreational drugs. Also, drugs are addictive and harmful while serving no medical purpose. PrEP is not, and prevents one of the deadliest and most infectious diseases of our generation. Finally, that’s the 2nd time you’ve referenced someone forcing PrEP down your throat. I’m not sure how an article on a gay blog, and a few supportive comments qualifies as such, but should someone ever actually try to force PrEP on you, let me know. I’ll happily step in and help you fight them off…

    • Random

      @bbg372: Very well said, bbg372. Gilead obviously needed to find an alternative way to get the PrEP message out there, and that some people genuinely believe the grants to non-profit organisations is something they are doing out of the kindness of their heart, shows breathtaking naivete.

  • bbg372

    @kjoemurphy: The issue with folks promoting Truvada as PrEP as effective, safe, and accessible is that it is not necessarily true:

    None of the studies of the efficacy of Truvada as PrEP controlled for factors that could be prevent seroconversion independently of the effects of Truvada.

    The median duration of clinical trials studying the safety of Truvada as PrEP is 1.2 years.

    Truvada as PrEP is currently not accessible to most black and latino young men ages 13–24 who are most at risk for HIV infection and represent more than half of all new HIV infections.

    Now, if I was Director of Marketing of a for-profit pharmaceutical company instead of an LGBTQ non-profit, and I was interested in marketing an HIV treatment drug to Hiv-negative men as a means of prevention, but wanted to avoid the perception that I was “pushing medications on healthy people,” I would do exactly what Gilead Sciences is doing: provide grants (i.e. pay) non-profit organizations (which historically struggle financially) to engage and educate (i.e. market) the populations they serve (i.e. potential customers) about the benefits of Truvada as PrEP (i.e. my product).

    Gilead Sciences is avoiding the appearance of impropriety by not directly marketing to consumers, but what it is functionally doing through third parties is no different.

    And as someone who works for a non-profit, I assure you that the oversight for these types of grants is not nearly as stringent as you seem to believe it is.

    As a marketing professional, the entire “Truvada Whore” meme (which anecdotally, I have never seen on a social networking application or dating site, or heard in real life) has the fingerprints of an advertising campaign all over it. As does the fetish and pornography communities serendipitously becoming early adopters, proclaiming its benefits and trying to silence dissent.

    • kjoemurphy

      @bbg372: I too work for a nonprofit and can assure you that these rules are followed. If they are not, then you don’t get funding next year. And as you said, with struggling finances, the last thing you want to do is risk any of your funding.

      I’m also confused by your argument about black and latino gay men not having access but then acting like there is some nefarious plot to force it on them. Either they can or cannot access the drug. The medication has not been taken up as broadly as it has with white gay men for a number of reasons — lack of health care, distrust of public health, lack of information targeted at those communities. But given traditional prevention’s failure to reduce infections in these populations, and infection rates actually increasing significantly, I don’t see how could oppose another possible tool to help.

      Second, I was there when the “Truvada Whore” t-shirt was made and can tell exactly by who it was. It started when David Duran wrote a piece on Huffington Post calling anyone who used PrEP this. To support those who would like to access PrEP, a sex therapist named Damon Jacobs started a Facebook Group called PrEP Facts: Rethinking HIV Prevention and Sex. One of the men in this group named Adam Zebowski (I believe it was him) made the shirts on a website and sold them to raise money for his AIDS/Lifecycle team.

      I can absolutely understand the skepticism and the reason that you would assume that this is all some ploy by the companies to get everyone on their meds, I can assure you that this is a legitimate grassroots effort to educate the public about a potentially powerful new prevention option. The grassroots nature of our efforts partly explain why only 4,000 people are utilizing it 2 years after it was made available. If they really were attempting to push it on the public, they would not be using nonprofits and restricting them from even advertising in any mass media. Gilead is making plenty of money as is and has no need to expand its business model. In fact, should PrEP become widely utilized, it will likely hurt its bottom line, as it pays anywhere from $200-800 per person each month it its payment assistance programs — that as an enrollee can ensure you are open to anyone — and would come under increased pressure by the public and the government to reduce their prices once large segments of the population and not just “HIV patient” are taking it. Finally, I am hardly a part of either the fetish or pornography communities. And your comment has the fingerprints of Michael Weinstein and his rantings all over them…

  • QNetter

    OK… 58, sexually active both with my husband of 18 years (who has been poz for 20) and others. I’ve been on PrEP for just under two years. Side-effects? Minor diarrhea during the first few weeks. Since then, the major side-effect has been peace of mind.

    As for the #TruvadaWhore meme: if you think it’s manufactured by a marketing department (as opposed to the SF AIDS Foundation staffer who did it on his own) and isn’t on social media, you haven’t been looking at Twitter and Facebook very hard.

    For the person who said it would cost $4800 per year from Kaiser: first of all, Gilead will cover up to $200 of each month’s co-pay. But more important, you should consider your Kaiser plan. I have friends on Kaiser plans with better drug coverage who are paying $50 a month or less (all of which is reimbursed by Gilead).

    Also, the service agency person who said it would cost well over $3000 per month: you folks must be ripping your clients off like crazy, because full retail is about $1300/month.

    • kjoemurphy

      @bbg372: I am not going to get dragged into a trolling war here, but to avoid anyone reading your — once again — misinformed commentary, I will respond. Actually, the vast majority of insurance plans ARE covering Truvada for PrEP. And if an individual is homeless or don’t have enough stability to be able to adhere to a medication every day, then no, of course PrEP would not be an appropropriate strategy for them. But that is decision that should be made by them and their care provider. Not in a comment thread on Queerty. But because some people aren’t not in the position to benefit from it, does not make it a bad option. It just means that we need to do more to ensure that those who are poor or homeless are better served and we invest to lift them out of these circumstances. Also, no one is advising anyone to stop using condoms. We are saying that PrEP is a tool that could help those who don’t — the majority of gay men — not get infected.

      Your entire argument seems to hinge on your own personal disapproval of these individuals. And that’s your prerogative. But your disapproval is not something upon which I’m interested in building a public health strategy. People are going to do what they are going to do. Our job is to provide them with the information available to help them limit their risk as much as possible. HIV should not be viewed as a form of punishment for actions that you deem immoral or irresponsible. And no one should be denied information or access to a strategy that could help keep them healthy, just because you don’t like it or it would result in potential profits for a company. Last I checked Trojan and Durex were making plenty of money themselves.

      You can demonize or dismiss those of us who are trying to constructively identify alternative strategies to address an epidemic that we have not made any progress on in more than a decade and which is actually growing among young gay men. But we’re just providing information about an option, not telling anyone what they should or should not be doing. You are actually the one here who is pushing an agenda. And yours is basically the status quo…

  • bbg372

    @kjoemurphy: I do not see how your point about marketing versus accessibility is a contradiction. Porsche can market its consumer models to every legal driver, yet they can still be unaffordable to many people.

    The MSM population most at risk for HIV infection is typically unemployed, homeless, and does not have the continuity of services to be able to get this drug for free and to be able to take it at the same time every day. I do not see why you would think this intervention would more effective for this population.

    Now, if the effort to raise awareness of this intervention is truly grassroots, then the blame for its underutilization lays solely at the feet of those feigning being slut-shamed, calling for the termination of people who question the wisdom of not using a barrier method of STI prevention, and attempting to silence skeptical inquiry and dissent.

    For-profit corporations are in the business of making money. There is no cap at which a for-profit enterprise says, “No, we are making plenty of money, and we are not interested in making a penny more than we are right now.” It is evident that Gilead Sciences is interested in expanding its business model in that it is literally paying people to buy its product through its payment assistance program. The “money” the company offers to consumers to buy its product are not real dollars, so every penny it makes through this program is profit. The only reason this program exists is because many insurance companies are not covering it yet and the drug manufacturer wants to get the product in the hands of consumers in the meantime. You can bet that as soon as insurance coverage increases that funds for this program will decrease.

  • QNetter

    Very few insurance companies are not covering it.

  • bbg372

    @kjoemurphy: The last two paragraphs of your post literally address an argument that I did not make. By all means, indicate where in any of my previous posts I expressed disapproval of the choices of people who are taking Truvada as PrEP, let alone demonized anyone simply offering it as an alternative preventative strategy.

    It seems to me that you are attempting to distract from your inability to refute any of the arguments I made, by attributing attitudes and positions to me that I did not state, so you can dismiss my arguments out-of-hand. This is precisely what I was addressing earlier when I stated that many proponents of PrEP are its worst advocates, resorting to this sort of behavior in an attempt to silence anyone with the temerity to dissent.

    You keep stating that you do not have an agenda and that you are merely providing people with information about an option, but my entire point has been that the information you are presenting is incomplete and misleading, and it is the point that you have continued to dance around and refused to address.

  • Geoff B

    I’m torn on this. I’m not someone who this is for (monogamous realtionship for 10 years), but I wish this were avialable 20 years ago when I wasn’t (I’m negative and always was safe, but this would have been a great second line of defense). To me, if you’re going to have many partners, using both is great, but it should be just that, an extra defense (there are other diseases to consider). Also, while there haven’t been noticable side effects yet, we don’t know the long term effects. I hope for those of you using this, I hope it works and without downside, but I hope you will consider still using condoms. I wish all of you to be healthy and posting here for many years to come and not becoming another statistic.

  • vive

    @bbg372, about half of the people on PrEP in the U.S. are (mostly) minority women of limited economic means who get it as part of public health programs.

  • vive

    @bbg372, so according to you, presumably a company a free to develop a preventive medication (or are they? – it seems to be a big no-no for you if another preventive method already exists). They just cannot in any way tell anybody about it or try to distribute it because according to you that would be some nefarious conspiracy. How then would you suggest preventive medications be made available to anybody. Or are you against new preventive modalities in principle?

  • vive

    I have been on PrEP for a year now. I have had no side effects at all, not even initially, and blood tests every 3 months confirm that my kidneys, etc., remain completely healthy. I pay $10 a month after insurance (United) and copay assistance.

    • Random

      @vive: That’s cool, dude. But not everyone wants these drugs, which are known to be toxic especially over the long term, in their body, and would prefer to stick with condoms which do a great job of keeping people protected from HIV, as well as minimising the risk of other sexually transmitted diseases, which Truvada doesn’t do.

  • sobedoug

    @queerT: Yeah, apparently it’s fine for drug-pushing poz barebackers (such as this article’s author) to use “fear tactics and grief” to further their agenda, but it’s unacceptable for others (including those the author castigates) to do the very same.

    • Stache99

      @sobedoug: None of your babbling makes any sense. I didn’t see the author using “fear tactics” or any agenda beyond pushing something that could possible end this plague. For whatever reason you seem to have an axe to grind with the author. Go away troll.

    • Random

      @Stache99: It made sense to me.

  • gaypalmsprings

    Condoms were designed for vaginal sex not anal sex. Condoms are not the only solution, and they do not protect against all STDs. And I don’t know anyone who uses condoms for all types of sex, under all conditions, all the time. If you say you do, think again.

    • Random

      [email protected]gaypalmsprings: And yet condoms were pretty damn well for anal sex, otherwise, the HIV infection rate would be far, far higher. And even the CDC states that condoms can minimise – though not eliminate – the risk of other STDs, whereas PrEP ONLY works on HIV.

    • Stache99

      @Random: No great surprise.

  • Random

    @Stache99: Probably best you and your fellow Big Pharma shills recognise that people just don’t want these drugs so you’re wasting your time trying to make them happen.

    Nice try, though.

    • Stache99

      @Random: Maybe instead of just giving everyone your narrow minded opinions you should just defer to people more informed or better yet the ones that are actually using it. Many commenters are posting their experience with no ill effects.

    • Random

      @Stache99: Far too soon to say. The serious side effects will only be known in years to come.

    • Stache99

      @Random: One commenter says they’ve been on it for 6 years now. If in 10 years they find problems then they’ll advise people off of it. Simple as that. By then there will be something new anyways. Right now the pros outweigh the cons by far.

    • Random

      In 10 years it could well be too late for the kidney that has occurred. The pros only outweigh the cons for those people who don’t use condoms.

    • Stache99

      @Random: The people on this aren’t doing it in a vacuum. They’ll be monitored by the their doctors. As an example. I was on the toenail medicine for fungus. The doctor advised me to come off of it due to elevated liver enzymes.

  • Stache99

    I’ve noticed allot of online profiles popping up advertising themselves to be on this. I think this will by the new thing along with getting tested.

  • vive

    @Random, I think you misunderstand the protocol. As part of PrEP I get tested every 3 months for kidney function, so any change would get picked up right away. And in the cases where changes in kidney function have occurred, it reversed itself when the drug was stopped.

  • Random

    @vive: @Stache99: I’m more

    Enjoy your liver damage, body fat changes and endless visits to the doctors, just because you can’t be bothered to use a condom.

    • Stache99

      @vive: Ha. That’s what you get when you try to apply facts and logic to the irrational screamers. I think they need slut shaming in their as a way to feel superior to others. Kind of gives their pathetic lives meaning.

  • TVC 15

    I’m sorry, but those of you who keep fighting back and forth, don’t you have jobs? It’s incredible how much time you spend arguing on this site. I’d cut off your Internet access if you worked for me. You must be those people that “work” at Starbucks on their laptops. And some of the time stamps are from 1 am! Sleep, anyone? It’s healthy. Geez!

  • Daniel-Reader

    Remember Phen-Phen? It was supposed to be a miracle drug praised by all the medical groups until the actual side effects kicked in and destroyed people’s heart tissue. They lost weight but it came from expiring and having their flesh decompose off their bones. And remember when they said it was safe to use plastic wrap in microwaves and that turned out a lie since it melted into toxic chemicals on your food. You have to be skeptical when someone makes money off proclaiming certain results with anything. The FDA, etc. are a joke in many instances.

  • vive

    Truvada has been in use for many years. It is not like phen-fen.

  • Random

    @TVC 15: Thank you for taking the time out your busy schedule to make such a valuable contribution to the discussion.

  • buffnightwing

    I was so upset by the comments on here about this issue, that I registered. UGH

    Anyway, PrEP works and the new drugs work. I am HIV positive and 47. I found out late and have suffered bells palsy and shingles and 3 years of recovering. I watched friends die in the 90’s. Today, I am very healthy, feeling the best I have felt in 15 years now. These new drugs work extremely well. I am alive because of them. I HATE the drugs companies. But, the pills work.

    To not use this awesome amazing new tool in the fight to keep this nasty virus out of OUR community, we would be FOOLS.

    The arguments being made are ignorant of facts.

    I will personally be telling everyone I can about PrEP because of the comments on here.

    Stop being selfish and let’s actually help these young guys.

  • vive

    The only criticism I have with the article is, it is not a “little” blue pill. It is one big-ass blue brick, and we can only be grateful that gay men have less of a gag reflex than the average person. :)

  • Paco

    Mr. Weinstein really angered me with his “Party Drug” comment about PReP. He sees the same statistics we see with the rise in new HIV infections. He is well aware that gay men have troubles with using condoms consistently. He is also very much aware that if something did come along to dramatically reduce the number of new HIV infections, his funding would begin to dry up. There is room for rubber AND prophylactic medication. We would have been lining up for this drug years ago. I wonder if a future vaccine will receive the same type of irrational push back Truvada is seeing now.

  • DonW

    @vive: I’ve already heard from one friend who is self-treating himself with PrEP by ordering a cheap generic version of Truvada online. He’s not getting the consistent medical supervision that everyone reassures us all PrEP users are under, and there’s no guarantee the stuff he’s buying from India or wherever is the real deal. It’s hella risky and I told him so, but it’s far cheaper than what he’d pay out-of-pocket otherwise.

    I wonder how many others are doing this — probably more than we suspect.

    • Stache99

      @DonW: India is actually a very reliable place to get your drugs. I’ve ordered generic ED drugs for years and always go with India. Of coarse that’s just ED drugs.

  • DonW

    I’m just guessing it’s India — who knows. Many of these online “pharmacies” are fly-by-night operations that source their meds from any number of places; you don’t necessarily get the same stuff each time you re-order.

    ED drugs are a very different matter. I have tried different kinds of these, mostly Indian, with widely varying effects. But I sure wouldn’t entrust my life, or at least my long-term health, to an unverifiable website.

  • vive

    @Paco, yes well, if you think the anti-PrEP crowd is bad, just wait until the anti-vaccine crowd has a reason to get involved with HIV. :) The Gardasil craziness is only a little foretaste of what we’ll be having to deal with then.

  • vive

    @DonW, yes I think the only source for generic “Truvada” is India currently. The HIV drugs they make are a fraction of the price, and are reliable and used the world over – these are the same companies who legally export (other) drugs for use in U.S. hospitals, etc. But it is true that with mail order you have no guarantee of the source and that the drugs have been correctly stored.

    Even at a fraction of the price the generic will still set you back more than $100-$200 a month

    This brings us to the tragedy, that people, for various reasons but mostly related to shame, are unable to talk about this to a doctor, even people who have a couple hundred lying around to spend on self-medication and could almost certainly get it much more cheaply through insurance and/or assistance programs. The general gist of the comments here give a good indication of the reasons for the shame.

  • DonW

    @vive: In fact, my friend says one reason he doesn’t want to get PrEP through insurance (in addition to the higher out-of-pocket cost) is that he’s afraid his file will be marked as “high risk” (he’s self-employed and has had trouble getting coverage in the past due to pre-existing conditions).

    Even if the generics he’s buying are effective, and the dose correct, I’m concerned that he’s not getting medical follow-up and blood tests. He says he will ask his doctor for an “off-the-record” chat, but he is adamant about keeping it out of his chart.

  • Paco

    @vive: Oh yes. Gardasil. The vaccine that will turn America’s daughters into insatiable sluts, or cause mental retardation if Michele Bachmann is to be believed. Most of the arguments I have seen against Gardasil have been based on morality. I suspect something similar going on with PrEP now. Unfortunately, much of it is coming from our own community. Beneath many of the reasons why PrEP shouldn’t be embraced, I think morality is lurking.

  • vive

    @DonW, preexisting conditions cannot be used against you any more since the ACA was passed (and this would not be a preexisting condition) and I think there are also limits to how much more a “high-risk” person can be charged than a “low-risk” one. I would inform myself of the details of that, though I do understand his distrust of the insurance companies. Still, I hope he is 100% certain of the integrity of his source, since getting HIV due to heat-damaged drugs, for example, will screw you over much more than any insurance company will.

  • Paco

    I just wanted to add that while I am supportive of PrEP, I do have concerns about adherence with taking the drug as prescribed. I would feel more comfortable if they could develop a longer lasting formulation of the drug. I remember reading somewhere that monthly injections of some HIV medications were being investigated. Hopefully something like that could happen with PrEP.

  • vive

    @Paco, yes, I seem to remember a depo injection lasting 3 months being in the works. I may be off on the details. That would be great.

Comments are closed.