“I’m On PrEP And I Think You Should Consider It Too”

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The following op-ed was shared by Reddit user Massachoosite who explains why he recently decided to start taking PrEP, or Pre-exposure prophylaxis, an FDA approved daily pill which interferes with HIV’s ability to copy itself in your body after you’ve been exposed to the virus.

December 1st is World AIDS day, a day when we pause to reflect on the effects HIV has had across the globe and take a moment to promote research for a cure and strategies for prevention.

I deliberated for a while how I would mark this day. I had a post written out that was largely informative. I scrapped it. I know that the few times I’ve been anxious about the results of an HIV test, the only things that ever eased my nerves were personal connections.
So instead I thought I would tell you why I take a little blue every day at lunch time.

For those of you who don’t know what PrEP is, it stands for pre-exposure prophylaxis. It is a daily pill that HIV-negative people can take to prevent them from contracting that feared chronic disease. Taken daily as prescribed, it reduces the chance of contracting HIV through sexual intercourse by 99%. Taken almost as prescribed (taking it 4-6 times a week) still reduces risk by over 90%. It’s like the pill, but instead of pregnancy, it’s preventing HIV.

Needless to say, it’s a game changer.

I’m 26, I’ve been single for a few years and I’m sexually active. I don’t think any of that is out of the ordinary. I use condoms. Mostly. Prior to this month I would have self-described as safe-only but in reality there were more than a few times when the heat of the moment lead to the start of intercourse that was unprotected. Usually I fixed that.

There were two incidents in the past several years where I was concerned about the possibility of having contracted HIV. The most recent time was accompanied with an illness a few weeks later and a rash around my armpit that a quick Google suggested could be HIV rash indicative of a recent conversion. Apparently armpit rashes are rare, otherwise.

I don’t usually worry, but I was admittedly a nervous wreck. Despite the fact that penetrative anal carries a risk of HIV transmission in about 1 out of 900 cases, I was sure I had ran out of luck this time around. I was convinced that I was positive. Being fairly educated on HIV and having some positive friends, I knew that it wasn’t a death sentence. I knew that minus daily pills (I take vitamins daily already, not really a hassle), my lifespan would be unchanged and not much would change from the day to day. I would be monitored more closely by my doctor and wouldn’t be able to give blood, but I could still do all the activities I normally do and be an otherwise perfectly healthy human. With proper treatment, it would almost be like it wasn’t there. Or so the research suggests. But like I said, I’m single. The mental and social stigma was what scared me the most. Maybe that’s shallow or short-sighted, but it’s honestly what frightened me. What mattered to me was that most people don’t know that HIV+ people with undetectable viral loads cannot transmit it to their partners.

So I went to get tested. It had been a few weeks. In Boston, there is a clinic called Fenway Health that offers free STD screenings without an appointment every Wednesday. Not only is the testing free, but they use advanced 4th-generation blood tests that are 99.9% accurate up to two weeks. They also screen for Hepatitis and Syphilis. The nice thing about Fenway Health is that they are known for their LGBT-focused care, so everything about the visit was designed to make me more comfortable. Their staff was friendly, calm and knowledgeable and I started to think that even if I did come out positive, things would be okay. I understand how lucky I am to live in a city where this resource is available, but most areas offer free or affordable HIV screening as well.

A week later I received my results via email. Negative on all fronts. I felt less relieved than I thought I would, to be honest. Instead I felt motivated and empowered to take action to avoid that kind of anxiety again. I had read about PrEP enough on Reddit and other publications to know that I should be on it as a single gay man, but for some reason (nerves? laziness?) I hadn’t asked my doctor about it yet. This incident was all I needed to get off my ass and ask. After all, the CDC and WHO both recommend that all sexually active gay men take this pill.

After a careful discussion of the side-effects (a small amount of people experience nausea and headaches that usually pass) and implications (very rare reports of kidney or liver problems require that I get blood tests done every 3 months to ensure these do not happen), my doctor wrote me a prescription. I have okay-insurance and it came out to $35 for a 3-month supply. The drug-maker offers a payment assistance program for those who have higher copays that would make it difficult to obtain.

It’s been a few weeks, and now I take a little blue pill every day at lunch time. It’s really not a bother at all and I haven’t forgotten a dose yet. I’ve experienced no side effects. It’s all just… easy. In the few times I’ve had sex since I started taking PrEP I’ve used a condom or avoided anal. I don’t feel a desire to start having a lot of unprotected sex, because I still want to avoid the other STDs (ie: all of them) that PrEP does not protect against. Sure most of them have cures, but the daily pill is also a daily reminder to look out for my own health and to take what steps are available to me to prevent problems from occurring.

Being sexually active is a part of being human. It’s not something we should shame people for. Some people find rewarding relationships and only have sex with that individual once they have committed. Some people don’t find that or don’t want to and have sex with multiple people throughout their lives. What matters, regardless of what shape our sexual lives take, is that we look out for our own health and well being. I won’t tell anyone they should get on PrEP, but if you’re sexually active, even if you’re in a relationship, I hope that you consider it. I’m glad I did.

According to the CDC, “PrEP” stands for Pre-Exposure Prophylaxis. The word “prophylaxis” means to prevent or control the spread of an infection or disease. The goal of PrEP is to prevent HIV infection from taking hold if you are exposed to the virus. This is done by taking one pill every day. These are some of the same medicines used to keep the virus under control in people who are already living with HIV.

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With 50,000 new HIV infections each year in the United States, and no cure or vaccine available, prevention is key. When taken every day, PrEP can provide a high level of protection against HIV, and is even more effective when it is combined with condoms and other prevention tools.

Visit the CDC’s PrEP FAQ page for more information about Pre-exposure prophylaxis.