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Thursday, February 21, 2013

Derek Brocklehurst - A Year on PrEP, That's All He Wanted

After taking PrEP for one year, I found the love of my life and decided to give monogamy a try.

by Derek Brocklehurst
San Francisco, CA

I started PrEP (pre-exposure prophylaxis) in October 2011. I was presecribed Truvada "off label" before it had actually been approved for PrEP by the FDA (Food and Drug Administration.) FDA gave its approval in July of 2012.

I had an honest, open-ended discussion with my Nurse Practitioner and, without any judgment on his end regarding my frequent condomless sex practices, he said, "You would be a great candidate for this medication."

It was covered 100% by my insurance, and Gilead also offers co-pay assistance programs to cover the co-pay of the medication if you are prescribed it, so I literally paid $0 for this potentially pricey preventative.

I had zero side effects during the year I took it, and it gave me peace of mind. I was very open about my condomless sex practices with many multiple partners and, along with seropositioning, I believe it has contributed to helping to keep me HIV negative.

I think stigmatizing anything in our community is not the way to go, so PrEP should be just another option out there to help negative guys stay negative. It's also important to get regular (every 6 mos-1yr) kidney function tests to make sure it's not doing long term damage to your kids, as well as bone density tests and evaluations.

After taking PrEP for one year, I found the love of my life and decided to give monogamy a try. I stopped PrEP after just one year of daily adherence (I really never missed a dose! Every morning.)

It's always important to re-evaluate where you are at in your sexual life. If PrEP makes sense, talk to your provider and get on it! If it doesn't make sense to be taking a daily anti-viral medication that could have long term effects on other body systems, reassess and move on. I have found that honesty and communication are the best policies in any relationship: be it with my provider, my friends, or my primary lover.


  1. Great story! I love this. Everything you've written about, it's honesty and truth about open communication are exactly what's needed.

  2. Derek - Can you sign a waiver that you did not receive any funds from the Makers of Truvada or any other Drug Company writing this? And also, I take exception that you did not mention Condoms or Safer Sex in any of your writing. Not everyone has the exceptional insurance you have or the assistance of Gilead to purchase PrEP. I am glad you found love. That is great. Have a great life together. Just remember we are in the midst of a 13 to 24 year old wave of HIV infections and PrEP should alway have the message of Safer Sex and Condoms for some to stay off of PrEP and remain HIV -.

  3. Timothy dear, as much as Derek sent his idea, that what he believes and worked for him. He has his vast thoughts, behaviours for example when he mentioned multi sex partners and seropositioning but was still negative. In essence, the best preventive method is use of condoms but how many times have we spoken about use of condoms or rather the ABC methods but the raise of HIV prevalence among gay men is escalating. Of course not everyone might or can afford PrEP but the mainstay here is Prep is withing the comprehensive prevention buffet which include condoms, safer sex, risk reduction counselling etc etc and possibly a microbicide in the near future, let anyone who would want to choose anything on that buffet and is willing to use it go ahead. On the Gilead issue may you please read some articles to the right hand side of this blog you might get to understand that there are no pharmaceutical companies that are asking people to market their drugs but individuals who wants to share their experiences.

  4. It should be noted that anyone in the United States who has no insurance, inadequate insurance, and meets income requirements can access Truvada as PrEP for FREE through a Gilead assistance program. Here is the link to the form that needs to be filled out by prescribers and patients:

    Here is the main website for Truvada as PrEP There is info there for patients, providers, and educators. Gilead is also helping providers by supporting the full cost of HIV testing, and is making condoms available for free to anyone who wants to order them.

    It should be noted that other drugs are being tested as PrEP. Truvada is just the first drug out of the box, but we will likely have others. And some of these drugs may be delivered as pills, but others may come in the form of an injection that is long lasting. Some of these drugs are also being put into gels/lubes, vaginal rings, and thin films and used as microbicides that would prevent HIV.

  5. Brian, NewPrevTech thank you for chiming in. I appreciate all posts here. I second all of the latter 2 posts. Timothy, let me ask you: whenever you use Lifestyles, Durex, Trojans or other brand name condoms, are you signing a waiver as to not officially represent those brands, when you leave them out in your home, or carry them with you? I feel similarly with Truvada. It's a brand and it's just another (yes, expensive) preventative measure to help keep me HIV negative.

    So, thanks for posting this and clarifying. No i didn't sign a waiver, YES i work with marginally-housed populations and underserved patients (i'm a nurse) and understand what it means to not have insurance. Luckily, at least in SF, there are many means to acquire preventative measures to help keep people HIV neg (see above link)


  6. Brian - I have never been a spokesperson for any condom maker, drug company, or AIDS Service Company. I appreciate that Truvada has kept you negative. I also appreciate that you work with marginally-housed populations and underserved patients. Just the kind of folks that often do not have the funds for medicines, much less a prevention drug that, if they have insurance might not cover or the expense of the drug out of pocket. Let us all be warriors stopping HIV transmissions as much as we can. Condoms work. Microbicides work. You know your self and how important it to take your medicine on time and regular. So with that model we know you have remained negative. Let's hope anyone else on Truvada has the same experience. Also, I hope you had not side effects either taking Truvada. Lets hope the manufacturer does long term studies on the drug and side effects if you take the drug a long time. By the way my partner is an RN in NYC. Be well. Timothy

  7. Thanks for this great conversation. Just want to make note that microbicides have not been proven to work - there are no vaginal or rectal microbicides that have been proven to be both safe and effective. There are no microbicides available to anyone outside of test products in clinical trials. There was one vaginal microbicide trial that found a gel with the drug tenofovir in was 39% efficacious - but that result is still being confirmed in another trial that is ongoing right now in South Africa. Rectal microbicide trials are further behind (as it were) - and have yet to reach Phase III efficacy trials. The very first Phase II rectal microbicide trial (ever), which will be testing safety and acceptability of a reduced-glycerine tenofovir gel, is about to enter the field in a number of countries in the coming months. If all goes well there, in a few years, that product could go into Phase III to test whether it actually works to prevent HIV. The earliest we might have a safe, effective rectal microbicide would be late in the decade. On the vaginal side, we might have a microbicide coming to market mid-decade.

  8. If I could chime in here: How dare people criticize Derek for his responsibility. Derek is brave. He chose to tell his story that could be taken fearfully by many public health nazis and the sex negative scare mongers. Derek is a role model who is honest enough to tell it like it is and not be guilt-led into making politically correct statements. In my my mind he is a hero in "defending those who are demonized." He's informed and responsible.
    And by the way PrEP is just another tool for HIV prevention. Condoms will never be the end all and be all. They fail, they break, and are used incorrectly. Be real. PrEP is critical as an added tool.



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