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Tuesday, March 11, 2014

PrEP provides peace of mind and relief... and I don't want to be on it forever


by J.

 

 Like most people I have talked to on PrEP my sexual habits haven’t really changed. 
I’m still a hopeless romantic looking for the right guy, sometimes in the wrong places.
I’m still not perfect with condoms, but I also have
confidence that I am still protected.
 

   
Growing up in the 80’s and 90’s HIV/AIDS was everywhere.  The news consisted of periodic death updates just like during the Iraq war.  Because I have always been a person who devours any type of knowledge I knew all about the disease but didn’t think about it in relation to myself.  Health class told me more, but I didn’t really pay attention because it was the standard fear mongering talk which said any sex was going to kill me. 
 
It didn’t hit home until my junior year sociology class where my teacher brought in a speaker who had AIDS.  He talked about the treatment he endured at the time including things like injections in his eyes to try and stave off blindness.  For the first time I with my eyes what the disease could do, and for a guy questioning his sexuality it was shocking.
 
 

After I came out sex for me was always varied, top, bottom, oral, it didn’t matter I loved it all.  Like most men I can’t say that I was always safe.


Despite the vision of the man in my soc class, and my better judgment, a hot man could still make me
do dumb things.  Soon I met the first guy I dated who was HIV+.  We usually used condoms, but when he told me not to put the condom on as he laid on my living room floor I complied.   Despite being educated I thought I was going to end up positive from that encounter.  I dated him for over two years before it ended.  It was only then that I had the courage to get tested. I had resigned myself that there was a good chance that I was positive from the occasional lack of protection, despite him being on treatment.  Again it was negative, but this time it had a lasting impact. 

From that moment I forward I always got tested 3-4x a year, but I still couldn’t say my practices were perfect, I am human.  As I grew up I gained knowledge, and wasn’t afraid to get tested anymore, yet it was always a nerve racking experience.  I still wasn’t perfect with protection, and I knew it wasn’t foolproof either.

The inevitable “promises to myself” would come on testing day that if “I’m just okay this time I won’t do that bad thing again”…

 
Bad boy!  This coming from an exceptionally rational person, it didn’t make sense even to myself.  Hoping and praying is not a substitute for real prevention based on science. 

HIV still one of those topics that people still talk about in hushed whispers saying things like “you’re clean right? okay, just don’t cum in me”  While recognizing the sheer idiocy of such flawed logic, I was not immune to this method of “prevention”.  The complete failure of this method of prevention hit home in 2012 when two good friends tested positive.  The emotional side of me was shocked, the logical side expected it.  Looking at the stats, I figured I was eventually going to be a statistic.

I don’t remember where I originally heard about PrEP, but what stood out more than anything was the figure 99%.  With that I devoured every article I could find on PrEP and Truvada.  I have a healthy skepticism about many articles about HIV treatment, prevention, cures etc.  You can only hear “a cure or vaccine is two years away” so many times before you become dismissive; yet in this case I was enthralled to find that PrEP was something that actually worked, and with that I knew it was for me.

I have always been open with my doctors because I figure there is no way they can help me if they don’t know the true story.   Because I was so honest the discussion was easy, I knew I was in a high risk group, and my doc agreed.  Within a week I had my prescription.  PrEP isn’t cheap, but luckily it’s covered by most insurance.  Also, Gilead the drugs manufacturer has an assistance program that covers much of the cost for many people. In my case it took a couple phone calls and faxed forms to make it cost me less than $20 a month.  Insurance or not, it is available. 
 
  
Before I started I was nervous about side effects.  Unlike many people I take very little medication, Aspirin for aches and pains, and Nyquil if I get sick is about as far as I usually go.  With that in mind I took my first pill on that warm July day in 2013.  After dating a few poz guys and reading up on the medications, I expected some side effects, but luckily for me I didn’t have any, even when first starting the medication. 

 

That first month I missed two doses. 
 
 

This annoyed me because I knew I needed to do this correctly for the protection I had wanted for so long.  That problem was solved with a $1 pill case.  A pill case would be my #1 recommendation for any “PrEPer.”  All you do look at the pill case and say, “Is the pill in there today?” take it, if not, you’re good.  I haven’t missed a dose since.

What PrEP has really allowed me is peace of mind and relief.  The testing anxiety that would come around every three months prior to PrEP is gone.  Before, I would get nervous even if I had done nothing dangerous. 

Like most people I have talked to on PrEP my sexual habits haven’t really changed.  I’m still a hopeless romantic looking for the right guy, sometimes in the wrong places.  I’m still not perfect with condoms, but I also have confidence that I am still protected.  Like myself when I was younger many people still don’t get tested enough.  It doesn’t matter how good the trade from the bar looks, if his test was a year ago, how can you be sure he’s negative?  Even if he’s not and you make a bad choice PrEP has got you. 

Now 8 months in, I can honestly say PrEP is one of the best things to happen to me.   I don’t want to be on it forever, but I REALLY don’t want to be on HIV medication the rest of my life for a disease that can kill. 

 
To me it’s one of the most important developments for gay men in the last 30 years.  We are no longer dependent on just condoms to prevent the disease that killed a generation of gay men.  I personally see it as the gay version of birth control.  Yes, you should still use other methods, but PrEP is there when you don’t.

 Three things have changed for me in the time since I have been on PrEP.  I am now much more comfortable talking about HIV, and prevention.  Coming from a person who used to work in prevention I always used to feel like a hypocrite because I didn’t use a condom every time yet that’s what I preached, PrEP empowered me to tell people to take a stand against HIV even if they forget the raincoat. 

Dating HIV+ guys has also become a non-issue, I had no problem with it before, but it was always on my mind.  With PrEP, I am more concerned about who is coming out for happy house. 

The third is that my wallet is lighter by $20 a month.  Even if it was $100 or more I would pay it.  Ask a senior, you can’t put a price on health, pay now or pay later.       
 
I’m open about being on PrEP with friends and acquaintances.  If they want to judge me, let them.  I would much rather let people know about something that can protect them against the cheating boyfriend, guy lying about his status, or person who never gets tested. 

There is no reason to be ashamed of protecting yourself.  HIV is still very much real, we can talk about it, and protect ourselves or we can ignore it, for me I will choose the 99% effective PrEP.   
 

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