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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.

Wednesday, February 20, 2013

Interview Part 2: Toronto Health Promoter Chooses PrEP

via Positive Lite (Canada)

Part 2 of an interview with Len Tooley, an HIV-negative gay guy who is taking pre-exposure prophylaxis. He works in Toronto as a gay men’s health promoter, HIV educator, tester and counsellor. In this part of the interview, he discusses the conversations he had with his doctor before getting a prescription for PrEP.

It took about four appointments for me to actually get the prescription from my doctor. The first time I mentioned the idea he told me that before we considered it, we’d have to have a lengthy discussion about what was going through my mind when I decided not to use condoms. I told him that I wished it was that simple (I’m an HIV counsellor after all), that it wasn’t as simple as a ‘yes or no’ decision, and that I could guarantee him I was trying my absolute hardest to have perfectly safe sex. I just wasn’t succeeding perfectly.

At the second appointment (I was there for something else) I again brought up the idea of PrEP. This time he was still a bit hesitant, and told me that if he was going to prescribe PrEP I was going to have to get blood tests to test my kidney and liver functions and make sure I was HIV-negative, and then, depending on those results, we could talk about it more. I agreed, he gave me the test requisition, and that day I went to a lab and got my blood work done.

Once I knew my blood work results had arrived, I scheduled another appointment and saw my doctor. He confirmed that I was still HIV-negative and that all my kidney and liver function tests were okay. I was pretty nervous and excited. He asked me what I’d do if I experienced the side effects of the medication. I told him that I knew that only about 5% of people in studies of the drug had reported side effects, so it wasn’t too likely, but that if I did have those side effects I’d reconsider staying on it if they didn’t go away and became intolerable. Then I told him that I knew there could be longer-term side effects, but that right now it was probably better for me to go on Truvada temporarily while I feel I’m at risk for HIV, than get HIV and have to take that drug, or other drugs, for the rest of my life.

Read the rest.


Aidsmap---PrEP wars: debating pre-exposure prophylaxis in the gay community

via Aidsmap, by Gus Cairns

Last World AIDS Day, 1 December 2012, Online Buddies (OLB) Inc. (the company behind, one of the most popular gay online dating sites in the US, and its affiliated health education site Manhunt Cares) sent out a bulk email to its members informing them of its World AIDS Day campaign to increase awareness of pre-exposure prophylaxis – PrEP.

PrEP means HIV-negative people taking antiretroviral (ARV) drugs to stop them from acquiring HIV infection. A series of trials two years ago, including the iPrEx study in gay men, showed that PrEP could prevent more than 90% of HIV infections in people who took it consistently, but also that a lot of people in the trials didn’t take it enough, or at all.

The US Food and Drug Administration (FDA) approved tenofovir plus emtricitabine (Truvada), the two-drug pill used in the trials, for use as PrEP, in July last year.

The European Medicines Agency (EMA) is still considering approval. Throughout Europe, centrally funded health systems are likely to demand more rigorous guidelines on targeting and budgeting before authorising PrEP.

In practice, uptake rates in the US have been low and not many HIV-negative men are aware of this new HIV prevention option. In conjunction with Fenway Health, the LGBT sexual health centre in Boston, and the Harvard School of Medicine, Online Buddies researched Manhunt’s users and found that even after the iPrEX study results1 were announced, only one in five of its users were at all aware of PrEP and only 1% had ever used it, though when given a description of it, nearly 80% said they potentially might.2

For those depressed by ongoing high HIV incidence rates amongst gay men and impressed by the PrEP trial results, a campaign to alert the community to the possibility of this new HIV prevention method was needed.

“One of our guiding principles is to fill critical gaps in health promotion campaigns,” says David S Novak, Online Buddies’ senior health strategist. “Normally, we spotlight a variety of different issues, but this year PrEP was the obvious thing.”

Wednesday, February 13, 2013

Toronto Health Promoter Chooses PrEP

via Positive Lite (Canada)

Interview with Len Tooley, an HIV-negative gay guy who is taking pre-exposure prophylaxis. He works in Toronto as a gay men’s health promoter, HIV educator, tester and counsellor. In the first of three interviews about being on PrEP, he discusses his decision to go on it.

I’m not perfect – even if I wish I was.  
And I have to admit, I haven’t had perfect condom use throughout my life. I’ve managed to stay HIV-negative for quite a while, but this was partly a combination of “responsible” condom use and – when “not-so-responsible” – luck.  
Those moments when I had done something that I knew might put me at higher risk often led to a lot of anxiety. Not constant, overwhelming anxiety, but one that prevented me from feeling good (meaning, guilt free and shameless) about the awesome sex that I had had. 
Read the whole thing on Positive Lite.


Monday, February 4, 2013

Next-PrEP clinical trial launches in U.S. cities

Next-PreP study is currently enrolling

Despite our best efforts to prevent new infections, more than 50,000 people in the U.S. are infected with HIV every year as reported by the Centers for Disease Control and Prevention (CDC). We know that young ( aged 21-35) gay, bisexual or other men who have sex with men are becoming infected more than anyone else. This is especially true among young men of color. While condoms are effective in preventing HIV, we know that people don’t always use them. For that reason we are trying to find new ways to prevent HIV. Next-PrEP is a study using three drugs to prevent HIV in HIV negative people; this is known as pre-exposure prophylaxis or PrEP. The idea behind PrEP is that if an HIV-negative person takes certain pills on a regular schedule before they are exposed to HIV through sex, they may be protected from getting HIV infection.

We know that two of the drugs that will be used in this study are safe for people who are HIV positive. However, we want to see if they are just as safe and easy to tolerate in people who are HIV negative. This will be the first study to see if the drug maraviroc is also safe and tolerable when used by HIV-negative people as an HIV prevention strategy. We will test four different combinations of medications.

NEXT-PrEP is currently enrolling a total of 400 men and transgender women aged 18 and older who have sex with men from 13 cities in the United States and Puerto Rico. In early 2013, the study will begin to enroll a total of 200 women and transgender men aged 18 and older who have sex with men.

This research project is funded by the U.S. National Institutes of Health through the HIV Prevention Trials Network and the AIDS Clinical Trials Group.


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