Interview Part 3: Toronto Health Promoter Chooses PrEP - "Maybe I should get a t-shirt made that says 'Truvada Whore' on it"

via Positive Lite (Canada)

Part 3 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.

Excerpt:

I wish that I could be 100% certain that even if I used a condom every single time I had anal sex I wouldn’t get HIV. I also wish that condoms could be made out of a magical material that didn’t have any texture, scent, colour or substance – but I know that not all my wishes can come true!

But I’ve had to admit to myself that I’m not perfect at using condoms 100% of the time, and, because I’ve been working as an HIV tester and counsellor for so long, I know that a lot of gay men that I provide HIV testing to aren’t perfect either. And that’s not because we’re not trying, it’s because we’re not robots. I can also admit that condoms aren’t some invisible barrier that doesn’t impact the quality of my sex life at all. Condoms aren’t easy to use, and for me (but not for everyone), they make sex a lot more difficult. I wish it wasn’t so, but alas, it is.

Read the whole thing. You can catch the first and second segments of this interview at this link too.

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.

Excerpt:

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 Manhunt.net, 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.”

Read the rest on Aidsmap.