PrEP, at last

Timothy Kincaid

December 9th, 2015

IMG_4155The last step in my quest for pre-exposure prophylaxis (PrEP) is complete. My liver is functioning fine and I received clearance to begin the process. I’ve taken my first pill and in about seven days I’ll be effectively immune from the virus.

In a few weeks I’ll return to the doctor for tests to determine whether my body is acclimating to the medication or if side effects have occurred. And, going forward, I’ll require testing every three months.

But finally! Hallelujah!

Lord_Byron

December 9th, 2015

Congratulations.

NancyP

December 9th, 2015

congratulations!

WayneF

December 9th, 2015

Congratulations Timothy!! SO happy for you!!

Mary in the ABQ

December 9th, 2015

This is great news!

Timothy Kincaid

December 10th, 2015

Thanks all

David Nelson

December 10th, 2015

so for $1500 a month you don’t have to use condoms (who casres about clap and syphilis ), share needles (who cares about hepatitis c ), and give head with sores in your mouth. congratulations

Priya Lynn

December 10th, 2015

Is it really $1500 a month?

Timothy Kincaid

December 10th, 2015

In countries which have not approved PrEP, the medication is not covered by public or private health plans and must be paid out of pocket. Cost for Truvada is about $1,200 to $1,500 per month but there are generic equivalents made in India for much less.

Currently only the US, France, and South Africa have approved Truvada for PrEP.

In the US, private health care covers the prescription and Gilead, the manufacturer, covers co-payments. For me, the drug is free.

Eric Payne

December 10th, 2015

@David Nelson,

Thank you. That’s the point I’ve been trying to get across as well, and — thus far — the overwhelming response I’ve received is, to paraphrase: “Who are you to tell me what level of intimacy I can experience?”

I guess I just don’t understand the need to let someone cum in you ass, or just never fully developed an insatiable craving for the taste of cum.

Eric Payne

December 10th, 2015

Timothy,

So you’ve got “PrEP at Last.”

And you get it free.

Good for you.

As someone who’s enslaved to cardiac medications, as well as medications to offset the effects long-term usage of those cardiac medications have wrought on my body (gout and kidney failure being the biggies), remember that missing dosages of your medication, however accidentally, can result in a painful death.

And I’ll make you a guarantee: The longer you’re on medication, the more likely you are to forget to take it… since taking it becomes such a habit, you don’t remember you didn’t take it until either the next day (if you separate your medication into daily dosages in some type of holder, and you see yesterday’s are still in their place when you remember to take today’s), or you have extra pills in the bottle at the end of the month.

Now, I’m lucky. If I forget mine enough times, I’ll just feel a great big electrifying pain, and go into a fatal face plant.

You forget, and potentially… well… it could be long, drawn-out, emotionally draining and pretty damned ugly.

But I’m sure you’ll be fine.

Lucrece

December 11th, 2015

Nelson, I don’t think Timothy is who should be worrying about getting his hands on this drug ;)

You should be less annoyed with him and more annoyed with the sellout websites like Towleroad and similar shills who will be marketing this to young gay men who we all know will treat take this pill as an excuse to not use condoms much like how women use their pill to avoid those as well. And then the government will have to foot the bill lest they face a bunch of protesters throwing themselves on the streets over budget cuts to AIDS medication.

Nathaniel

December 11th, 2015

Timothy,
I have a friend who started Truvada, and he experience severe exhaustion, erectile dysfunction, etc. He thought it might be recent changes to his diet and exercise routines, but it persisted for months. He finally talked to his doctor and found out his problems were likely side effects of Truvada. Long story short, do be on the look out, because the side effects are real possibilities.

Timothy Kincaid

December 11th, 2015

Thanks Nathaniel. So far I can’t tell any difference, but I’ll definitely keep an eye out for any possible side effects.

Lord_Byron

December 11th, 2015

On the topic of side effects,

All medication has possible side effects, some are just worst than others. I’d take ED over the possibility of liver failure or acidosis which can lead to coma if not treated.

At least people on PrEP can stop if they experience severe symptoms. I’d rather be in that situation rather than the current one where if I miss a dose I could end up with a mutation that could kill me in the end.

Larry Gist

December 16th, 2015

To all of you who are holier than thou and think that the ONLY way to get HIV is to have someone cum in you, let me give you an education. Meet – me. I was once in your boat, I wouldn’t let anyone NEAR my ass without a condom on. When I was 37 I met a guy that was so beautiful it hurt to look at him. We fooled around MANY times, but never taking the anal plunge. I would jack him off a LOT, and he would do the same to me. Then one day a few months after we had been fooling around for a while I got a cold I couldn’t shake, in August. I was watching an old episode of CSI and the Kathryn character was going through a litany of early HIV symptoms, in my head I was mentally checking off the entire list. So I called my local HIV outreach center and went in and got tested, Positive. After YEARS of being so careful how could this happen to ME I cried! Well it turns out that Mr. Gorgeous was also newly positive and didn’t know it and I have a perinichea condition that causes me to almost have chronic hangnails that crack and bleed often. I had been infected by getting his HIV+ semen on my fingernails. So please spare me your “I would never let some one do me without a condom” and “I am not a cumslut” crap – this is an equal opportunity disease.

Larry Gist

December 16th, 2015

Dear Eric Payne,

Can you forget your medication for about a week or so? I have had enough of you already…

Me

Timothy Kincaid

December 16th, 2015

Thank you Larry for reminding us that things aren’t always in simple black and white terms.

Eric Payne

December 17th, 2015

@Larry Gist,

If it weren’t for bad luck… and your infection is just that. Bad luck.

There’s a huge difference between an open-sore and bad luck, and bodily-fluid deposit regular, repeated exposure, though.

Pre-Exposure Prophylaxis. PrEP. It’s right there in its name: exposure to HIV is, simply, assumed… so a healthy person starts a regimen of this drug (well, actually, two drugs combined into one pill).

All to alter the biochemistry of a healthy person so that their body can keeo their viral load undectable.

Does that make ANY sense at all?

You were cautious, both as a sexual partner and in your sexual play, but you contracted the virus via a source of contact which could not be statistically calculated.

Tim, and others utilizing Truvada are talking about purposely engaging in behaviors that have led, historically, to over 85% of ALL infections, up to present day.

And that’s before there’s any long-term usage data associated with the drug. Yes, right now, it seems safe, with nausea being the major “side effect.” But 10 years from now, after 10 years of continued usage? How about 20? Don’t know, and there’s no way to tell except to take it and wait.

If a comparison were to be made in… oh… automotive safety features: It’s like saying any person in a car should wear driving gloves, but the seat belts can be removed.

Priya Lynn

December 17th, 2015

I think it would be prudent for anyone having sex with multiple partners to use condoms and take PREP. Condoms by themselves aren’t foolproof.

Timothy Kincaid

December 17th, 2015

All to alter the biochemistry of a healthy person so that their body can keeo their viral load undectable.

Does that make ANY sense at all?

No, it doesn’t make any sense at all. Because that is not what PrEP does.

What PrEP does is alter the biochemistry of a healthy person to make them immune to a particular virus. Much like a vaccine changes does.

Tim, and others utilizing Truvada are talking about purposely engaging in behaviors that have led, historically, to over 85% of ALL infections, up to present day.

No, that is completely false.

At no point here have I proposed, pondered or discussed “purposely engaging in behaviors” at all. I suggest that you stick with what has actually been said, not what you imagine about the sex lives of others.

Eric Payne

December 17th, 2015

@Timothy:

No, Truvada doesn’t make a person “immune” to HIV, what it does is inhibit growth of the virus in a recipient’s system via protease inhibition, so that the virus cannot replicate, in its current form. Without being able to reproduce, the virus, while still in the system, is undetectable (again, in current testing procedures). So while a person continues taking PrEP, their “viral load” is “undetectable.” But. They. Are. Still. Presumed Infected… so if they cease the medication, and their body chemistry returns to “normal,” the retrovirus is still in the system… but the system is returning to a state where it can begin replicating.

Alnd, Tim, I don’t spend my time fantasizing about anyone’s sex life. I apologize for attributing to you comments about sexual activity; it was actually Jim (Burroway) who publicly chastised me: who did I think I was to dictate the level of intimacy he had with his partner, who is positive?

But if a person so desperately wants to begin PrEP that his search for PrEP is recounted in a multi=part journalistic endeavor… and that person then begins PrEP therapy (changing insurance companies along the way), there’s a reason for it outside of news reporting.

Timothy Kincaid

December 17th, 2015

No, you are flat wrong.

The virus does not take hold in a person’s system. And They. Are. NOT. Still. Presumed. Infected.

That is complete BS.

And if they cease the medication, the retrovirus is NOT in their system.

And please stop speculating on what you imagine what might be my “reason for it outside of news reporting”. Frankly, it’s a little creepy.

Nathaniel

December 17th, 2015

Eric, the entire point of regular testing WHILE on PrEP is that you should you become infected, you can be switched to disease treatment, rather than disease prevention measures. I.e. the drug doesn’t just “keep their viral load undetectable,” but actually prevents infection from taking hold. I have known men who have started PrEP, then stopped when they were no longer in a risk group (i.e. known, exclusive partners with known negative statuses). They didn’t suddenly come down with AIDS, and are HIV-free, which is the entire point of the drug. BTW, these men took other measures to protect themselves. If the point of any anti-HIV measure is to stop the spread of HIV, and if no measure is 100%, it makes sense to have as many people possible taking as many measures possible to protect themselves and their partners. Denying people access to those measures out of self-righteous indignation is completely counter to the goal of ending this disease. It is also entirely unrelated to your own medication and health issues, which are legitimate concerns that society should ALSO be trying to address. Fixing one problem doesn’t mean we can, should, or will ignore other important issues.

Lord_Byron

December 17th, 2015

So, continuing with the PrEP theme, the AHF recently released a letter about the “failure of PrEP.”

http://www.advocate.com/hiv-aids/2015/12/17/aids-healthcare-fdn-ads-call-cdc-prep-plan-failure

At the link they have an image of what is going to be in gay magazines and newspapers nationally.

It’s kind of funny because one of the comments they make on PrEP is how few gay men are on it. On most sites that I’ve come across the majority point out that the insurance companies and doctors’ willingness to prescribe limits it.

Eric Payne

December 18th, 2015

Timothy,

In recounting your quest to begin PrEP treatment, you state:

I’ve taken my first pill and in about seven days I’ll be effectively immune from the virus.

And in response to one of my comments, you say:

What PrEP does is alter the biochemistry of a healthy person to make them immune to a particular virus. Much like a vaccine changes does.

Tim, Truvada DOES NOT PROVIDE IMMUNITY FROM HIV.

Even Gilead Labs — maker of Truvada — says the medication is to be used IN CONJUNCTION with condoms. Gilead also considers, at least on its Truvada website, that the medication should be used only by those in the highest risk categories of HIV infection, and not by everyone.

Go digging into those pages, and one finds even more information by Gilead as to how the medication works, what it does, the possible side effects — a few of which, like liver and kidney failure can be fatal in and of themselves.

But “immune”? Gilead makes no such claim.

And that’s what scares me. Do you remember the 1980s, and the “cure of the month”?

I do.

New drugs, like Truvada, make it to market very quickly, What, prior to the 1980s, was once a years- to decades-long rigorous testing of new pharmaceuticals/therapies by government agencies became a months long process, and the market has been flooded with new medications from Ambien to Xarelto, because the process for approval was changed.

And that process of approval was changed only because AIDS forced it to change; had the process not been “sped up”, the death toll would have been staggering.

Even with these more relaxed standards, Gilead doesn’t claim HIV immunity.

But you do. At least twice, above.

As for your comments about your perception I’m fixating on your sex life; I explained I didn’t, and don’t, give your sex life a thought at all, but you insist I am “creepy” for even considering it.

Again, referring to Gilead’s own Truvada website:

TRUVADA is indicated in combination with safer sex practices for pre-exposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV-1 in adults at high risk. This indication is based on clinical trials in men who have sex with men (MSM) at high risk for HIV-1 infection and in heterosexual serodiscordant couples.

Uninfected individuals at high risk for sexually acquired HIV-1 infections include:
individuals with HIV-1 infected partner(s)
individuals who engage in sexual activity in a high prevalence area or social network and have one or more of the following: inconsistent or no condom use, diagnosis of sexually transmitted infections (STIs), exchange of sex for commodities (money, food, shelter, drugs), use of illicit drugs or alcohol dependence, incarceration, and/or sexual partners of unknown HIV status with any of the above risk factors.

And that’s the extent of my thinking about anyone’s sex life: if they want to go on PrEP, they want to have sex.

Timothy Kincaid

December 18th, 2015

The test results show that during the trials no persons who correctly and consistently used Truvada as PrEP became infected with HIV.

As with all drugs, haphazard or inconsistent usage leads to less effectivity. But it appears that for every participant so far who took the drug daily (or 4 times or more a week) did not contract the virus.

Eric Payne

December 18th, 2015

No, Timothy, it does not show they did not contract the virus.

It shows they have no viral load — that if they do have the virus, at present, the medication is preventing the virus’ ability to strip out of its host RNA those chains it then rearranges to become a copy of itself, so that the amount of HIV in the system, if present, is in such a low quantity, it can’t be counted.

And if the virus which with a person is infected does begin to replicate, according to Gilead, it is then time to change medications to the more virulent protease inhibitors, as the lower molality protease inhibitors of Truvada are no longer sufficient.

But reading through all the material provided by Gilead, nowhere is any immunity, immediate or ultimate, ever even implied/inferred.

Timothy Kincaid

December 18th, 2015

Eric,

You are making false statements. They DID NOT contract the virus.

For some reason, you keep insisting on things that are not true. I don’t know your motivations for this falsehood, but you either need to provide evidence that those who used PrEP properly contracted HIV or I will delete any future comments which make false assertions.

I believe in letting you state opinions including (or especially) those which do not agree with mine. But you cannot use BTB to propagate claims of fact that are false.

Eric Payne

December 18th, 2015

Timothy,

Having no viral load is not the same as being uninfected. HIV is detectable, at present, after it has replicated to a certain point.

All the material at Gilead, even the PR material, make it a point to use the term “undetectable.”

But go ahead. Delete all you want. That’s within your power.

I had thought, if nothing else, the 1980s and 1990s taught our community one thing: When it comes to HIV infection, accurate information kept us alive.

Guess I was wrong. So go ahead. Gamble with your life.

But it’s wrong for you to help justify your gamble by persuading others to gamble with theirs. Especially when you start bandying about “immunity” that doesn’t exist.

What Gilead clearly states is the purpose of PrEP:

To provide another layer of protection; PrEP with the use of condoms offers those at the highest risk a better chance of being less likely to become infected by preventing HIV-1 replication, so that it is undetectable by current testing procedures.

Timothy Kincaid

December 18th, 2015

Eric,

You’ve made your last comment that states, implies, or suggests that those on PrEP become infected with HIV.

You have nothing – zero – to back up that assertion and it WILL NOT be propagated here.

You are perfectly welcome to state your opinions about those who use PrEP so long as you don’t make false statements of fact. That part is over.

Priya Lynn

December 18th, 2015

Eric, when Gilead says those using PREP will have undetectable viral loads they are not saying the virus is necessarily present or the person is infected – it may or may not be. People who are uninfected, who have not a single HIV virus in their bodies will also have undetectable viral loads. You can’t jump to the conclusion that someone must be infected with HIV when a company says their viral loads are undetectable.

Timothy Kincaid

December 18th, 2015

No, Gilead DOES NOT “say those using PREP will have undetectable viral loads.”

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