bearbandit

If you can get hold of PrEP, the side effects, which are not compulsory - less than 20% have them, in HIV negative guys seem to run to nothing more than a bit of nausea and a bit of diarrhoea. Really nothing more than a few days of that fish you got out of the freezer and thought was alright. It's true that tenofovir can cause kidney problems, but any physician in a position to prescribe truvada will be thoroughly aware of the markers to look for, at which point your PrEP prescription ends while your kidneys recover. PrEP is a single pill a day - if I were negative and on PrEP I'd wash it down with my morning cuppa tea - and a big weight off your mind. You have the bonus of regular health checks, more thorough than usual, and better observation of your physical health. Yes, if you go back through the archives you'll find some posts from me that are very anti PrEP, but I've changed my mind to the extent that I wish to fuck that the authorities here would just accept the USA experience and permit its use.

One thing that helped me enormously, though it sounds silly, it wasn't so silly in the eighties when there was no therapy was to imagine the virus as literally a bug and send an imaginary pest control guy through my system. When I did start medication I stopped this fantasy, but even today if I have a dream that involves insects I know I'm subconsciously worrying about HIV. The other thing I still do is to refer to "my little passenger" - after all it depends on me for life support, but erm, it ain't going anywhere because it's so bombed out on all the antivirals I keep throwing at it...

Thank you! I can get my tongue around Welsh but for some reason that name always escapes me.

I'm glad you're so much calmer now - and kudos for posting an apology: it can't have been easy! There are few things worse than not knowing some vital bit of information like viral load, and isolation makes it worse. In the UK the National Long Term Survivors Group runs weekend-long courses for people who are within about two years of diagnosis, which are very well received by the people who attend them. If you can find something like that in your area it's almost certainly going to help even if it's just an hour a week. (At the Newly Diagnosed weekends, like the Long Term weekends, most of the real talking is done in the bar!) The trippy dreams side effect is experienced by up to 20% of people taking efavirenz, a component of atripla, and by a very few taking FTC whose medical name I can never spell. The effects can range from a hangover-like feeling on waking to extremely vivid, often bizarre dreams (apparently the sexual ones can be a lot of fun). Unfortunately the feeling of trippiness can extend into the waking hours (which is why doctors advise taking them at night). One guy I know used to describe efavirenz as "free acid", and there's an urban myth about a crane driver doing over half a million pounds worth of damage while still tripped out on efavirenz. For that reason, many doctors in the UK won't prescribe atripla or efavirenz to anyone doing a job that requires any form of precision work (a friend, who is a pharmacist, was told by his doctor that when the time came for drugs, he wouldn't prescribe efavirenz or atripla. I have to admit that I'm merely reporting what people I'm working with have said: I've never taken the drug. The FTC dreams are rare - it took us at myHIV a long time to find the references. For me I dream of family members and they dreams are intense enough that I think they're still alive, a feeling which persists for several minutes after waking and which can be very confusing at first. The safety margins are much, much higher now: up till about 2003 drugs tended to be fast tracked onto the market and little was known of the correct dosage, so people taking them were taking fairly large overdoses. You're right in that most drugs are processed through the liver, so be nice to it. No getting falling down drunk every night and ease up on the amount of fatty food you eat. (I often recommend DiabetesUK's site which has an excellent section on diet - including low carb - together with a ton of recipes and a downloadable cookbook.) One drug that still causes problems is tenofovir (a component of truvada), but the problems are well known and reversible when they're caught in time, which is why guys on PrEP have to have bloods done every three months. The slightest hint of tenofovir causing trouble and any doctor who deserves the title will change your drug regime to avoid it. (Note for guys on PrEP: another drug, maraviroc, is already being investigated for use as PrEP.) Both efavirenz and tenofovir are popular because the lower the viral load very quickly, the a new class of drugs, integrase inhibitors (they block the enzyme HIV needs to get into a cell)are probably going to be very important as they can get further into the places where HIV hangs out. I think the reason that the fear of ARVs persists is because of the damage that earlier drugs which were rush-released did. When it was originally released ritonavir was prescribed at 800mg per day. Now it's just 100mg per day and the reason for using it isn't strictly therapeutic: it's because it's pushy and insists on being processed first, allowing the other drug processed by the liver more active time in your body. I've been on meds since 1989 and have taken a few hits from side-effects, things that just wouldn't be allowed to happen now as we know what to look for and we know the correct dosage. The combination I'm on now has had only one side effect, which was to give me a coppery aftertaste for a few hours. It quite offended an American bulldog who lives by me and suddenly I didn't smell right. Take your pill(s) as prescribed and as I said before your life-span will probably be slightly higher than average because most guys go for years without seeing their doctors, allowing hypertension, heart disease, diabetes, and so on time to do more damage. The best of luck to you!

Jtonic, Don't know if your "banned" status means you can't read this, but just in case you still can, I've had a night's desperately needed sleep, and can give you a more detailed answer. You're in shock and acting a bit on the hysterical side, which is no wonder: you're very frightened. I repeat what I said last night and find your local HIV services agency and talk to them. Use them to bounce ideas off. If you've just been infected your viral load is likely to be very high, but they'll also put the sample in for resistance testing, a study of which drugs are most likely to be effective in getting your viral load down as quickly as possible. Atripla is a favourite as it hits the virus hard and fast, but at the expense of trippy dreams which some people can't take. Stribild is also proving popular as it contains an integrase inhibitor, dolutegravir, which achieves deeper penetration into the tissues where HIV likes to hide out. Both are single pills, once a day. But most important is that you need psychological support right now. As you say you're ill right now, you're probably still going through seroconversion illness: it clears up and goes away, after which , left untreated your viral load will drop down and your CD4 count will rise naturally. The future? well, we're beginning to see the beginning of a functional cure, ie a cure whereby the HIV is cell locked and drugs aren't needed. A "sterilising" cure is one whereby HIV is completely eliminated from the body: these are a bit further off. If you can't find your local HIV services, call your doctor and ask them if they know how to get in touch. The general rule of thumb is that a 20 year old guy who gets pozzed today will live out a slightly longer lifespan that someone who doesn't, the reason being that we have regular doctor's visits and things like diabetes and high blood pressure are picked up much earlier and stopped in their tracks. We're beginning to see guys like me who've gone past the thirty year mark, though with what we knew then wasn't enough and some of us got sick because of side effects of the drugs (we didn't know the correct dosages, and poz guys were demanding they be released early, before the research was complete). There are several guys here who had it as long as I have, and I've got to know guys on Facebook who've been poz about the same time as me. To repeat, you need the psychological support of a counsellor or a peer supporter, and you need to keep your appointment next week and sort out drugs. Hopefully atripla, stribild, or eviplera (all one a day pills) will suit. Once your viral load hits undetectable you'll be the safest guy around.

No your life is not over: I got pozzed at 23 and now I'm 57 - See what the test say next week and make treatment decisions based on them. I lived through no meds, then meds that would kill you as soon as look at you, then meds that would cause lifelong conditions like diabetes (which I cope with quite successfully) and now a period when the meds are better than ever. What a doctor's visit and a pill or two a day? Contact your nearest HIV support agency and talk to them, talk to other poz guys - we all go through the "my life is over" phase. It's just a reaction to a big shock. I was at hospital today and found a condition unrelated to HIV was actually worse than I thought. Felt like shit on the way home, and over the evening put it into perspective: by the time my Dad was my age he was four years into the cancer that killed him, and he didn't have HIV. I'm too tired right now (the hospital is eighty miles away and it's a slow train journey) but you're welcome to PM me if you want to know more...

Where to start?... Some medical professionals here still refuse to wear gloves, even for the patient's comfort: they claim that gloves lessen the sensation of "getting it right" I can only just remember the last time I had blood drawn by syringe rather than vacutainer: last time with a syringe must have been in the eighties. A CD4 of 900 and an undetectable viral load after only six days? Yes, possible, but the HIV wouldn't show up on the test either. Why did they choose to exaggerate facts when the charities who do testing reckon a waiting period of two or three weeks before before they begin to consider testing - at least they got the 72 hours for PEP bit right. But far more likely is rawTOP's scenario of VL going haywire in as little time as six days. Blood drawn for HIV testing by vacutainer goes into a plastic bad - bo need for the ominous sharps box shots. The whole thing strikes me as a bunch of film students trying to be arty and informative. They fail at least at one of those objectives.

I'm having a dry spell - so pretty much anything! Make me an offer

It's something I consider perfectly normal: I had a colonoscopy a couple of years ago and managed to bleed then, which was somewhat more embarrassing as the doctor doing it could have been the twin of a British comedy actress. It freaks some guys out (I'm always open about being poz, but stress the fact that I'm undetectable). I've deliberately self harmed as part of a scene on skype and careful readers will find a point when Poz cuts his cock when seeding Mochyn (look for Pozdaddy in BugChasing fiction).

Yes I can feel a condom - that's why I moved to condomless sex. They scrape and just don't "feel right" either way round. I have ED as a result of diabetes: why would I want to reduce the pleasure of sex any further? I treasure each moment that viagra works for me. Cut or uncut: I'm in the UK where the majority of men are uncut - I guess I just got used to that extra bit of flesh to play with!

I'm a volunteer for THT, and it always surprises me the number of guys I talk to there who are also on myHIV, which is an advice/support site. (Suppose it helps that I use the same avatar on both sites, even if I use different names. In fact I'm surprised at the number of guys working for HIV services who are here... And yes, I make the occasional referral here when it seems appropriate (distant sound of my paperwork being torn up!)

I was at university studying classics when one of the Latin lecturers announced in awed tones that someone had made a film with dialogue entirely in Latin and we really ought to see it, especially as it was being shown at a cinema only a mile or two from the campus. She obviously went to see it before our next class because it was one of those things never spoken of again...

The bad news for the chasers is that this not a reliable way to get HIV: it's too fragile to survive outside the body for more than a few minutes. The even worse news is that Hepatitis C virus is much more robust. Hep C (for which there is no vaccination) is sexually transmissable, though its being contained in a condom implies a measure of protection as its mode of transmission is more blood to blood (hence its transmissabilty in heavy sex scenes). But consider the other STIs you might be picking up... syphilis, gonorrhoea, chlamydia (50% of men never show symptoms) and so on. If I were stuffing a used condom up my ass, I'd want to know where it came from...

The problem with getting generic truvada is the lack of followup: You must have regular checks on your liver and kidneys when taking truvada. I speak as someone who was failed by his doctors - they paid attention to my CD4 count and viral load, but missed the markers for minerals and vitamins. I had developed Fanconi's Syndrome which is an incredibly rare side effect of of tenofovir (one of the two drugs contained in truvada). Tenofovir especially attacks the kidneys amongst the unlucky: Virtually every vitamin or mineral I injest just gets pissed out. I can get a PA ring so bound up with limescale within two weeks that it takes an overnight soak in white vinegar to clean it back to bare steel. Even above my usual diet I have the doctors urging me to eat more dark greens, which is fine by me (I'm a good inventive cook, specialising in Asian foods) but I still need my daily dose of folic acid as well as extra Vitamin B12 and calcium. I admit that my experience has been unusual, in that I ran into Fanconi's Syndrome, a chance of 1 in 100,000 But we've noted in the UK that people on long term tenofovir experience bone loss and vitamin deficiencies. There is no way that self treating with truvada is safe: it nust be accompanied with regular blood and urine tests to avoid the possibility of vitamin/mineral depletion. Believe me I know: because of a negligent doctor I went through Fanconi's Syndrome and I can sure you that it's not worth the risk. Two years later I can still only walk a few hundred yards...

Well done! It's almost like having a new dick isn't it? For the record I had a wank within twentyfour hours of having it done

I'd strongly advise against buying truvada online. One of its components has an admittedly small chance, but it happened to me with prescription truvada, of causing kidney damage such that your kidneys start pissing away vitamins and minerals that are essential for good health. That's good health as in not have irregular heartbeat, strong bone structure, the ability to think clearly and a host of digestive issues. My clinic was negligent with my blood tests and when I was finally admitted to hospital, there was a police car just around the corner. My social worker told me later that if I hadn't gone voluntarily I would have been forced to by court order (English: sectioned, American: I don't know the appropriate term). As it was I was days from dying of starvation: I had this idea in my fuddled brain that a small pot of yogurt and a litre of fruit juice was an adequate diet. I'd spent several months acting irrationally (this was two years ago) and I'm still clearing up the messes I made. Sorry to hand you a scare story but had my clinic noticed my abnormal blood readings, the past two years would have been very different for me. If you want truvada, see your doctor!

The only stupid question is the one you didn't ask...

A lot of the reason for atripla falling out of favour with those who don't have problems with the side effects is that efavirenz (one of the three drugs in atripla) comes out of patent this year, thus allowing generic versions to be manufactured. This will have the knock-on effect of making atripla cheaper even though it's other two components (FTC and tenofovir, essentially truvada) are still in patent. In the UK we're expecting people on atripla to be switched to either a new combination pill containing generic efavirenz, or truvada plus generic efavirenz for economic reasons. In the US I can well imagine doctors being induced to steer people away from generic efavirenz, again for economic reasons. Money speaks louder than health

Guys with HIV should check with their doctors or pharmacists before taking vitamin D as overdosing on it can be as dangerous as being deficient. I have kidney damage from an HIV drug which means that I piss away many minerals and vitamins essential for good health (I piss so much calcium that I can put limescale on a PA in two weeks). I asked my consultant about the pain I was having in my bones (I have osteopenia - thinning bones) and his response that it could be that my prescription for vitamin D supplement needed to be lowered...

Get checked for diabetes: you're still young enough for diabetes 1 and old enough for diabetes 2. While it's unlikely to be diabetes, it does damage the nerve that closes down the return of blood from an erection. Nothing to eat after midnight and see a pharmacist (or friend with a testing kit) around nine. If the result is in double figures, damage is happening to your veins and arteries: see you doctor. Between 4 and 7 (under the old system) are considered normal.

I wish it were that simple for me... last testosterone came in at 23, where 25 is considered the high end of normal.

Poz1956 has it right as usual. I seroconverted in 1980, tested in 1987. Despite the "exclusivity" of having HIV there's always the inconveniences. Today's meds don't guarantee you an illness-free future - I'm fairly sure that I've got thrush in my throat as I type. There's the side-effects of the drugs: tenofovir (one of the components of truvada) nearly killed me a couple of years ago. BTW truvada seems to be metabolised differently in the presence of HIV so don't worry about your PrEP! I'm a regular on a British message board for PwHIV, almost all of whose members haven't had HIV longer than me, if you see what I mean. I read their posts and despair: they didn't have much choice but to limit their sex lives because of HIV since PrEP hasn't been approved in the UK. It's there for you: take it. And to add a personal comment, if you're only nineteen, there's no way you're ready to decide to chance getting a life-threatening illness. Yes I'm aware that it's been downgraded to a chronic condition in the UK, but take away all those expensive antivirals, and it's still a killer. Get yourself on PrEP. You do not need HIV.

Also worth checking for diabetes: it gradually destroys the nerve that stimulates an erection, which was pharma's excuse to market viagra. The records show I've had diabetes for seven years, my intuition is ten years (I'm also HIV+ and had the early versions/doses of many HIV drugs which have been shown to promote diabetes). Most guys wake up with a hardon - I can't remember the last time I did. Also viagra is a sod to get right: it depends on your HIV drugs what dose you take and too much ain't fun)

I was raped in 1977 - as in the real thing, not knowing if I was going to see the morning and so on. Some twelve years later an ex-partner who fancied himself as a playwright wrote a play about our breakup which included the fictional element of him raping me. I'd read the reviews, knew what to expect and warned my then current partner about it, saying that I wanted to see what the ex had to say about our relationship. All through the performance my current partner kept whispering "did that really happen?" and the answer was always "yes". Until the final scene dealing with the rape which was pure fantasy, though it included details of the 1977 rape that I'd told only to the ex. Unfortunately he has a distinctive surname which made it easy for me to track him down and arrange a meeting in a bar we both knew. Being the end of the eighties and having an idea about my sex life, he'd expected me to be dead. Had he really wanted to rape me after we split? He said no. Somehow I don't believe him. I gave him hell, rather loudly, for exploiting my life in the way that he had. Years later I reconnected with his girlfriend (though he identified as gay, he was actually bisexual) and we've resumed our previous relationship as being best buddies (albeit through Facebook). She describes him as having a personality disorder, though she's never been specific as to which one. I know she's had to throw him out of her flat in the past. All that said, however abhorrent I find actual rape (and I've done more of my share of picking up the pieces on helplines) I think there is a place for fantasy rape: it enables us to act out the fear/power trip of the real thing. Fantasy good, reality bad.

Be careful of what you wish for: there has already been a (failed) prosecution for transmission of herpes in the UK