kernowk9

It sounds like your doctor has got the labwork side of things under control. The PrEP situation is the US appears to be far better than in the UK. When I approach my local GU clinic about PrEP in May this year, they wouldn't even agree to do the follow up care if I chose to buy the medication myself. That's changed a bit now, and they did agree to do the initial screening (kidney function, liver function, HIV + other STDs, Hep-B antibodies etc.) plus follow up. It's all a bit hit and miss though. I'm the first patient in my clinic to be taking PrEP, so the Doctor had to get himself educated before he could help me. With regards to toxicity, then I totally understand where you're coming. My Doctor was originally going to call me back after 3 months, but has now decided to do the initial follow up at one month. Apparently, if there is going to be any decline in kidney or liver function, then it will be evident quite quickly. After that, I'll be going back to a 3 monthly monitoring cycle. I understand the US healthcare dilemma very well, as I've lived and worked in both Boston and the Bay area. I was fortunate enough to work for a very good company, so never really had too much of an issue with healthcare. The prices of some things are totally scary, though. A colleague had to go in for an emergency appendectomy, and the cost of his hospital room was more per night than a suite at the Ritz in London!!!! As soon as my friend has his initial test results, then I'll get in touch. Take care. Ian x.

For maximum effectiveness, you really need to take PrEP daily. Like you, I too suffer from hematuria, but I had this prior to starting PrEP. I've had ultrasounds, cystoscopy, CT scans and there's nothing amiss. It just happens to some people. I've only been taking PrEP for 4 days, so it's too early to tell if this will have any effect on it. A friend has been forced to go back to taking a tablet every other day, as his kidney function is compromised due to age (he's 84). He is being closely monitored to determine if the levels of Truvada are still maintained at a therapeutic level. I'll let you know how he's getting on. If you can put up with the GI problems, I'd continue to take it daily.

I find that attitude really hard to get my head around. Why would he want to 'knock up' as many other bois as possible? Having reached sexual maturity at the height of the AIDS epidemic, I find it impossible to understand why anyone would want to pass it on, or would want to get infected. Especially now that we have PrEP. I guess it's an age thing. Having never experienced the fear and the loss of close friends, he just doesn't see anything wrong with it.

I'm in the UK too, and am in my first week of PrEP. I'm assuming you purchased from one of the outlets on www.iwantprepnow.co.uk? It's not enough to just test HIV- before you start. You need to ensure that your local GU clinic will provide backup for all the other tests that are required. Currently, some will, and some won't. As a minimum, you need to ensure the following before starting PrEP: - You have two negative HIV tests at least 3 months apart. - Prior to the second test, you've not had any risky sexual contact that might have resulted in you being in the 'acute' infection stage, but HIV not be detectable by the tests. - You have been vaccinated against Hep-A and Hep-B, and have good levels of antibodies in your blood. - You have negative results for all other STDs. - You have liver and kidney function tests, so that the GU clinic has baseline numbers prior to taking PrEP. Your kidney and liver functions can decline as a result of taking PrEP, so it's important that these tests are done, to ensure that they can track any changes. When I first wanted to go on PrEP back in May, my local GU clinic were totally unprepared to deal with my request. I was the first person to ever ask about it, and their policy making committee had not had chance to discuss the issue of initial and follow up care for PrEP patients. There is clearly a cost to GU clinics of managing the initial tests, and the subsequent follow up every 3 months. I'm happy to say that my GU clinic has now agreed to undertake the work required to ensure patients take PrEP safely, even though the NHS still won't pay for the medication. I'm hopeful that your local clinic will do the same. You need to be open with them, and tell them that you're planning to take PrEP. As of now, I've been taking it for four days, and have had no obvious side effects. I'm going to wait at least seven days before any sexual contact. With regards to my sexual behaviour, then I've only recent woken up to the joys of barebacking. Previously, I always used condoms. Around the middle of last year, I had my first gay relationship, and was happy to bareback with my partner as we both tested HIV- at the same time. Now that I've tried bareback, I find it hard to have sex any other way. At the beginning of this year, I got a major wake up call, when my partner admitted that he had been sleeping bareback with other guys. His risk was lessened by him being a top, but it still scared the shit out of me. Reaching sexual maturity at the height of the AIDS epidemic resulted in me having to watch good friends die, and there was nothing I could do about it. Intellectually, I know that modern treatments mean that HIV diagnosis is no longer a death sentence, but some fears run deep. Fortunately, both my partner and I tested negative at 3 month intervals. It made me think long and hard about how to reduce my risk, as I have to accept that most gay men have difficulty in being monogamous. I therefore decided to start taking PrEP. My partner didn't want to, and also indicated that he would continue to see other guys and probably bareback them. We parted ways shortly after that. The whole experience has caused me to do a lot of research, and it has helped me come to terms with my fears over HIV. I no longer see poz guys as a threat, which was very much the case before. I've now met several local guys who have undetectable viral loads, and am quite open to the idea of having bareback sex with them. Hearing their stories, and talking to them about their treatement has made me realise how narrow minded I was being before. I'm still unsure about how much barebacking I'm going to do. I don't want to give it up, as I enjoy it too much. There is something so special about feeling your partner cum in your ass. Any sex carries risk, even if you use condoms. For me, it's all about managing that risk. I will no longer play Russian roulette with my sexual health. I've chatted with loads of guys online who claim to be 'safe sex only', and then you see them getting verifications from guys who fucked them bareback. The worst part is that a lot of these guys have never been to the clinic, and always claim to be 'clean'. Half of them are probably running around with 'acute' HIV infection and viral loads through the roof. No thanks. From here on out, I think that the safest bet is to have sex with poz guys who are undetectable. Good luck with your treatment. You're definitely doing the right thing.