Questions about Prep

[cumslutfordaddy]

First of all, someone told me you can't get Prep in canada, and I'm just wondering if anyone knows if thats bulllshit?

As per this thread exactly how much does prep reduce the risk?

Say that I take my prep pill every day and I never skimp on taking it. And then say that once a week every friday night I go to my local bathhouse and whore myself out.

If I do that for a year, would I still be at highrisk for HIV?

If I just want to go to a bathhouse and whore myself out would post-exposure prophylaxis be a better idea?

[bearbandit]

I've replied to this privately, the only thing I'd add to my my explanation on the status quo as I see it is your introduction of PEP. PEP assumes that HIV is already in your body and in a quantity capable of causing an infection. It's prescribed for 28 days for a reason: to get every last bit of HIV out of your body. Your proposition has you in the position of the girl who's getting her morning after contraceptive pill from Accident and Emergency every weekend.

If PrEP isn't available in Canada yet, I'd wait till you got a reliable supplier before you start taking it. It's very rare, but one of the ingredients in truvada can kill you, which is why it's essential to take it under medical supervision.

PrEP is approximately as effective as prper use of condoms, more so if you're fucking with someone with someone who's HIV+ and has his VL under control.

The effectiveness of PrEP doesn't change over time, at least not that's yet been seen. What we are learning is that guys who don't have HIV react differently to PrEP insofar as the lucky bastards are less prone to side effects.

As long as you take your PrEP every day, you're at a minuscule risk of getting HIV. As soon as you skip more than a few days your risk starts increasing until you're back at the starting point, which tends to happen within a month, no matter how much truvada you've swallowed in the past.

[rawfuckr]

1) PrEP is not approved in Canada but you can get Truvada off-label

2) 99% if you take it every day

3) You must take PrEP full 7 days every day to be protected. Continue taking it. Then you have to take it 30 days after last exposure to make sure it kill any possible HIV. Taking one pill on friday probably won't do much.

4) Yes. You just have to take the pill every day to have the 99% less risk of getting HIV.

5) PrEP is definitely a much better idea so you have protection at the time of infection. PEP is only 80% effective, has to be done on 72% of exposure, the drugs have more side effects, and maybe more difficult to find at the moment.

[cumslutfordaddy]

Thanks for the replies guys.

So as long as I take my pill everyday, I could spend 6 hours in a sling at a public pathhouse once a week, every week for a year, and not have to worry about HIV? (I understand the risk isn't zero%, but its still lower than lets say 1% right)

What if the guy has a mutated virus (say neither of us know about it) and say that his virus is resistant to meds, would that put me at risk?

[rawTOP]

So as long as I take my pill everyday, I could spend 6 hours in a sling at a public bathhouse once a week, every week for a year, and not have to worry about HIV? (I understand the risk isn't zero%, but its still lower than lets say 1% right)

The only significant risk is if you encountered a top who was not on meds and had a strain that was resistant to Truvada. That's relatively low risk.

And of course there's the risk of other STDs.

[wood]

Thanks for the replies guys.

So as long as I take my pill everyday, I could spend 6 hours in a sling at a public pathhouse once a week, every week for a year, and not have to worry about HIV? (I understand the risk isn't zero%, but its still lower than lets say 1% right)

What if the guy has a mutated virus (say neither of us know about it) and say that his virus is resistant to meds, would that put me at risk?

If you are looking for zero risk then neither PEP or PrEP are for you. All of the replies so far are accurate, but any sex carries risk, PrEP doesnt change that.

For me as a person on PrEP that means I still ask if a person is HIV+, and if so are they on treatment. If so, I have no issue having sex with them. I personally haev no interest in having sex with a guy not on treatment. The vast majority of men with HIV would most likely be in better shape on treatment, and they are also much less likely to infect others.

I see it this way, reducing risk whether you are on PrEP or not is still a good idea. The people that dont take are of themselves may have a greater chance of harboring other STD's that while they may be curable, are still a literal pain in the ass.

Also PrEP over PEP everytime. PEP is no where near as effective, and in many causes has severe side effects.

[bearbandit]

A couple of extra points: truvada may be off label in Canada but it is still esssential to have bloods done at least quarterly, firstly to make sure that the drugs are still working and secondly to make sure that it's (specifically tenofovir) not attacking the kidneys, which, believe me, is unpleasant in the extreme, leaving you open to osteopenia (fragile bones), irregular heart rhythm and distorted thinking/hallucinations. I can still remember clearly details of hallucinations I had: I know they were hallucinations, yet I cannot remove the feeling that they actually happened.

As rawTOP says, there's always the risk of getting fucked by someone whose strain of HIV is tenofovir- or FTC-resistant. Pretty unlikely given how difficult it is to get HIV in the first place, but a possibility nevertheless. and again there's the risk of other STIs: it's long been recognised that syphilis makes HIV transmission easier. Other STIs are also gaining in resistance, especially gonorrhoea.

Finally, as Wood implies, a guy whose VL is undetectable (ie not just on treatment) is a damn sight less likely to be infectious than someone who has never bothered testing or who leaves long gaps between tests. It's reckoned in the UK that something like 22% of people with HIV don't know they have it. Something you haven't mentioned is that if you want to live up to your name, every guy after the first in your ass is running the risk of picking up HIV - how do you think men get HIV from women? Just be careful who Daddy picks out for you...

[rawfuckr]

A couple of extra points: truvada may be off label in Canada but it is still esssential to have bloods done at least quarterly, firstly to make sure that the drugs are still working and secondly to make sure that it's (specifically tenofovir) not attacking the kidneys, which, believe me, is unpleasant in the extreme, leaving you open to osteopenia (fragile bones), irregular heart rhythm and distorted thinking/hallucinations. I can still remember clearly details of hallucinations I had: I know they were hallucinations, yet I cannot remove the feeling that they actually happened.

This is very important. Truvada is very well tolerated, but in the few cases where it's going to cause trouble you want to know right away and you need a doctor checking this for you continously.

[cumslutfordaddy]

So I've made some calls and if I can get a doctor to write me a prescription for it, there is a pharmacy at my local hospital that can special order me 30 tablets for just about 900 dollars.

I obviously can't afford that, and when I called my provincial government to see if I can get help paying for it, they told me truvada isn't in there system. Now theres a chance that I can get covered for it since I have extended healthcare from work (it isnt great but if it helps it helps) I just hope that its A) in there system and Will just assume I'm on it since I have HIV and not using it for preventative purposes.

If that doesn't work I'm considering just getting a second part time job to pay for it. I really wanna go to a major metro steamworks while I'm still younger than 24. :/

Edit: Also since it cost me 900 dollars for 30 tablets, and your suppose to keep taking it everyday for 28 days after last highrisk exposure, I assume it's a smart idea to always have an extra 30 tablets on hand just to never run into the situation where you can't afford a new order, and the amount of pills you have is less than 28 days worth?

Also when I do start taking it, how long does it take to be firmly in my body so to speak? A week?

Edited March 10, 2014 by cumslutfordaddy

[wood]

you need to be on it for at least 7 days for optimal concentrations in your body before you can consider yourself protected.

You may be able to find the generic version much cheaper. Its call Tenvir-em, and its made by Cipla. This is important because Cipla is the only company that is licensed to make a generic of Truvada. With that said if you do, you still need to get the regular blood tests.

Heres a link I found for it.

http://www.unitedpharmacies.com/Tenvir-EM-Tenofovir-Disoproxil-Fumarate-Emtricitabine.html

[Guest JizzDumpWI]

7 days after starting you have the intended protection. As you have read, you need to stay on it at least a month after last possible exposure.

[cumslutfordaddy]

Oh that is interesting thank you. So according to that link I can buy a 60 day supply for about 150 dollars.

Even though I don't need to get a prescription for this anymore I still want to go to my doctor to make sure my kidney and liver is working normal and also I should see him every 3 months to get checked out and see how the drug is reacting to my body.

What information should I give him so he knows what tests to run? Just give him the CDC and FDA report for prep/truvada and tell him that I'm buying the generic version online?

[Guest JizzDumpWI]

He is looking for proper kidney and liver function. You need a baseline before you start. Also a fresh sti and hiv test.

[cumslutfordaddy]

So I can't buy it online since I don't have an american address .