Starting the process

[fskn]

One area i don't see discussed much is side effects to Truvada when using OTC supplements. My I.D. Dr. at South San Francisco Kaiser dropped me from Truvada as I had high creatine level. She never asked me about the impact this would have on me. It wasn't until I STOPPED ALL supplements (including ibuprofen) for a surgical procedure and subsequent kidney test that my levels returned to normal (still taking Truvada at the time!). I'm now "challenging" the previous results in hope she'll get on my side of this topic and work with me to prescribe the drug. To her credit, however, she passed along a study (http://www.cdc.gov/nchhstp/newsroom/2015/IPERGAY-2015-Media-Statement.html) where "..findings combined with other recent research suggests that even with less than perfect daily adherence, PrEP may still offer substantial protection if taken consistently". The take home for me is our Dr's need education about outlying factors of side effects and we need to educate THEM on what it means to be in our position.

Get PrEP from KP San Francisco rather than South San Francisco. It is worth the trip. You will find a world of difference. The suburban Kaiser medical offices lack the volume and thus the experience -- if not also the competence -- to serve GLBT patients. Trust me on that one.

If you really want to deal with SSF, have their ID doctor call Dr. Robert Grant at UCSF. I heard him speak last December, and he mentioned great success in briefly stopping Truvada in patients with poor kidney results, and then resuming it.

The fact that the KP SSF doctor cited IPERGAY (results released this spring) as evidence for less-than-daily dosing is worrisome. This person might not be current on her reading. The conclusion that 4 pills per week are protective in men was reached over a year ago, in the iPrEx-OLE trial. (For other potential readers: new evidence shows much less forgiving results in women.)

Edited June 26, 2015 by fskn