Abstinence before PrEP?

[Verbal76]

So I know you need a confirmed negative diagnosis before they put you on PrEP. Does that mean I need to abstain for three months or two weeks or what?

I'm scheduling an appointment with the doctor who specializes in it. I last had raw sex Saturday...would like to get on the treatment ASAP but it's hard to resist.

Can anyone who's been put on the treatment sort of give a walkthrough of what to expect from the initial sets of appointments?

[rawTOP]

No, it's not necessary to stop sex before taking PrEP. If recent infection is a real concern then they can do a different type of test that can detect infection more quickly.

The worst case scenario is that you're poz and develop a resistance to Truvada. That's not the end of the world. Since recent infection is not likely in most cases, and the worst case scenario isn't all that horrible - doctors don't worry too much about it. (And neither should you).

[Marathonbear]

My Doctor did a viral load test, which amplifies the amount of HIV DNA in your blood stream so that it can be measured. It's the most accurate test and when guys say they are undetectable this is what is measured. Takes about three days for the viral load count to come back from the labs. If its a confirmed negative along with the antibody test you can start PrEP immediately.

My doc (gay) said I should anticipate about a week of being on PrEP before fully protected. Need to get the drug into your system.

[Verbal76]

But if I get bred Wednesday and my appointment is on Thursday...shouldn't there be a window where I abstain so they know for sure I'm 100% negative before starting treatment? I think my friend had to do that, but it was more like two weeks, not three months.

[rawTOP]

But if I get bred Wednesday and my appointment is on Thursday...shouldn't there be a window where I abstain so they know for sure I'm 100% negative before starting treatment? I think my friend had to do that, but it was more like two weeks, not three months.

There is no such thing as 0% risk in life.

[lungfucker]

All of these questions are the types that doctors' offices, especially those specializing in gay clientele, answer routinely. Almost nothing shocks them, and they can give you the sort of protocol they prefer for prescribing PrEP. Just give the office a call to find out what they prefer.

[Guest JizzDumpWI]

It's your health, not anyone else's. Seems as though you've a reasonable intuition. Discuss with your doc, and follow whatever his recommendation. Indeed though, there are tests that are pretty sensitive they can give you before starting PrEP.

[Verbal76]

Well I had my first appointment. Doctor prescribed the Truvada but he wants me to abstain two weeks, get tested with the super sensitive test, and then, assuming the result is negative, start taking the meds.

It's annoying to have to go without sex for two weeks, but I'm hoping it will be worth it in the end.

[seaguy]

Just jerk off allot for a couple weeks if you want to be sure, shouldn't be that hard. Find some good bareback porn to help.

[Guest JizzDumpWI]

just discuss truthful details with your doc. they will know what to do....

[fskn]

Just for curisity's sake, can you let us know whether by "super-sensitive" your doctor means:

1. A 4th-generation HIV antibody test (a traditional-type test that nevertheless detects antibodies earlier than past versions did),

2. A qualitative PCR HIV RNA viral load test (which detects copies of the HIV virus in the blood, but yields a yes/no answer instead of a number, the number's being useful for tracking the health of an HIV-positive patient), or

3. A pooled qualitative HIV viral load test (where your sample is divided into two parts, one part is set aside and the other part is mixed with other patients' samples, the pool is tested as in Option 2, and individual samples are only tested if the pool was positive; this is slightly less sensitive than a non-pooled design)?

Abstinence is futile with option 2, which detects HIV in a matter of days.

In any case, if you're having sex with known, communicative, health-aware partners -- including positive men who are undetectable -- ask yourself whether you'd really be incurring much risk if you continued fucking during those two weeks.

I wasn't asked to abstain before starting PrEP. My intake testing involved Option 3, in advance, and then a rapid HIV antibody test and questions about symptoms of acute infection, on the day I received my first Truvada prescription. Had I been asked to abstain, I know what choice I would have made.

Edited August 8, 2014 by fskn