Stopping PrEP

[subbitch33]

Hi

I am about to start PrEP.

The instructions are to take it for 7 days before you can consider it effective... and start taking BB.

However, I am curious as to how long it should be taken after your last BB exposure, if you want to stop taking it. I have read you should take it for 14 days although some websites say 30 days.

Talking to a doctor, he said that the 7 day period before starting BB was over the top and you would get decent protection after just 3 days.

So 30 days after exposure to continue taking it sounds excessive. Does anyone know if you can get away with less?

I only ask as I a plan to start it asap.. but then am going away on holiday and don't want to keep taking it whilst I am away.. and the 30 day period is right in the middle of my hols!

[Guest JizzDumpWI]

30 days is to ensure it works. you can probably get away with less - but always best to discuss with your doc.

[bearbandit]

I'd go for the 30 days - after all, it's how long PEP is prescribed for. Take a poz load just before you stop and, frankly, we don't know what your chances are as PEP involves at least one other drug. And what happens if you get lucky on holiday? Personally I wouldn't stop at all: studies into the residual protective effects of PrEP would be unethical and immoral, so all we've got to go on is anecdotal evidence. It's only one little bottle in your luggage.

I can tell you, though, that in the quarter I skipped taking my ARVs (sheer pill fatigue: I take something like 25 a day) for a week, my viral load went from 0 to 156 and I lost 200 CD4 cells. I'm saying this in the full knowledge that guys on PrEP seem to process truvada differently from those of us with the virus, but frankly, mate, in your position I wouldn't be taking any chances.

[rawfuckr]

I'd go for the 30 days - after all, it's how long PEP is prescribed for. Take a poz load just before you stop and, frankly, we don't know what your chances are as PEP involves at least one other drug. And what happens if you get lucky on holiday? Personally I wouldn't stop at all: studies into the residual protective effects of PrEP would be unethical and immoral, so all we've got to go on is anecdotal evidence. It's only one little bottle in your luggage.

Yeah, listen to bearbandit. There is really not much scientific evidence about what to do to stop PrEP other than the 30 day PEP-like course. Better to be safe than sorry.

[rawTOP]

I'm not quite sure the context of your question, but if you're thinking of starting and stopping it on a regular basis - don't. Once on PrEP stay on PrEP. Especially with the results of recent studies it's probably OK to take it just 4 times a week - that's what I do - I take it Mon, Wed, Fri & Sun (plus on "off days" if I was a slut the day before). But whatever you do - don't drop below 4 times a week - the effectiveness starts dropping pretty quickly below 4x/week.

[subbitch33]

Sorry.

The context was I am going away on holiday for 3 weeks and don't want to be travelling and taking PrEP. So want to stop it for a 3 week period.

Was just asking how long it needs to be taken after your last BB exposure? The consensus seems to be 30 days, but this seems excessive.

I compared it to starting PrEP where it says take a full 7 days before considering yourself protected. Although some docs say 3/4 days is enough for adequate protection when starting out.

Hence, I am asking if 30 days is indeed excessive, and I could get away with taking less before stopping entirely (after last exposure)

[rawTOP]

So you're not having sex on holiday? That sounds boring!

The other part of the equation is how risky was the sex you had before stopping. If you put your ass up in a bathhouse and took 15 anonymous loads then you may want to take the pills longer than if you got fucked by an undetectable guy or another guy on PrEP...

[bttm79]

Here is a article I found to be very helpful about PrEP.

http://www.frontiersla.com/frontiers-blog/2014/07/22/aids-2014-new-report-says-prep-90-effective-with-as-few-as-3-doses-per-week

[subbitch33]

The article mirrors other advice which says 3/4 doses a week, or 3/4 days after starting PrEP for the first time is enough to afford a decent level of protection.

However, I was asking about the need to take it for 30 days AFTER a potential BB exposure.... I am looking to stop it sooner because of a holiday but there doesn't seem much advice out there on this particular scenario

[Poz1956]

The reason people suggest following the 28 day PEP guideline, when you stop PrEP, is the same reason why a course of PEP is 28 days.

Lets say the last load you took was from a newly infected, didn't know he was Poz guy, with a viral load in the 10 million neighbourhood. I've read somewhere that it would up the chance of transmission to 1 in 3. Some CD4 cells may have become infected. Truvada interferes with the viral replication process, not with the attachment or fusion of the virus to the CD4 cell. While reproduction is inhibited in most cells, there may be some where the virus manages to make copies of itself. The 28 day regime is enough time for the original virus, and any of the first few generations to die out. No more replication = you don't become Poz.

[subbitch33]

Thanks, that's useful.