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How To Obtain Prep In The Uk/europe


berlinboi

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These two sites have recently (this week) gone up from the UK, where we're arguing to have PrEP available pretty much on demand, within our health system rather than having to get private prescriptions. Be aware that the information on legality is specific to the UK.

 

http://i-base.info/qa/10743

http://i-base.info/qa/10734

PrEP is a protocol, a method of doing things, to prevent transmission of/infection with HIV. I say that because people frequently think that PrEP is a drug. The drug used for protection against HIV is truvada, which in turn is composed of two drugs: tenofovir and emtricitabine. Although tenofovir has, in the laboratory, been seen to have some action against hepatitis B, it isn't used to treat hepatitis B. Otherwise the two drugs comprising truvada are ONLY active against HIV. If you're using truvada to protect yourself from HIV, it's important to understand that you're still open to a wide range of sexually transmitted infections (STIs). With truvada protecting you, you don't have to worry about HIV, and you can be vaccinated against hepatitis A and hepatitis B. There is a vaccination available for some strains of the virus that causes genital warts (which can lead to cancer) but that's often only available to teenage girls.

Even taking truvada you are still at risk from other STIs, so it's important (and indeed is part of the PrEP protocol) to have a full STI checkup at least every three months: many of the STIs don't necessarily have any symptoms. While this all sounds very daunting, it's how we lived in the seventies: having your three-monthly checkup was often treated as a social event, with friends going together to the STI clinic, and guys picking each other up there.

An STI check should consist of blood tests for hepatitis and syphilis (and if you're taking truvada, HIV - just to make sure it's working), a quick visual exam if you think it's necessary, the taking of swabs from inside your ass and the back of your throat (in the UK there's a move to get you to take these swabs yourself - they're easy enough to do, just get the nurse to show you the first time so you know what the swabs should feel like) and finally a piss sample. Be honest about what you get up to sexually: they're there to help you not to judge you. Most STI checkups are over very quickly (about five minutes for the physical stuff and a bit more time talking to a doctor).

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Thanks for that - I also am prescribed tetracyclines for a skin condition. I have checked that it looks like it protects other stis. I will get tested on Monday and again a few weeks later. Idea is to ensure i'm negative - keep on being checked every month then take Prep from the new year.

 

This is all part of a new health and gym regime.

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  • 4 weeks later...

Just to let people know that I'm about to go on PrEP - I have the drugs from alldays (was pretty easy). You have to go to 56 Dean Street clinic in London (make a day of it by going to museums etc) if you don't live nearby. If you think of clinics as the usual finger wagging of schoolmarmish women and repressed finger wagging men you're in for a big surprise.

 

The staff use the same gay vernacular as yourself and are often gay or bi. My advice is to go to the CODE clinic on a Tuesday night at 5pm. It's quieter as it's set up for chemsex guys and it'll be all over by 15 mins. They know about PrEP and generic drugs.

 

I'm starting tomorrow on guy fawkes morning!

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The advice at www.iwantprepnow.co.uk is geared to the UK, but it shouldn't be too difficult to translate to the health system of another country. As berlinboi says, the testing is the essential part of the PrEP programme: getting the generic drug is the easy part.

 

I'd urge everyone to make damn sure they stick with the testing side of the programme: STIs can make it easier for HIV to establish a bridgehead in your body, and if there's ever going to be a documented case of someone getting HIV while fully adherent on PrEP I'm betting that there'll be another STI involved. The HIV test is essential because if you forget too many tablets and do pick up HIV, then you need more than just truvada or its generic to deal with it: truvada is not enough in itself. Finally the liver and kidney testing are essential: if you're going to have problems with the drug (which is extremely unlikely: everything I see says that neg guys have it easier than poz guys with truvada), these, and your bones, are where the problems will manifest. It takes a long time and a negligent doctor for problems to happen, but it can happen. The odds are on a par with hitting the jackpot in the UK lottery, but, gentlewhores, I hit that jackpot. Trust me: jump through all the hoops the doctors tell you to. And if you're in the UK, I've heard so much good about 56 Dean Street... If I lived in London I'd be using it.

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I still find it pretty shameful that PrEP hasn't been approved by NICE and isn't available on the NHS, but I understand why. There's very little political pressure to do so. No-one is going to fight for the right of gay men to have condomless sex after all the safe sex campaigns, even when it looks like PrEP is actually a more effective solution.

 

This is one of those rare situations where the free healthcare model lets us down. Since money is tight there's little incentive to approve treatments for 'lifestyle' situations unless its one with a powerful lobby behind it.

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