Prep Questions

[sxcj87]

i have a few questions about the PreP treatment

 

1. How many days/doses do it take for PreP to take effect?

 

2. Is it possible/effective to take PrePs for a period of time (when I intend to be slutty and raunchy)? What are the pros and cons of doing that? 

 

Thanks

[snaketat]

I am probably the worst person you might expect to answer a prep post. I am poz after a brief but intense and enjoyable chase, a fine young man eventually shared his virus with me, so there is no reverse.

That being said, prep seems to be a very effective method of preventing hiv transmission.. When my own doctor pitched prep to me, he had many facts that supported the concept of barebacking with protection. His good efforts were for nil, the until led script is on my refrigerator as a stark reminder....right next to my latest blood test results.

Anyhow, and please verify this with a professional...there is a window of 5-10 days to have enough protection in your system and it is most effective if used continually. I did not understand it to be a sort of party drug where you could start on Wednesday for a fuck filled Saturday at Cumuniom Others may have actual experience, so please take my words as just my recollection from a doctor visit a couple years ago

[fillmyholeftl]

PrEP is effective after 7 days of daily dosing. There are studies done regarding interval dosing.  The effectiveness is a bit less.  "Interval" dosing, lets say you'll be slutty for a month or two & then take a break... Is fine.  Just take daily during those active times.  You can take a break of any length then resume when you're a horny bastard again. Just wait the initial period.  This doesn't adversely affect the effectiveness, nor cause any resistance issues.

[bearbandit]

As fillmyholeftl said, seven days and you're good to go. Some guys like to leave it a little longer to be sure, but it's been shown to reach its required levels after seven days. The whole idea is that you can stop and just need those seven days to re-start, though if you're planning on stopping for just a couple of weeks, I'd say you'd be better off carry on through the "dry" period, simply because you need to develop the habit of taking it every day. Forgetting once in a while is okay (hell, even those of us using ARVs for therapy are only expected to maintain an adherence level of 95% - equating to missing meds once every three weeks on daily dosing as truvada is).

 

If your stops are less than a couple of months, I'd suggest sticking to your prescription appointments so the blood works can be done: again, a matter of establishing a good habit. But in any case, be sure to keep your doctor up to date with how you're taking it, so to speak.

The French(?) study IPERGAY is showing good results for "event dosing": two truvada a few hours before sex, one afterwards and a fourth 24 hours after that, but personally I'm skeptical of that: part of the seven day loading period is to allow the drugs to penetrate into anal tissue (it's 21 days for vaginal tissue), and if I were seeking to remain negative (29th HIV birthday tomorrow) I'd prefer to be on daily dosing: I've often not had the 2 or 3 hours warning that I was about to get laid, it's just happened If taking a truvada is something you just do after you've brushed your teeth in morning, or whatever daily event you've chosen to link taking truvada to, then you don't need to be worrying about taking it in time, or having it with you...

 

[rawfuckr]

Regarding IPERGAY, it's not clear at all the benefit came from intermitent dosage. The people on the study were so slutty that 'on average' they were taking 4-5 pills per week. We've seen before that +4 pills/week is close to perfect protection, so their protection could come from accumulated levels over time and not from the just taken pill.

 

Also to answer the OP, the usual talked about regime is:

7 days to 'load up', fuck like no tomorrow, stop, 30 days to wind down sort of like a PEP regime just in case. 

Edited January 26, 2016 by rawfuckr

[sxcj87]

30 days to wind down?? what do you mean exactly?

[tallbtm]

30 days to wind down?? what do you mean exactly?

 

Current recommendations are this:  If you're on PrEP and want to stop (say during a period when you're not expecting to have sex), you should continue taking your PrEP pills for 28 days after your last high-risk (condomless) sexual encounter. This is the same length of dosing as what's recommended for effective post-exposure prophylaxis (PEP) which is taking HIV medications to prevent infection after an exposure event.

 

See this January 2015 article: http://betablog.org/prep-open-house-know-youre-interested-prep/ 

[sxcj87]

oh is it 30 days? my doctor said take it for a 4 days after alst exposure would work. Am I missing something?

[drscorpio]

oh is it 30 days? my doctor said take it for a 4 days after alst exposure would work. Am I missing something?

Apparently, this is an aspect that hasn't been sufficiently tested for there to be a definitive answer. Doctors who say 30 days are erring on the side of caution.