Prep Side Effects

[hurri]

i've been thinking about going on Prep, but haven't seen much written about the possible medical side effects, especially after long-term use.  I can deal with (in fact, welcome) the behavioral changes, such as becoming a total slut, that the perceived "protection" will engender, but does that protection (or just the perception) come at the cost of other medial problems down the road?

 

Thanks in advance.

[bearbandit]

Side effects of truvada are much commoner in people using it for treatment than prevention, except in one area: a few people find that their dreams can be somewhat intense. It's rare enough in poz people that my doctors insisted that the FTC (emtricitabine) in truvada couldn't possibly be the cause. Basically it was people on truvada-as-PrEP who convinced the doctors that this was real. Go figure!
 

Apart from odd dreams (which only happens to a few) the commonest side effects are felt in the gut: a bit of nausea maybe, gas and loose stool, not enough to call diarrhoea. But most people get away with nothing at all. The thing to do is to experiment with the time of day you take it, with or without food, until you find out when your body's happy about it. But most people, probably 80% to 95% get away with no problems at all. If you do have problems try and work through them as they pass after a few weeks. 

The other problem with truvada is that the tenofovir can, in a very few people, cause a slight loss of bone tissue, but this is completely reversible simply by stopping taking the drug. About 1 in 10,000 poz people (a guess given my involvement in long term survivor groups, and that Fanconi's syndrome, a symptom of which is severe weakening of the bones occurs in about 1 in 100,000 poz people) will develop significant enough bone loss to require supplements, but this just hasn't been seen in HIV- people.

Don't worry about long term use: the history of PrEP is six or more years old, which is a bloody long time in HIV terms, including all the trials and truvada is incredibly well tolerated. And within in a few years there's very likely to be another drug replacing truvada, I'm guessing cabotegravir, which from all my reading seems to be very promising. It's the drug that they're talking of being an injectable, so if it's approved for PrEP, it may be once a month or even once a quarter your get your PrEP injection.

Don't worry: take the blue pill!

[rawfuckr]

 

The other problem with truvada is that the tenofovir can, in a very few people, cause a slight loss of bone tissue, but this is completely reversible simply by stopping taking the drug. About 1 in 10,000 poz people (a guess given my involvement in long term survivor groups, and that Fanconi's syndrome, a symptom of which is severe weakening of the bones occurs in about 1 in 100,000 poz people) will develop significant enough bone loss to require supplements, but this just hasn't been seen in HIV- people.

 

 

A note on this. It seems Truvada causes a 1% bone density loss on *everyone*, specially young adults the first six months and then it stops there. ( sources: http://goo.gl/4oS2Qz  http://goo.gl/dpBFfv ) Definitely true with negative guys, I'm assuming it's the same with poz guys.  

 

Long term consequences of BDL with Tenofovir based PrEP are unknown at the moment, although most researchers insist on the term 'not clinically significant' meaning more bone fractures are not being observed, it's just that we can measure the 1% BDL through DEXA scans. 

 

Something to keep in mind.

Edited August 31, 2016 by rawfuckr

[bearbandit]

Thanks for the clarification there: I was meaning the sort of bone loss that constitutes osteopenia. 

[hungryhole82]

Anyone had issue with fatigue, lower back pain since got on PrEP? 

[Guest shybottomhole]

I started PrEP on August 20, so 11 days now and so far just a bit of queasiness in the gut. Of course that might also be anticipation for my big outing in Berlin at the end of September.

[Read1]

Guys,

 

I had a bit of stomach discomfort at the start of taking PrEP. It's gone right now. I'm in the 5th month of daily PrEP. Enjoying great sex with men of all shapes, sizes, and ages!

 

Read1

[hurri]

Thanks for your time and your sharing your experiences and expertise.  Very helpful.

[hungry_hole]

PrEP causes changes in behavior that increase the risk of other STD. I would consider this a side-effect.

 

What happens when someone has to stop PrEP, will he be able to change back his behavior and stop taking anon loads at a bathhouse?

[dude8688]

Can it be taken topically? Like, for a month or so while a guy wants some raw fun, say if he knew he was visiting a place he's more likely to be taking regular bare dick? If he has enough Prep in his system (over 7 days worth right?) Could he theoretically enjoy his filthy trip (barring any sti's!)?

[uncutbritwhore]

I think I've had an (extremely rare) side effect: gout.

I'd been taking prep for almost a full month, daily (rigidly). Then, out of nowhere I get a slight dull ache in my left big toe joint. Went away after a few hours. 2 days later, same feeling but stronger and lasted pretty much the whole day then calmed down. Early hours of day 4 searing pain, throbbing, swollen, red joint. Didn't know what the hell it was - just assumed a bunion. Saw Dr that afternoon: gout. I was shocked as I'm only 34 and otherwise really quite healthy (apart from having a six pack of beer, or bottle of wine twice or occasionally 3 times a week - more than recommended I know, but hardly excessive). Calmed down slightly after day 4, but still extremely uncomfortable and unable to walk in shoes, walk properly etc. Took prescribed meds after a couple more days after no improvement. Just over a week later almost back to normal.

Anyway, racking my brain as to how this could have happened (apart from alcohol/diet (again, fairly healthy)), I remembered that Truvada had a slight chance of affecting the kidneys (gout caused by kidneys being unable to fully clear uric acid from the blood). Searched Internet and found a study done in San Francisco a few years ago that found 0.08% of the sample group taking prep experienced gout, but only in a very narrow band: men 30-39 years old and taking it for a month or less. That helped me feel a bit better - but am taking no chances. Haven't drunk for almost 2 weeks, and plan to cut consumption by 80%+ and making appropriate changes to diet. Never want it again!

So, second months Truvada currently sitting unopened in the bathroom cabinet until I've excluded all possible causes.

Anybody heard of similar instances?

[uncutbritwhore]

Oops, sorry. Didn't get my facts correct - was trying to recall. Study wasn't done in San Francisco - it seems to be some kind of database (must have conflated all the other info I'd read re prep with this gout info). Also, they weren't on it for a month - more like 2 to 5 years (wishful thinking on my behalf perhaps? Lol).

http://www.ehealthme.com/ds/truvada/gout/

Still, does anyone know of similar instances? Thanks!

[bc8]

I am battling against lethargy, intense dreams, depression, tiredness, and lack of Libido since stating on prep. Ive been told that the side affects will go away.

 

I took PrEP for 4 weeks, then decided I needed a break from the symptoms, so I took a month break from the PrEP.

 

Im now on day 3 of my second attempt with the medication..so far no depression.

[Read1]

bc8, stick with PrEP for the full 7 days, then enjoy sex again. It's worth it. Be patient.

 

Read1

[bc8]

Thanks Read1 its been better second time around....the only affects seem to

be lethargy, and lack of Libido....so far so good.