How many times can you come off PrEP and start again

[Leather69]

There is a discussion some 6 topics below this one covering this very subject.

a relevant bit is after the  w's iwantprepnow.co.uk/how-to-take-prep

I for one can't take it 365 days a year, as due to kidney cancer a few years back, have to look after my remaining one.

[concerned1]

I appreciate the replies that keep coming in, but as I've actually already mentioned, I went to the sexual health clinic yesterday to get my results from my last round of tests and also to get 3 months worth of PrEP. I asked the nurse there about this and have my answer. Thanks guys.

Edited January 30, 2020 by concerned1

[boy4you]

22 hours ago, smokey1121 said:

boy4u how was mal

Had a great time there 

[PissPigBrooklyn]

[think before following links] https://www.iwantprepnow.co.uk/how-to-take-prep/

[concerned1]

The nurse I asked at the clinic actually said I'm OK to have bareback sex after 2 hours of starting PrEP again (two hours after an initial dose of 2 tablets). Though I have been told previously you must wait 7 days. Suppose it's better to just wait the 7.

Edited February 1, 2020 by concerned1

[rawTOP]

There's a lot of misinformation in this thread. So let me clear up a few things… [Everything I'm about to say is about Truvada, but may not be true about Descovy.]

You can stop and start PrEP as much as you like. Poz guys cannot start and stop their meds as much as they like because their virus can become resistant when the drug levels are low. But neg guys don't have HIV, hence they have no virus that can become med-resistant. [Not that anyone implied otherwise.]

When PrEP first came out they told people to take it for 7 days before having sex. But now "PrEP on Demand" is a thing and it's been validated (for gay men) by numerous studies. PrEP on Demand means you take 2 pills (at the same time) at least 2 hours before sex, then one pill every day until 48 hours after your last sexual encounter. That protocol works and is approved by a number of major countries (France being the most prominent). The initial IPERGAY study involved people who were having sex regularly to the point that they averaged ~4 pills/week, but later studies have shown that that protocol is also effective for guys who don't have much sex.

The other thing to know is that Truvada has a very long half life. So if you're taking it daily and stop, you still have >90% protection a week later. But then the levels of protection drop off pretty quickly, so you'll hear stories about infections 10-14 days after stopping.

The other thing that the studies have showed was that almost no one who took at least 4 pills in a week has become poz. That said, it also depends on the nature of your risk. Drug levels are quite high in the digestive system (e.g. in your colon), so if your risk is primarily anal, then lower doses are possible. However, people who have vaginas (and possibly tops) probably need to take PrEP every day. In other words bottoms take more than they need so women, trans guys, and tops get enough.

The bottom line is start and stop as much as you like provided you remember to actually take the pills when you're supposed to. No harm will be done if you're taking it daily and forget a pill here or there. But if you're using PrEP on Demand you can't forget to take the pills – there's much less margin for error.

I hope you can parse all of that into something that will work for you…

[1981virginia]

This a slightly different topic, but, hopefully a valid question. My PrEP doctor recommended that I take my PURE for Men (fiber bottom-readying pills) opposite from my Truvada, the non-scientific theory being that medications in the gut at the same time as fiber supplements can bind to the fiber and pass through the intestine faster than they would without fiber, possibly lowering their ability to penetrate into tissue and do their job. My doctor just suggested it, and it does make sense. I've read online to stagger fiber supplements with multivitamins as well for the same reason. I don't know of a study that focused on this... I figure even if it doesn't help, it can't hurt. Anyone have thoughts on this? And yes, I'm much more confident bottoming without a lot of planning with a psyllium husk tablet... No nightmares yet. So, I take my blue pill in the morning and my three fiber pills at night...