PrEP On The Sly

[Guest hungandmean]

On 2/2/2021 at 10:54 AM, takemeuseme said:

First of all, thanks for all the feedback.  It was sort of what I was expecting.  

If it comes down to telling my current doctor about M2M sex or replacing him with a new, gay friendly doctor then I will stick with my current doctor and drop the whole idea.  My current doctor is that good and my health is the most important thing, certainly better than sex.  

But one thing that hasn't been mentioned is taking daily PrEP (or a better substitute) for 5 months, ending it 1 month before lab work, then resuming for another 5 months after lab work.  

Even if I was taking PrEP (or suitable substitute) I would still be careful and selective with sex partners.  I know abstinence is the only safe sex but I'm willing to take some sort of risk, but I'd like to minimize that risk as much as possible.  I guess that I should talk to a local clinic and/or make an appointment.  

Your doctor can be the greatest doctor in the world - but if you're with holding information then he won't be of much use.

Men who have sex with men, especially if you bottom, sometimes need more specific tests. You could have a case of HPV, internally, and not know it. It could become cancerous. You need rectal swabs to check for it so you don't find out when it's advanced far enough it's fucking up your blood work and you're having major surgery. This is just one of many examples of things that can happen.

There's more at stake here than really just not wanting to tell your doctor you have sex with dudes and need some PReP. If you're that worried about how your doctor feels about you taking dick then atleast make a lie you can live with. Tell your doctor you're in a serious relationship with a woman who happens to be an escort and you want PReP so you don't catch anything and he'll sign you up for more complete STI testing and most likely hook you up with what you need. 

Or just be honest. If your health is *that* important it seems like theres an obvious solution. 

 

[PG1961Canada]

Some good advice from the other folks.  I did notice you mention going for 5 months and stopping for 1 month so 'things' don't show up in your tests.  I respectfully suggest - don't do that.

My family doctor retired. New doctor is traditional but approachable.  He knew I was in a same sex partnership and also that I had been married with kids previously.  When I went for my first physical with him as my new Doc, we finished with a chat.  He was the GP for my partner - who was HIV+ and now undetectable.  He point blank asked me if I was also being treated? When I said no, he said - then let's talk about PrEP and side effects (reduced kidney function). He referred me to a PrEP clinic within the hospital where he practiced and booked an appointment for me.  They were awesome and answered all my questions - and then wanted to know what OTHER meds I was on - so they could make the right choices as well.  I am on arthritis meds.

I started on Truvada.  When I go for my 3 month checkups, they always test for the whole range of STD's (as many have mentioned) and oral/anal swabs and bloodwork for HIV.  It is a great system and just last year, he moved me from Truvada to Descoy.  I am fortunate that my company pays for the PrEP.  They have decided (wisely) it is cheaper to prevent than deal with other issues.    This clinic is well respected and they are clear that they are happy I am 'managing' my sexual health.  They are also clear that they want me to go through the labs every 3 months to stay in the clinic.  It is a teaching clinic, so the results are all tracked for demographics etc.   When he changed over to Descovy, he was clear that my kidney function were pretty good - but I fit the 'more senior' demographic (and we laughed and laughed) and they wanted to reduce impact to the kidneys due to 15 years of PrEP.

In Ontario, ALL the test results get sent back to your family GP.  As I mentioned, while he is a conservative type doc - he is thorough and pretty much unshockable.

I remember going for an annual checkup a couple of years ago.  My PrEP test labwork showed I had picked up a dose of syph... I was shocked, as I hadn't experienced any classic symtoms.  So, my PrEP guy managed all the public health penicillin treatments.  But, my results all went back to GP.  I had my annual visit and at the end, he looked me dead in the eye and chuckled and said.... "Ed Ed Ed..... you gotta be a little more careful about where you stick or get stuck buddy". And he winked.  And that ... was that.

Worst case? You tell him you want to manage the situation and gauge his reaction.  The worst he can do is tell you he doesn't agree.  Then you decide if you want to go the public health route.  He won't know you're on it from testing.

BUT

What if he agrees and says... "Great idea.  Let's get you started with........".  Again - as others have pointed out already - it is in YOUR best interest if your medical treaters all know what meds you are on.... they can definitely have an effect on one another.

Good luck with your choice.  Let us know what you end up doing!!!!

Cheers

Edited February 10, 2021 by PG1961Canada

[TallHungNYC]

"My current doctor is that good and my health is the most important thing, certainly better than sex."

You're absolutely right - your health is the most important thing.  

However, being healthy and having sex --- the way you not your doctor want it -- are not mutually exclusive. 

Your doctor is not "that good."  He is undermining your health (and likely others) by letting his personal bias impair his ability to be an effective health care provider.  The stigma he is perpetuating is why thousands of people are still dying of HIV-related causes while PreP and treatments are available and effective.  Shame is a powerful deterrent to diagnosis, treatment, and prevention.  

Shame on him.  There are thousands of doctors.  You only have one life. 

 You deserve better.