News about Apretude (cabotegravir) 2-month injectable PrEP

[viking8x6]

1 hour ago, BlindRawFucker1 said:

I always thought that you took the first two within 24 hours, 12 is better, before the encounter, then 1 every 24 hours until 48 hours after your last encounter.

Meaning, if you were to fuck Friday, Saturday and Sunday nights, it would be best to take the first 2 Friday morning, then 1 every 24 hours through Tuesday night.

Is that not correct?

That is not the protocol that was tested in the French study.

It is, however, a completely logical extension of that protocol, and there is no logical reason to believe that it would work any less well. It simply hasn't been proven to work (i.e. in a study subject to statistical verification).

 

[BootmanLA]

21 hours ago, viking8x6 said:

That is not the protocol that was tested in the French study.

It is, however, a completely logical extension of that protocol, and there is no logical reason to believe that it would work any less well. It simply hasn't been proven to work (i.e. in a study subject to statistical verification).

And that, in a nutshell, is also my (personal, idiosyncratic, not backed by any study) problem with the on demand method. Once you deviate from a measurable, set pattern (one dose, every day, same time of day every day if possible), you introduce variability that's hard to measure.

Conceptually, 2+1+1 makes sense: you take a double dose ahead of time, so that any HIV entering your system hits a larger-than-usual (ie daily level) wall of protection, and then continue to take the medication afterwards for a period, in order to boost the level of protection until it's too late for HIV to gain a foothold.

But consider: let's say it's a long weekend and you're going away to some "event" where you plan to be active starting Friday night. You take the first (double) dose about 8 AM Friday before you leave. You end up having sex about midnight on Friday (so 16 hours later). Then you also have sex on Saturday night about 11 PM, and on Sunday night at midnight because Monday's a holiday and you can stay up late, Then you have one last fuck before heading home Monday at noon. Using the "2 doses after the last time you have sex" AND the "24 hours after each dose" rules, both, your final dose would be 8 AM Wednesday.

But that puts your last dose at 40 hours after your last sex - is that enough? Does the final "+1" contemplate being close to 48 hours after your last sex? What if, thanks to scheduling, it's more like 36 hours?

And all this assumes you can take each dose 24 hours after the first ones. Again, in this example, you started at 8 AM on a Friday; what if you're not up again on Saturday until nearly lunch because you sleep in after a long night dancing/partying/having sex? What if, on one of the "+1" days, you find yourself away from your meds when the 24 hour clock strikes, and you can't get back to them for four or five hours?

Obviously, it's still way better than nothing, and I'm not going to suggest it's not helpful. And certainly for people who already have some issue like compromised kidney functions, the less such medication you take, the better, so daily may not be right. But if Apretude turns out to be less damaging to kidneys than the oral medications, it'll be far better than "on demand" PrEP because it's one less thing to have to remember and/or calculate.