The true side effects of Prep

[Guest]

Most of the information you find online about PrEP is positive or simply showing how it basically has little to no side effects... I understand this is better than the extra meds you'd need if HIV+ and that some mild side effects on a large population/strong on a few extreme cases is tolerable to eradicate HIV...

HOWEVER, on an individual level, I've found some pretty significant side effects (I'm not including the common ones around GI issues, which I do not get or get very mildly), specifically around sleep. I simply don't sleep the same when on it, it feels as if I had a very light sleep throughout the whole night, as if my brain didn't get rest. I will start to use a wearable to track my sleep, get some measurements without Prep and then on it. 

I naturally began to do some research and found that TAF or TDF (PrEP's main active components) do impact the CNS (Central Nervous System) - which is a well known fact since these are drugs used to treat HIV+ people: 

Source: Despite these advances in the management of HIV, neurocognitive impairments continue to be diagnosed in HIV-infected patients on treatment, even when the viral load is low. Of interest is the observation that deficiencies in brain function in these individuals are marked by a persistent presence of neuroinflammation. Therefore, in this study we investigated whether long-term exposure to ART could contribute to neuroinflammation. Mice were subsequently administered a daily single dose of either Tenofovir disoproxil fumarate or Nevirapine orally for 8 weeks. After treatment, hippocampal tissue was collected from the brains of drug-treated and control mice and the levels of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and brain-derived neurotrophic factor (BDNF) determined. Our results showed that administration of Tenofovir disoproxil fumarate and Nevirapine induced astrogliosis and up-regulated IL-1β and TNF-α. In addition, we found that Nevirapine reduced the expression of BDNF. Together these results suggest that Nevirapine promotes inflammatory and reduces neuroprotective processes in the hippocampus of mice. Our findings therefore highlight the potential of ART to be harmful to the brain and as such these drugs may contribute to the development of HIV-associated neurocognitive disorder (HAND).

It also has an impact on the replication of mitochondrial DNA. A study found that PrEP-exposed MDMs had decreased mitochondrial mass, increased lipid uptake, and reduced efferocytosis. Another study found that PBMCs from individuals treated with PrEP showed reduced cellular respiration and mitochondrial mass.

This research plus my personal experience has made me reconsider my decision... I love BB and PrEP has given me that for a bit but... I don't know if I'd continue taking it knowing what I know now just to go BB. 

Just needed to vent haha. 

[viking8x6]

This information would seem more relevant with some information about what doses were used in the studies, or better yet links to the actual studies.

That said, side effects can be expected to vary quite a lot across the population; some people (such as yourself) may experience substantial side effects where others experience few or none. That's true for any substance we put into our bodies, of course. So, as with most things in life, "YMMV"