On-demand PrEP: stomach issues

[greo]

3 hours ago, Tiboer said:

I don’t believe Descovy has been studied for Prep on Demand like Truvada has been.

Theoretically it should work but Truvada is the one proven to.

European AIDS Clinical Society (EACS) Guidelines 2024

・The standard “2+1+1” regimen for on-demand PrEP (2 pills taken 2–24 hours before sex, 1 pill 24 hours later, and 1 pill 48 hours later) is strongly recommended based on robust scientific evidence and has been shown to be highly effective for MSM (men who have sex with men).

・Descovy (F/TAF) can be considered for on-demand PrEP. Pharmacokinetic (PK) studies suggest some effectiveness, and it may be suitable for individuals who need to consider kidney function and bone marrow health.

[DevilDawg]

On 6/10/2024 at 10:38 AM, blackrobe said:

I started PrEP and had no side effects. Except I got to take a lot of bare dick and seed without fretting about HIV at all. 

I'd consider trying the daily dosing to see if ii's a matter of your body being able to adjust/adapt.

I agree with this post. I have been in multiple Leather Clubs, most all of which put major monies into stopping the mass deaths during the peak tide of AIDS. One group of 4 clubs  pooled their resources and funded the simple Gay Men's VD Clinic at the Methodist Church in Georgetown - Washington DC into becoming the bright star of Elizabeth Tailor - The Whitman-Walker Clinic. When I was looking into PrEP, and then PEP after starting and stopping PrEP I received the same synchronized advice between the Veterans Administration Infections Disease (ID) clinic of the DC VA MC, Georgetown Medical, ACT Toronto, and others. At the time, there was a lot of noise about the European Dosing Model which is close to the 2-1-1 model cited. I also supported the outstanding efforts of the  Aids Council Toronto (ACT). As Bernard one of the VA Experts explained to my technical geek mind DOSING plus and minus is an exacting measurement set based on tested and lab trial methodologies. For instance, I am prone to uric crystals better known as Gout. If I take the prescribed dose of ONE Colchicine micro tablet - existing crystals fade and if I am not symptomatic, they are prevented from appearing in any large amount (and I drink a LOT). If I take MORE than one Tab a Day, I get diarrhea. Likewise, when I was on different versions of PrEP, and forgot and took two tabs in a day, I would get diarrhea. I was advised just how stupid this was even through he called me an idiot (politely). You see, excess medication is set for a reason. Taking more only loads up your kidneys and places your health at more risk than not taking anything. Look it up and do the math. If you fill your car gas tank with 15 gallons, and hose and additional 15 of  gallons into a ditch you are 'throwing away' 15 gallons, breaking the law, harming the environment, etc. If you take 2 pills where the dosage is calibrated for (1) in a 24 hour period, the waste is something your kidneys and liver have to deal with. Too Much is TOXIC, Too Little is ineffective. Take a lesson from Goldilocks and do not overthink medical dosing beyond the FDA, and your National Health recommendations. If you have a quack doc or nonDOC like Kennedy who is giving you advice contrary to the listed dosing just remember (please)  you cannot sue them if you are dead.

Lastly, try moving your 1 pill PrEP dose to bedtime. Any watery poop (I used to refer to them as pooping Tribbles) would be passed in a normal Morning bowel Movement.

OR - If you are a slut like myself who bends over when opportunity presents itself at any  Glory Hole that interests you, you can avoid all the issues of loose poop and trying to remember the last time you popped a PrEP dose, I am now on Injectable Prep and get 6 shots a year with periodic liver and kidney monitoring. If any of this proves useful, It is My Pleasure to Serve and Protect Your Anus....... -

[Iker80]

Yeah, I thought I was good with it at first. My first few times it made my stomach bad, then I seemed to get used to it for a bit, then after a while my stomach didn't like it again. So I have to be careful when I take prep, not too much coffee, maybe no coffee if it's being very difficult :( avoid spicy food, just eat more carefully than normal. And not go hungry too long. I take it and half hour later I have a weird feeling in my stomach, but have a bagel or something and it's ok. I'm learning how to manage it when taking prep and it's helping. Maybe my stomach will get ok with it in time.

[J-raw]

Honesty, I think that when starts going from taking no medication to take any pills daily that it takes the stomach time to adjust. I had to start taking some meds for a magnesium deficiency and when I was complaining to my doctor about loose bowels he told me that that was usual. Also think middle age plays a role when you grew up never taking anything younger. Everyone's body is different.

[UnsureAboutThis]

I started barebacking a few years ago and started on prep shortly after that.  I tried for about 6 weeks to adjust to prep (Truvada) but had too many symptoms to make it work.  The headaches, diarrhea, upset stomach and general fatigue was too much. I tried Descovy; even though the side-effects were not at prevalent I still couldn't tolerate the medicine. There's no way I could feel horny when I had a constant headache and felt like I might throw up at any minute.  I was told that the injection might be the way to go but I've been hesitant to give that a try because I'm afraid that I'd have a reaction and there wouldn't be anything to stop the side-effects until the dosage tapered off.  I'm also unsure my health insurance will cover it since it is still considered new and does not have a generic alternative available (something my health insurance seems to require). 

So, after all of that,  I decided that I would just play with guys who I was relatively sure weren't going to infect me.  I know, there is no absolute way to be sure someone is not harboring an STI but I thought I'd at least give that a go.  Recently I met with a couple that are undetectable and took their loads.  I think taking their undetectable loads awakened a hunger in me so I have started playing with guys and not asking about their status.  Now I'm not sure why but I want to try getting fucked and taking a poz load just to see what it's like. I know the chance of getting infected the first or second time out is very low so I feel like I need to try this.  My question is, should I at least try to get the prep injection before I take a known poz load.  

In the matter of a few years I have gone from a safe sex advocate to a "safe" barebacker, then to taking undetectable and unknown loads to now wanting to try poz loads.  I might be a chaser at this point who just hasn't admitted it to himself. Thoughts? 

[cman54]

We all change what we want over time. I feel much like you now myself it's been a different journey for sure but I'm at the point now where I really want to  take a poz detectable load. I'm a little nervous about it but I know I want to do it . I am really to do it . Just need th

O find that guy that can and wants to do it. I'd say in your situation if you know of a poz guy not on meds or and poz guy that will take aeds break I say yes go for it. I had an opportunity years ago to meet a gifter and I chickened out. Now I cannot seem to find one.i regret not going through with it with that guy. I'm hoping I find one now.

[polyglutton]

When I began taking daily PrEP I didn't feel well and had very loose stool for the first 3-4 weeks; then the side effects disappeared. Even when I have been intermittent (during prolonged periods without sex) the side effects never returned.
 

I hope that if you hang in there, your body can also get used to it, even if for event-based PrEP

[phillygwm]

I'm not as sexually active as I'd like so usually do 2-1-1.  Took 2 today, for instance, because I'm trolling for sex 🙂  Hopefully, I'll need the 1-1.  I do notice some diarrhea, which is OK with me because my weight loss med (Contrave, not a GLP-1) makes me irregular.  Nothing where I'd have an accident but noticeable.  

[cwhatley]

switch to injectable prep

[UnsureAboutThis]

6 hours ago, cman54 said:

We all change what we want over time. I feel much like you now myself it's been a different journey for sure but I'm at the point now where I really want to  take a poz detectable load. I'm a little nervous about it but I know I want to do it . I am really to do it . Just need th

O find that guy that can and wants to do it. I'd say in your situation if you know of a poz guy not on meds or and poz guy that will take aeds break I say yes go for it. I had an opportunity years ago to meet a gifter and I chickened out. Now I cannot seem to find one.i regret not going through with it with that guy. I'm hoping I find one now.

Thanks. I feel like I'm ready to take that step. I just need to find a guy who is willing to fuck his load in me. That's not as easy as one might think.