I've been taking it for several months and haven't had any of the side affects many of our well known gay activists screamed people who went on PrEP would suffer. I'm single, very sexually active and use it as an additional level of protection with other safe sex practices.

The best part is I'm not nearly as worried about "Oh fuck, what if the rubber breaks!" and despite popular belief myself and others I know on PrEP don't treat it like a party drug. I take it every morning with a glass of water and usually head off on my 5 am run or work out at the gym.

But for anyone thinking about going on PrEP I would advise you NOT to listen to the Gay Talking Heads on TV or executives from various AIDS foundations who make over $300K per year. Do something insane: TALK TO YOUR DOCTOR, you know the medical professional in your life and talk to other who are on PrEP about their experiences before you decide to take it.

But yeah, I stunned this hasn't been talked about more on Slog or in the gay community in general.

Fantastic points. I, too, have been amazed that there aren't celebrations in the streets and extensive coverage in news media about PrEP. It seems like a lot of the mistrust and reluctance to consider PrEP comes from similar reservations as the anti-vaxxer movement, which is really sad because there are 50,000 new HIV infections in the US every year that are completely preventable. We have the technology!

I'm one of those old farts who spent way too much of my youth stressing about HIV and watching friends die from it. A few decades of prep might just wipe it out. That would be awesome.

Have fun, kid.

It's simple. Money. It ain't cheap.

Well, I guess this is my big coming out. I'm on it. Started it last month. I have been deathly afraid to tell ANYONE, even friends, family ,and sex partners because straight people look bewildered when the subject comes up, and gay people immediately raise an ever judgmental eyebrow. And if it's a potential sex partner, they immediately assume your legs are more open than 24 Hour Fitness.

Why did I take it? Believe it or not, it wasn't to be a bareback slut. It was because I was tired of being crippled by fear to the point where I was denying myself sex and relationships TOTALLY. Even with condoms every gay guy knows the pendulum we have swinging over our sex lives that is just waiting to drop. I've only had sex once since I started and it was with an old flame (probably shouldn't have, he was kind of an ass but it was nice to get naked with someone familiar). I don't know when I'll have sex again, maybe this weekend, next week, month, 6 months from now, hopefully with a steady boyfriend. But I don't know, so started prep just in case. I may go off it if my sex life doesn't pick up I may stay on it for a while. But I'm not going to feel guilty for protecting myself from spreading a disease, any more than a woman should feel guilty for using birth control.

Is it common for folks to use it combined with condoms? As opposed to as a replacement for? I'm just curious if anyone has a anecdotal impression of the trends.

Reasons to freak out about PrEP:
1. Because that guy who insists on not using a condom because you're "bot on PrEP" could be lying.
2. Because there's no evidence it will protect you from the inevitable new mutations of HIV coming down the block. And no evidence that it won't encourage new superstrains while you're barebacking with abandon.
3. Because non-HIV STDs are already on the upswing in the gay community and you good ol' barebackers are the people doing it.
4. Because it's something only privileged people can afford or have access to in the first place.

@7 Shut the fuck up. This ignorant bullshit internet comment is the exact problem.

So I'm supposed to give up PrEP and be at greater risk of infection because you think its not fair everyone has access yet? Fuck you.

@7 - If a guy insists on not using a condom, you kick his arse to the curb. Problem solved. Seems to me that PrEP is just an extra layer of protection, and all the sensible people are using it that way - not as a single line of defense. You don't like it, you don't have to use it, but you don't get to dictate how people protect themselves, and you don't get to slut-shame because you're ASSUMING that guys are out there barebacking all willy-nilly.

Medicaid covers PrEP, and we're in one of the many states that benefits from one of the better aspects of the Affordable Care Act which is the Medicaid expansion.

@7 - Man, I really love the way you assume anyone who uses PrEP is going to be out in the streets barebacking with anybody who winks in their general direction. This kind of attitude is precisely why so many people who could and should be using it do not. Your reading comprehension seems slow, so let's repeat the concept of PrEP: It's a pharmaceutical addition to other methods used in safe sex. Get it? "Addition to other methods". = Used in conjunction with other forms of protection. = Used with condoms. Now go to the board and write "I will not jump to unfounded conclusions" a hundred times. Neatly.

Here's my concern--other than your misuse of the word berserk, which is a great word with a specific meaning, and it's not "outrageous"--when they gave Truvada to someone who had HIV but hadn't tested positive for it yet, they got a super-drug resistant form of HIV.

I wish I could find the link--I can't remember where I read it, but I do remember thinking at the time that it was a reasonably reliable source.

Having said that--it's still something I've been meaning to talk to my doctor about.

@12. This is a reasonable concern. PrEP guidelines now advise that everyone undergo viral level/RNA PCR testing prior to starting PrEP, for just such this reason. These tests are more sensitive for early infection, when an antibody assay may still test negative.

@12/14 - according to Evan's first PrEP article, Truvada was originally approved as a treatment for HIV and has been used by HIV+ patients for many years. So why would it be bad to give it to someone who already has HIV, but didn't know it?

People are dying en masse of HIV. Women.

HIV/AIDS is the leading cause of death worldwide for women ages 15-44 years, and young women ages 15-24 years are twice as likely to be at risk of HIV infection compared to young men in the same age group, according to the World Health Organization.

http://www.uab.edu/news/innovation/item/…

That article mainly discusses use of a vaginal antiviral ring. Good as far as it goes, but if contraception not also widely and cheaply available, you have increased pregnancies and/or men pressuring for anal sex, which would presumably not have the same anti-HIV protection. Women would be better off with oral, systemic anti-retroviral, but cost… oy.

So it only took 7 comments before ignorance from some one who just signed up for Slog yesterday showed up.

You would not get a "super drug resistant" form of HIV if you took it and didn't know you were infected. You would develop a Truvada resistant form and they would have to switch you to myriad other drugs. The problem is Truvada for PrEP is a much lower dose than a HIV positive person would need. But doctors require HEAVY screening before hand, you can't get your hands on the stuff without getting screened. So the problem is over blown. And don't forget, this is a drug people have been taking for at least a decade, just not for this particular use.

But don't listen to me, and don't listen to ANY internet comments. Listen to your Doctor, the CDC, and the WHO.

I'm very proud of this comment thread. Thanks to all of you for your input, which has stayed mostly thoughtful and non-attacking. And Brandon: I'm especially proud of you.

That we are being socially remanded to forcefully swallow yet one more drug at an expense that once again subsidizes the pharmaceutical industrial complex is beyond reprehensible. Seriously.

@20 I don't see anyone holding a gun to your head. Big Pharma are bastards, but in this instance they are our bastards. And their morality is an issue that can and should be addressed separately.

@19 Thanks Evan. My interactions with people besides my doctors regarding PrEP have been almost universally negative, the support is nice to hear.

thank you so much for sharing your journey on prep, i am a 56 yr old gay male and all my adult life have had to deal with the possibility of contacting hiv and the hurt both mental and physically this has had on me ,feeling terrible after sex wondering if something went wrong and having to get tested has been the biggest heartache in my life ,sex while great has been a burden to me ,therefore i have now took the first steps to getting generic truvada as we cant get the real thing in Australia but we can legally import generic .getting this oppertunity has totally changed my frame of mind i feel like a kid waiting for xmas