Day 36: Changing the Message

Hey everyone thanks once again for reading Let’s Talk About PrEP. Thought I’d do a little check in, seems like it’s been a while since I’ve written. Not too much on the home front to report, I got my prescription refilled, which worked a lot easier than I expected it to. Really, I didn’t have to do anything. The medication was shipped to my doctor’s office with no action required on my part. I have to say; that it was an unexpected, pleasant surprise when I got a call saying my medication was in. Other than that, I’m still feeling great, and I’ll be honest, my sex life is healthier and happier than I think it’s ever been. It’s amazing the great burden that is lifted once you know that protection is in place and the peace of mind that PrEP has brought to both my partner and me.

I have been reading a lot about PrEP lately. And it’s brought a few things to mind and has also opened my eyes to something that seems counter-intuitive to me as a human being, the idea of stigma for protecting yourself. So ok, I’ll start with a personal story. A few months before I began taking Truvada my boyfriend was asked to speak on a panel in LA in regards to PrEP. I, wanting to get out of St. Louis for a few days and in desperate need of a vacation, decided to join him. (Ok I guess I also went to support him, but don’t tell him that. It will go straight to his head.) So, we get to the Hollywood Improv, which was pretty cool, and toward the very beginning of this panel discussion a simple question was asked of the audience, which consisted primarily of gay men; How many of you use a condom every single time you have sex? The response wasn’t very surprising, a sparse raising of hands but a vast majority of the room looked around with their hands still firmly planted at their sides. With this information, the panel proceeded to discuss the merits of changing the message of what constitutes protection. I was dumbfounded when the leader of the AHF (AIDS Healthcare Foundation) continued to preach that the most effective tool for prevention was condom use and that should be the only message to the world. He would not accept the fact that there is a medication in Truvada that will provide people at high risk of infection with an alternative.

Fast forward to this week. I read a great article on HIV Plus Magazine’s website about PrEP. It was written by Michael Lucas and made some really interesting points. You can find the article here. Then I got curious and started reading the comment section. This is where once again the stigma of using PrEP reared its ugly head. Comments such as “I wonder if there is a pill that would stimulate brain activity? Why on earth would you take medication that you don't need? Stupid. Irresponsible.” Or “Gay men are not shouting from the rooftops about this potential game changer" because it's both woefully toxic and ruinously expensive.” These comments really seemed like an attack on those of us taking PrEP by uninformed people. But this is the culture that exists, gay men have been told since HIV/AIDS became a prevalent factor in our community that condoms are the only way to protect themselves from becoming infected. Times have changed and it is time that our message has as well. Luckily, I have not experienced the stigma that seems to exist, in fact I have had a really positive response to my sharing my PrEP journey. What have your experiences been? As always, I’d love any feedback or questions you might have. Thanks again for reading!

Day 21: Why PrEP

Hi everyone! Thanks for visiting Let’s Talk About PrEP. This is day 21 of my experience taking Truvada as PrEP and so far, things are going really well. No side effects to talk about and life seems to be business as usual. So I want to take this opportunity to talk about why I decided to start using PrEP. Now I said in my first post that there would be sometimes I would be discussing my sex life in this blog, and that I would warn you if that were coming, so… WARNING!!! WARNING!!! WARNING!!! Here it comes, if you happen to be a parental figure in my life, or if you view me as that big or little brother, or if the idea of my sex life makes you uncomfortable, thanks for reading and you probably want to stop reading after this paragraph. Now this is not to say this is going to turn into a pornographic blog by any means, so I don’t want to scare anybody off, but what parent really wants to read anything about their son’s sex life?

Ok now that that little bit is out of the way, back to the question at hand. Why PrEP? Why would a healthy, young man decide to take a pretty substantial medication every single day? It ended up being a decision I made after considering several factors. The most prominent factor in my choice was intimacy. For the past two and a half years I have been in a serodiscordant relationship. When we started dating, my partner was very up-front about his status. But he was amazing and I was determined not to allow something like HIV status to be a defining factor in our relationship. We decided it just meant we needed to be very careful and vigilant when it came to sex. But fact of the matter is when being safe is always in the back of your mind there is a certain level of intimacy that was eventually missing. I am versatile, I enjoy being the top and bottom, but my boyfriend hated wearing a condom, so I ended up primarily as the top in our relationship when we actually had sex. But the fear of transmission always stood in the way of a healthy sex life, even with a condom the fear of it breaking and the lack of intimacy made me question the traditional message of “the only way to protect yourself is a condom.”

I know it may ruffle a few feathers when I say; there is a certain level of closeness with bareback sex that, for me, could not be achieved when wearing a condom. With a partner who is undetectable, the probability of transmission is already pretty low. But when you add in the 99% protection rate of Truvada, the likelihood of HIV transmission basically becomes negligible. Now, all of the guides recommend using condoms while still being on Truvada. But I feel that by taking PrEP in combination with my partner’s undetectable status I am doing my part to be safe, while still allowing us to truly enjoy our sex life without condoms.

The other thing that PrEP does is allows me to have control in my protection. There are some medical professionals who look at my situation and even with the idea of bareback sex; they might say taking Truvada is an unnecessary precaution. However being on PrEP insures that I am in control of protection, I trust my partner and trust that he will be compliant with his treatment but this allows me to feel like I am not strictly dependant on his compliance to be protected.

Another great thing that Truvada gives me is peace of mind. Every three months when I would go in to get an HIV test (since I was in a “high risk situation”) both of us were nervous wrecks. There was still that fear in the back of both of our minds that something had gone wrong despite precautions we had taken. The addition of PrEP to our regimen really does give us peace of mind, which makes our sex lives a lot better.

PrEP might not be right for you. You might not be the kind of person who is able to or wants to take a pill every day. Maybe you are not in a situation where you are at risk of contracting HIV. Maybe you use condoms EVERY SINGLE TIME you have a sexual encounter. But for me Truvada allows me somethings I would not have otherwise.

Thanks once again for reading. I would love any feedback you might have for me. Tell me of your own PrEP experiences. Feel free to ask any questions you might have. And as always feel free to share this with anyone else you think would find this useful or interesting.

Day 11: Jumping Through Hoops

Hey everyone, I hope your new year has started off well! I know mine has. (I mean aside from the frigged temperatures and the several inches of snow St. Louis is experiencing today). So far, aside from the hangover morning I blogged about earlier, I have experienced zero physical side effects while on PrEP. But I wanted to take this snow day and check in and also talk about my process getting my PrEP prescription.

I titled this post "Jumping Through Hoops" because that is what it felt like I was constantly doing in order to get my hands on the TRUVADA, but I also have some extenuating circumstances that made it a bit more of a challenge. To give you an idea of the time frame, I first spoke with my doctor about getting a PrEP prescription on November 22, 2013 and I finally received the meds on December 26th. Now several factors played a roll in how long it took, so I'll walk you through my experience step by step to explain. I'm sure most people have different, easier stories, but this might serve as a resource for some people who are in my same shoes.

When I spoke with the nurse about the reason for my visit at the beginning of my first appointment, I actually had to repeat that I wanted to talk to the doctor about getting put on PrEP. She later told me she had never heard the term used before and had to ask the doctor what that was. I'm sure this is not uncommon. Luckily I go to a doctor who is familiar with PrEP and who I feel comfortable talking to about such things. It definitely made this process much easier.

When I spoke to the doctor about the circumstances of my relationship and told her about why I felt PrEP was an appropriate course of action, she agreed that TRUVADA would be a good tool in preventing infection. I'll go into my reasons behind my decision in a later post, but I will cover them because I feel that is an important part of this journey as well. Now after we decided to go forward with the prescription the first thing I needed was an HIV test because before you can get a prescription for TRUVADA as PrEP your doctor has to provide a negative HIV test.

After this is where the process became more complicated. The biggest reason for all of the hoops is simple, insurance. As I mentioned in my first post, I am currently an unemployed theatre person, I have spent the past two and a half years as a full-time student. Health insurance has been a very minimal expense for me. I have it, but just bare-bones emergency coverage, (one of those plans that is being dropped because of the Affordable Care Act), until I get a job, or win the lottery, or I am forced to change policies, my insurance does not include prescription coverage.  TRUVADA is NOT a cheap prescription, however most plans will cover it. If you do not have prescription coverage there is another option. Gilead provides assistance for PrEP. This was the route I took. After discussing with the pharmacist my options, my doctor directed me to the webstie start.truvada.com. She said there was an agreement form I needed to print out and have us each sign. After some hunting I foundhttp://start.truvada.com/hcp/truvadaprep-resources which had many different forms including the agreement form. I printed it out signed it and delivered it to my doctor.

I assumed this would be the end of it, I could give that signed form and the prescription to the pharmacy and get the meds. WRONG, I then found out I had to call Gilead. 1-855-330-5479 is the number for the Medication Assistance Program. They ask for information about your health Insurance and your income to determine whether you qualify for assistance. They also require a form to be filed out by both you and your physician. That form can be found at http://start.truvada.com/Content/pdf/Medication_Assistance_Program.pdf. So I filled out that form and got it to my doctor, who filled out their part and faxed the form to Gilead. I waited about a week for the confirmation that I qualified for the program for the next six months.  Gilead then placed the order for my prescription with a pharmacy that would ship my medication directly to my doctor's office.

Now for most of you who have prescription coverage on you health insurance, most of these hoops won't be necessary. But if you do not have coverage, there are still options. I hope this was helpful information for some of you. Please let me know if you have any questions or comments about this or anything you would like me to cover in this blog. I love hearing from you all. Have a great day.

Day 4: Holy Hangover Batman

Ok, so I admit it, at times I forget that my frat boy, college days are well behind me. I'm not that same boy who would drink Jack Daniels just as easily as water (and did it on a fairly regular basis). But there are nights I still like to go out and have a few drinks and at least reminisce about the glory days at Hugh's Jungle Room (a biker/karaoke bar in Des Moines). Last night was one of those nights. I was out having a drink... or several drinks... and enjoying some local drag. I brought my TRUVADA with me since I have begun to take it at 10:30 at night and want to remain consistent with that choice. At 10:30 I took the medication and carried on with the rest of my night, not thinking too much of it since I read every piece of information that came with my medication, and nowhere in any of the information did I see any warning about interaction with alcohol.

Then this morning hit and so did my hangover! I have had hangovers before, oddly they have become more prevalent as I get older... But I digress, NEVER have I experienced a hangover like this. And I thought I was being good last night, comparatively. What I failed to take into account is that my liver is already working overtime now that I have started taking PrEP, and I just demanded even more of it last night. My body was not pleased with me. While there wasn't really an interaction with the alcohol, there was more to consider every time I said "yes" to a shot that I didn't even think about.

So here I am, in bed still, at 3:45 in the afternoon nursing this awful hangover, and realizing I might need to take it a bit easier. I'm asking a lot of my body already, I don't need to be that much harder on it. Live and learn, and now I know. And in the heroic words of G.I. Joe, "Knowing's half the battle." Thanks for taking the time to read. I've got some more posts on tap, but I though this was also something worth sharing. Feel free to follow me and share this with anyone you think would be interested. Also please feel free to add a comment below. What would you like to see me write about? Have you had similar experiences? Any questions or comments are very welcome.

Day 1- Who are you? And What is PrEP?

Hello everybody and thank you for reading the very first entry in my blog, "Let's Talk About PrEP," a blog chronicling my experiences using Pre-Exposure Prophylaxis. Through this blog I plan to cover several topics including: Why I chose to go on PrEP, The process of attaining PrEP, the stigma that goes along with being on PrEP, and my own personal journey as I use PrEP. I also would love for this blog to be a resource for others. I have decided to begin this blog right from the very start of my journey so I can create the most complete picture of the PrEP experience possible.

But this is day one, so let me start with a simple introduction to myself as well as an introduction to PrEP. My name is Phil Gill and I am currently an unemployed theatre person. I graduated in December of 2013 with an M.F.A. in directing. I live in St. Louis, Missouri with my partner and our beagle. I am the HIV negative part of a serodiscordant or magnetic relationship, where one member of the relationship is HIV negative and the other member is HIV positive. It is very important to me that the serodiscordance of our relationship is not the defining factor in our relationship. This is where PrEP, comes in for me.

PrEP is short for Pre-Exposure Prophylaxis. It is a medication that someone who is HIV negative can take to help prevent infection. The only drug that is approved for use as PrEP at this time is TRUVADA (tru-VAH-dah). Now TRUVADA is used with other antiviral medications to treat HIV positive patients, but has also been found to be effective in reducing the risk of getting HIV in men who have sex with men as well as hetrosexual couples where one partner has HIV and the other does not. The medication guide continually states that TRUVADA does not cure HIV infections. For more information about TRUVADA as PrEP go to http://start.truvada.com/individual.

PLEASE NOTE: Nowhere in my introduction to myself does it at all say anything about me being a medical professional. I am not anything close to a medical professional, I've never even played doctor. I am simply a man who has decided to talk about his experience using PrEP in order to get the word out about it, to document my experiences and to potentially help out anyone who might be interested in learning more about PrEP. Odds are if you have medically specific questions, I'll direct you to a website or to your doctor. I might not have your answer, but i will try hard to guide you to someone who does.
Also know that since PrEP is designed to help prevent the spread of a sexually transmitted disease, there may be times my sex life is discussed. If you do not care to know about my sex life, this might not be the blog for you to read. I will try not to be too explicit and I will try to warn you if something like that is contained in a post.

So that's all I have for you right now, but please feel free to leave me feedback, what topics would you like me to discuss? Are you currently on PrEP? How is your experience with it?
Also please share this with anyone you think would be interested in this blog. Thanks for reading.