Just Started Taking PrEP

Hey bros,

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I've seen a ton of posts about HIV recently on this sub, and I wanted to share an experience I had with you all. I recently began taking Truvada as PrEP for HIV, starting about a week ago. I hope that by reading a first-hand experience, I might assuage some concerns, and feel free to ask me any questions in the comments.

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So, as a bit of background, I am a college student at a large university in a Midwestern city in the US. I grew up in a very small town of about 30,000 people, many of whom are deeply religious. The Catholic and Baptist churches in the area had huge attendances every Sunday, and being religious was very much a part of the town's social fabric. Driven by these religions, homophobia is still, unfortunately, alive and well in my hometown. I met very few out LGBT+ people during my childhood. Coming to a large city was a wonderful experience for me. Being able to see professionally successful, out gay men has been inspiring. But, more to the point about my HIV risk, being in a large city has also afforded me the opportunity to hook up, which I happily have taken advantage of.

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I have only had one serious relationship to date, but I am really happy being single and enjoying college life as much as my challenging academic schedule allows. I want to settle down eventually, but I want to be able to obtain my undergraduate degree before I start a serious relationship as I want to go to grad school out of state.

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I have multiple sex partners, but I have always been very, very consistent with condom use. I have had bareback sex only once, and that was with my boyfriend at the time who had been tested. Given my consistence with condoms, I never really saw a need for me to be on PrEP. I really thought it was only for guys who were having bareback sex regularly, which I have never been. But, as I was hooking up, I had a gnawing fear of contracting HIV. I knew objectively, my risk was relatively low, given my condom use, but every time that I got an HIV test (every 3 months), I was afraid of it turning up positive.

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When I came out to my father, one of the first thing he told me was that "you damn well better be using condoms". I never wanted to be the gay guy that got HIV. I felt like this would be another burden for my family. Not only would they have the gay son, they would have the HIV+, gay son. I just was and still am afraid of the stigma that being diagnosed would burden me with. It's an unfortunate reality that HIV still carries this stigma, but it is reality in some part of the United States still.

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At my university, I had the wonderful opportunity to take an entire course dedicated to studying HIV, its microbiology and its history in an interdisciplinary course for an general education requirement. Thinking about and discussing HIV every Monday, Wednesday, and Friday of this semester, well, it just made me reevaluate my risks and behaviors. As part of the course, we were given a link to a quiz that evaluated HIV risk based on behaviors. Plugging in my behavior, I was "moderate" risk. While this was expected, it was another tipping point in my decision to start PrEP.

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Then, finally, the thing I was afraid of happened, a condom broke during a hookup. I had discussed HIV status with the guy beforehand, and he had tested negative about a month ago. When we realized the condom broke, he was very concerned, as was I. We both were actually able to show records of out HIV tests, which assuaged some of my concerns, I was still afraid that he may have been within the window period. I reached out to a local nonprofit specializing in AIDS healthcare the day after, and they were able to get a same-day appointment. I met with a nurse practitioner and discussed PEP. Ultimately, we decided that I did not have enough reason to deal with the side effects of the medications. I was tested and everything came back negative. I then got tested three and six months afterwards, and I still was negative. I have never been so relieved.

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After all of this, I was tired of passively being afraid and decided to take my future into my hands. I had health insurance, yet I was still sitting on my hands and doing nothing. I made a doctor's appointment with a local primary care clinic operated by the hospital that my university is associated with. Unfortunately, I was only able to get an appointment months out due to high demand, but the appointment finally came about a week ago. I did research into the side effects of PrEP and eligibility criteria. As a health young man with no history of kidney problems, I believed I was good to go. After the initial work up, I discussed my sexual practices with the doctors, and he agreed that PrEP would be a good move. I had blood drawn for a syphilis test, a creatinine test for kidney function, and an HIV test. They also tested for chlamydia and gonorrhea with urine samples and oral and rectal swabs. After everything came back negative/normal, my doctor sent in for the prescription.

I knew copays could be very steep for Truvada, even with insurance, so I made sure to sign up for the Gilead Advancing Access Program (link below), which was surprisingly easy. When I picked up the prescriptions, it initially rang up for over $500 for one month, which as a full-time student, is very much out of reach. However, after the copay assistance, I ended up paying nothing out of pocket. I was very grateful for being in the position where I actually had the financial means to have this medication.

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I began taking the Truvada, one pill everyday in the morning. There were some side effects. I had some minor nausea and some nasty headaches the first couple days, but now, after a little more than a week, I am not experiencing any difficulties. I set reminders to take the medication on my phone, but I'm considering getting a pill box, just to make it a little easier to keep track of. I am so relived to just have an extra layer of protection. I do not plan on changing my condoms habits or my sexual practices, but, with the combined protection of safer sex practices and Truvada, I can finally be confident about my HIV risk. I feel so relieved.

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Thanks for reading through this, and let me know if you have any questions. I hope that this can help anyone who is considering getting on PrEP inform their decision. My biggest take-away from the experience was that copay assistance is a must, even though no one told me about it. I was only able to find out about it through my own research. I have linked below in case anyone is interested in reading more.

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Gilead Advancing Access: https://www.gileadadvancingaccess.com/

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TLDR: After a condom broke, I got on PrEP. After some side effects (headaches and nausea) abated after the first couple days, I feel much better about my HIV risk, but I don't plan to change my condom use.