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truvada for prevention - hes positive and i'm not
Sep 28, 2012

I have been dating a guy, who was diagnosed as HIV positive about a year ago (he is being treated currently), for a few months now and we are considering becoming sexually active.

I am negative and only practice safe sex. For all intensive purposes, I'm top and hes a bottom.

Besides committing to practice only safe sex, I have been considering getting a prescription for truvada to help reduce the chances of transmission, but I am a little concerned about the side affects associated with taking the drug.

If we strictly adhere to safe sex practices, do you feel taking the truvada could / would significantly further lower the chances of transmission.

Is truvada available to couples like us who have only been together for a brief time?

I know this is a fairly broad question, but I have not been in a situation like this before and want to be as safe as possible. I would greatly appreciate any insight you can provide me on this issue.

Thank you very much.

Response from Dr. Young

Hi and thanks for posting.

You ask several really important questions- ones that have been given a lot of recent attention with the recent FDA approvals of Truvada (tenofoviv/FTC) for pre-exposure prophylaxis (PrEP) and home-based HIV testing.

First, off, probably the most significant aspect about HIV prevention (other than consistent condom use) is whether your partner is on HIV treatment, and if his HIV viral load is undetectable. If this is the case the risk of HIV transmission is already much further reduced.

The clinical studies that showed the ~95% effectiveness for optimally adhered Truvada PrEP were in comparison to best-practice safer sex (ie., training on correct use and access to condoms, screening and treatment of other sexually transmitted infections). So, yes, there is the possibility of substantial additional reduction in HIV transmission, if you were willing to be adherent to the treatment (this is no different that for treating people living with HIV; namely that the medications have to be taken to be fully effective).

PrEP might indeed be of the optimal value in new sexual partnerships, whether they are the anonymous hook up or the new relationship, since knowledge about one's HIV status or viral load might not yet be proven. (or the new partners could be in the "window" period of HIV testing, that doesn't detect recent infection).

Truvada PrEP isn't for everyone. If you have kidney disease or osteoporosis, I'd probably focus on other strategies (or medications, not yet approved). But PrEP is usually very well tolerated and has been proved to reduce HIV transmission in at-risk people. For these people (and you could be one), it's an additional tool to keep yourself healthy and HIV negative.

I hope that helps. Be well, BY



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