Returning to PreP after 3 month summer break?

Question

So my boyfriend from out of state uni is HIV+ and his viral load is undetectable, even so as a precaution I take Prep (Truvada) during the school year since we used to have unprotected sex often. Currently we're on summer vacation so I haven't taken PreP since May, and I'll be going to back to uni and seeing him in late August. The reason I don't continue to take PreP over the summer is because I'm afraid my mom will find out. So can I simply order a refil and take PreP when I go back to school in August or how would this work out?

Answer

Hi there - Congratulations on you and your boyfriend discussing HIV prevention, and coming up with options that help you to experience the connection and intimacy you seek. Although you refer to it as "unprotected sex," the fact is, using TasP and PrEP is the MOST protected sex you can possibly have!

The short answer to your question is yes, you can absolutely restart PrEP when you return to school. PrEP is recommended during times in our lives we may be at risk of acquiring HIV, but it need not be used during times when we are at no risk. It sounds like you already made the determination that not taking PrEP over the summer is the right decision for you (more on that in moment). I would highly recommend keeping your provider informed about your decisions, and you may need their assistance in order to get a refill after this long.

There is simply one thing, but a very important thing, to take care of before you restart. It is imperative that you get an HIV test that can confirm you are still HIV negative before you restart using Truvada. Especially if there have been any sexual encounters during the summer break and if you may have been exposed to detectable levels of HIV.

Remember, Truvada was originally approved for HIV treatment and is used in combination with other drugs to make someone's viral load undetectable. If you were HIV positive, and did not know it, and then took Truvada by itself, then that is not enough medication to suppress your virus. The virus can then build a resistance to the medicines in Truvada, which would limit your treatment options. This is why I can't say it enough times: Please get tested before restarting PrEP.

The other issue you bring up is confidentiality and privacy from your mother. You don't say why that's important, but I trust you've considered the pros/cons of being open about this. If you think it could jeopardize your safety, finances, or academic career, then it is probably wiser to keep this from your mother.

But IF your mother was a caring and concerned parent who wanted you to have the very best future, relationship, and career, wouldn't it make sense to share your decision to use PrEP with her? To put it another way -- If you were a woman who was choosing to use birth control pills to prevent an unwanted pregnancy, do you think she would have a problem with that? If we had a vaccine that you could take in order to prevent HIV, do you think she would have a problem with that? If she wouldn't be upset by birth control pills, or an HIV prevention vaccine, then why would you choose to hide your use of PrEP from her?

Ultimately how you use PrEP, when, and who you tell are up to you. I just ask you to consider the pros/cons of keeping something like this from your mother, given you are not doing anything "wrong" or medically unwarranted.

The first step to take here is contacting your prescriber, and tell them you want to restart. They will hopefully be aware of the importance of getting verified HIV negative, but if not, you may need to remind them. But assuming everything goes according to plan, then there is no reason you can't resume your use of PrEP, and continue to create an intimate and pleasurable connection with your primary partner.

For more information about PrEP, starting and stopping, and "Seasons Of Risk", please visit us in the international Facebook "PrEP Facts" Group at https://www.facebook.com/groups/PrEPFacts/.