Hi Damon! Thanks for answering my question. I've been in PreP for a while and all has been good, tested every 3 months and always neg. Unfortunately, I won't have access to prep anymore, I only have provisions for 2 months of medication. I take it daily. My question is: How long after my last sexual relationship without condoms is it safe to stop taking prep. I mean, for instance, if I have sex today without condoms, for how long should I continue to take PreP to be safe from the HIV infection?
Hi David, thank you for writing in!
When Truvada was first approved for PrEP in 2012, the recommended doses were 28 days after any potential exposure to detectable HIV during anal sex. However, after "Ipergay" (or "On-Demand") results were released in 2015, that changed. As Dr. Robert Grant spoke, "28 days may be more than what's needed. Two doses after a potential exposure to HIV appears to provide substantial protection in the Ipergay study if men were taking PrEP before the exposure." https://betablog.org/dr-robert-grant-what-does-ipergay.../.
More recently, the preliminary results of the three year Prevenir study were released, in which there were zero HIV seroconversions among the participants who chose to use the on-demand strategy to prevent HIV (http://www.thebodypro.com/content/81187/on-demand-prep-vs-daily-hiv-prevention-prevenir.html). Keep in mind, these results are based on studies with cisgender men having sex with other men and might not be generalized to transgender individuals.
In other words, if you are a cisgender man using PrEP to enjoy condomless anal sex, then two days of PrEP after a potential exposure to detectable HIV appears to be sufficient.
Now on that note, I'd be interested in knowing more and why you are stopping. From the way you worded it, it seems this is not a choice that you are making. Please keep in mind that PrEP is accessible in many areas of the world at this point. In the U.S., someone without insurance can usually get PrEP covered by the manufacturer at no cost (https://www.gileadadvancingaccess.com/financial-support). Outside the U.S., one can usually obtain PrEP through an international pharmacy (https://www.prep.global/get-prep). You may also be able to find a clinic or prescriber near you in the global PrEP directory at: https://www.pleaseprepme.global [Or in the U.S. at www.preplocator.org].
If you are on Facebook, I'd encourage you to join my "PrEP Facts" page where we discuss access issues around the world 24/7. You may get even more leads or resources there: https://www.facebook.com/groups/PrEPFacts/.
I hope this information enables you to learn to that you probably do have options for staying on PrEP if that is your choice to do so. I believe all individuals have a right to enjoy condomless intimacy free of fear. For more than 356,700 people in the world, PrEP is allowing for that choice. I hope it remains a a choice for you as well.