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 times 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 the 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 it 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 ensures 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 dependent 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 the 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 some things 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.

[Editor's note: This blog was originally written on Wednesday, Jan. 15, 2014, Phil Gill's 21st day taking PrEP for HIV prevention.]