This article was published on June 25th, 2014
Abstinence is the safest way to protect yourself from STI’s and HIV/AIDS, but what gay men can go a lifetime without sex? Most gay men are very sexually active. Every sexual experience puts yourself at risk. Single gay men are at higher risks because they tend to have multiple partners, as do gay men in open relationships. But until there’s a cure for HIV/AIDS, education and safer sex are the only options currently available. But not every sexual encounter is perfect and mistakes and choices happen. It’s reality.
Over the past decade there have been massive strides in HIV/AIDS research, which have dramatically improved medication for people living with HIV and for people who are HIV negative and want to protect themselves. The technology is called anti-retroviral drugs. Gay men can reduce the risk of HIV.
Pre-exposure prophylaxis (PrEP), is a drug that can be made available for an HIV negative person who is at risk of an HIV infection, or at risk of becoming infected with HIV. Taken daily, PrEP can reduce the risk of HIV infection by as high 99%. In the United States, Truvada is an approved drug choice; however in Canada, Truvada is not an approved drug by Health Canada, but may be prescribed by a doctor off-label. Similar to birth control for women, PrEP is less effective if not taken every single day.
PrEP must be taken daily, in advance of being exposed to HIV and continuing afterwards. Anyone taking PrEP to reduce the risk of HIV must commit to taking the dosage on a daily basis, attend regular doctors appointments, and get regular blood test screening.
PrEP does not protect against sexually transmitted infections (STIs) including gonorrhea, chlamydia, Hep C, or syphilis, and is currently only available in pill format. The anti-HIV pills have tenofovir and emtricitabine, two powerful drugs for reducing cells from becoming infected with the HIV virus.
A recent study conducted on the use of PrEP. The first study showed gay and bisexual men who took Truvada every day reduced their risk of HIV infection by 44%. For men who took Truvada every day, consistently, reduced their risk by as high as 73%. Further research has shown that protection may be even higher among gay men who took Truvada every day, determined by the drug levels in their blood. Studies have shown that Truvada taken every day did not work for women; however, the women in these studies did not take PrEP consistently.
HIV negative men who are not on PrEP and who have been exposed to HIV can take post-exposure prophylaxis (PEP). An HIV negative person needs to start taking a combination of anti-HIV drugs within 72 hours of exposure, and continue taking the drugs every day for four full weeks. PEP is not the same treatment or pill as PrEP; however, both use anti-retroviral drugs to reduce the risk of infection in HIV negative people.
It is very important to know that a person who is HIV positive and doesn’t know it when they start taking PrEP, or become HIV positive while taking PrEP, can develop a drug resistance to the drug and the anti-retroviral drugs may not work for treating their HIV.
There is the possibility of side-effects that come with taking anti-retroviral drugs including nausea, vomiting, diarrhea, headache and dizziness. PrEP may also cause decreases in kidney function and bone density. Most research has shown these side effects to be mild and uncommon. PrEP can also interact with other prescription and recreational drugs or other substances. In some cases, there have been fatal overdoses.
It is common for people who take PrEP to have a false sense of security when taking PrEP, including engaging in risky sexual activities, like not using condoms or having sexual encounters with multiple partners. A person who becomes HIV-positive they need to stop taking PrEP and begin taking other anti-retroviral medication.
Anti-retroviral drugs are not covered in all jurisdictions in Canada; however, some private health insurances plans do cover the cost.