There should be an ‘it gets better‘ video for your first month of side effects.

Just about every single person I know (save for a few notable exceptions) who is around my age, and has a similar volume (quantity? amount? Sum?)  of sex to what I do, is or has been on PrEP for what seems like forever. In reality, it’s only been a few years (because it’s only been offered to HIV neg folks as a prophylaxis  – that’s what PrEP actually stands for: Pre-Exposure Prophylaxis – since 2012), but it’s been such a loud and significant issue in that short span that it’s settled into my brain as just always existing this way.

As someone who attended public school in the south, my government-sanctioned sexual education classes dealt only with heterosexual sex, and sounded suspiciously like Coach Carr’s from Mean Girls:

Except instead of chlamydia, it was HIV (which one assumes wasn’t used in the movie because it’s not as funny as chlamydia) or pregnancy. There was a general undertone, too, directed at the presumed homosexuals in the room, along the lines of “you guys will definitely get HIV if you have sex.” I can even recall my high school drama teacher explaining to me, during rehearsal for Patient A (a school-safe lecture about the dangers of HIV stigma, as presented by a cisgender, heterosexual white girl who contracted the virus by accident at the dentist’s office), the reading of “gay” as an acronym standing for “Got AIDS Yet.” I don’t totally remember what the point of her mentioning this was, but even at the time, it felt like a cautionary tale.

And so my adolescence was filled with much fear and stigma-based misinformation about what HIV was, how it was spread or contracted, and what it meant to live with it. To say that this didn’t affect my adult sex life would be a silly and naive understatement. It impacted me in ways that, even nearing 30 years old, I’m just now discovering. Truth be told, I suspect it’s at the root of my psychological inability to bottom, too.

Butt, 2017: New year. New health insurance, and thusly, a new primary care physician. My initial meetings with PCPs are always sort of nerve-wracking because I know that I’m going to have to sit in a tiny room with a stranger, explain the types and amount of sexual interactions I’m having on a regular basis, and if they have even the mildest of curiosities, why I’m having so much sex in the first place.

I’m a big believer in the idea that there are certain people in your life who need ALL the facts, and with whom modesty or selective information sharing is counterproductive in the extreme. My lawyer knows everything about who I am and what I do. So do my accountants/tax people. And I really make an effort to ensure that medical professionals do too. I don’t tell the phlebotomist that I’m getting 5,000 STI screenings a year because I can’t stop putting dicks in my mouth (and also might be a hypochondriac). But I do tell the guy who’s ordering and interpreting the lab results. He and I need to be on the same page about my body and what’s going on.

So it was on my mind when my new doctor and I met for the first time, and I asked what he knew and thought about Truvada for someone in my ‘activity’ bracket. Unlike my past PCP, he was into it, we ordered some lab work, and based on my “fantastic” (his words, not mine) results, I started on PrEP that week.

A lot of my previous personal resistance to Truvada was wrapped up in the cultural stigma that came with even expressing an interest in the drug. If you’re unfamiliar with the expression “Truvada Whore” I highly encourage you to to read this short essay by the guy who came up with it (as a way to disparagingly describe the sort of person who would be interested in taking a pill every day so they could have unsafe sex). The gay community (or, more accurately, parts of the gay community – there is still much division on this issue) were quick to claim the term as one of pride and many adult entertainers and escorts loudly proclaimed themselves to be #TruvadaWhores in an effort to strip off the grossness attached to the initial meaning of the term.

And it worked.

I’m 1000% sure that I could still walk outside and find someone who had something questionable or shitty to say about people who decide to protect themselves with PrEP, even today. But I’d bet that there’s way less of them than there were 5 years ago, when the FDA first approved Truvada as a preventative measure. And I know for sure that my doctor’s opinion on the stigma related to Truvada was challenged by the #TruvadaWhore campaign on social media (he’s actually written about it).

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We’re about two weeks into my PrEP journey at this point, and while it’s interesting to think of myself as sort of extra-insulated from HIV, the side effects have been testing my patience. Oddly, the digestive stuff that most everyone else complains about hasn’t really been a thing for me. But the ultra-vivid and strange dreams definitely have, I definitely had a bout of sinus something-or-other that lasted for about a week, and I’m mild to moderately itchy most of the time.

I’ve also been experiencing some heightened anxiety and depression. Those have both been scientifically ruled out as being caused by Truvada specifically, but the timing is suspicious, and if you google them in conjunction with Truvada, there are many reports of other men going through similar experiences at the outset of the medication.

Of course I’m going to discuss all of this on my 30 day checkup with my doctor, but in the interim, I’m trying to figure out what I can live with, if this just ends up the cost of that extra insulation.

And for what it’s worth (and to save some conversations in the future): condoms remain a significant part of my life. Truvada doesn’t do a damn thing to stop chlamydia, gonorrhea, genital herpes, human papillomavirus (HPV), syphilis, trichomoniasis, or viral hepatitis, and I like my penis SOOO much that I won’t let any of that stuff get to him, if I can possibly prevent it.

-t

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