Using Truvada for HIV prevention

Published 30, Oct, 2012

He's not happy! Danny Miller gives a big no to using Truvada as pre-xposure prophylaxis (PrEP)

So with all the health issues I have had this year I haven’t really had the energy for a good rant in quite a while. But this issue has been nagging at the back of my mind since about mid-summer and I cannot ignore it any longer.  So here goes, hold onto your hats!!

This summer, here in the U.S., the FDA (Food and Drug Administration) approved the use of the ARV (anti-retro-viral) drug Truvada as prevention therapy, or PrEP. In short, people who are classified as being in a high risk group, such as sexually active gay men who are HIV-negative, can now obtain a prescription for Truvada for the purpose of preventing them from contracting HIV.

Now this is not a necessarily new concept. Doctors, scientist, and pharmaceutical companies have been talking about the side benefits of ARV therapy for several years now.  There have been many arguments for and against this type of prevention, especially for use within sero-discordant relationships. I myself have engaged in quite a few of said discussions on the topic. So where does Danny stand? Well, you guessed it, I’m about to tell you.

I very vehemently feel that using ARVs as prevention therapy is complete and utter rubbish! That’s right I said complete and utter rubbish!!  (Boo and hiss if you like, but I have to speak my mind or I’ll be on a short road to a long nervous breakdown)

In my opinion, as RVs to stay in the green health-wise I think the approval of the use of ARVs as prevention is one of the dumbest and most irresponsible things the FDA could ever do.

Sure the concept is inviting. It says hey, here just take this pill and you won’t catch HIV. It sounds like a legitimate, attractive, easy means of prevention right? But like the old proverb says, if it sounds too good to be true, IT IS!! Not to mention  the fact that when something new and flashy comes out on the market many people don’t take the time to read the small print to see what they are really buying into. They see something that is nice and convenient and they jump up and down saying “I have to have it now!”  Too many times that usually turns around to bite them in the ass. And I see this situation as no different.

Sure, taking Truvada may be an easy and somewhat effective way of avoiding HIV infection but people need to see the whole picture. It’s not going to just be taking a pill every day and that is that. There is so much more to consider here.

I’m talking about things like the possible side effects of taking this drug. There is the ever popular nausea and vomiting that can occur. There is diarrhea that can sneak up on you out of nowhere, because you know it is tons of fun marathon-running to the nearest bathroom to keep from shitting your pants. Dizziness, confusion, sleeplessness, and the always super fun “unusual and or vivid dreams”, What that really means your sleep is going to be invaded by alien beings giving you anal probes  while listening to Cher’s greatest hits under a giant rainbow disco ball EVERY NIGHT!!!

And let’s not forget  the havoc that this drug may wreak on the body. It may attack the kidneys, liver, and pancreas. It may send your cholesterol through the roof and of course there is the possibility that you will enjoy some level of sexual dysfunction also. And you don’t just take it when you want to go out for some crazy, fun, dirty, bareback sex. On no that would be too easy, you must take it every day, every single day for the rest of your life.

Not to mention the HIV virus has mutated, meaning that there is more than one strain out there, and Truvada is not necessarily completely effective against all strains. So using this drug alone as prevention can still be playing Russian roulette, which brings me to my biggest point of contention with ARVs as PrEP.

Now the FDA and prescribing doctors are going to strongly recommend that even while taking this drug as prevention it is still a very good idea to use condoms, and they would be right. But let’s be honest here. We as humans are lazy; we are always looking for the easy way to do everything. How many are really going to take the time to use condoms on top of the ARV? Call me a cynic, but I think that percentage will be really low.

To me, the FDA approving, and doctors being willing to prescribe Truvada or any other anti-retro-viral drug as prevention says, forget everything you have been taught about protecting yourself over the last 30 years! This is the modern age; condoms are such a 90’s thing, so not hip, ya catch me? This is the future, and the future isn’t using condoms, it’s taking unnecessary drugs that are going to  trash your body, ya dig?

In short I am afraid that people are going to see this as a get out of jail free card. They will see it as the reason they have been looking for not to  use condoms, because let’s be honest again, very few of us actually enjoy using condoms do we? But they are a necessary evil. Anyone in this day and age should have that ingrained in their brains: condoms save lives, it’s that simple, condoms save lives!

Truvada as prevention therapy, in theory seems to make sense.  Truvada as prevention therapy in actuality, most likely leads to a new epidemiological catastrophe! If you or someone you know are considering ARVs as prevention, please think long and hard, read the small print, learn all the facts, and consider all sides of the story before jumping into it. Remember another proverb ” nothing in life worth having is gained easily”, and that includes your sexual health. Protect yourself and others, please.

Thank you for reading. XXOO Danny