Should You PrEP?

Should You PrEP?

The other night I was at the Alibi, Fort Lauderdale’s signature gay bar, and ran into one of the docs I know who works at our town’s largest HIV clinic. Somehow we got on the subject of PrEP, and he knowing me from past conversations, said after a few minutes, “Hey but you’re the conservative type, aren’t you,” meaning I’m a bit of a skeptic when the world around me says something’s wonderful.

Up to now when I’ve spoken about PrEP, I looked at from the perspective of the guy you plan to do it with and whether you should take his word when he tells you he’s on the little blue pill and wants to do it raw. After all, even in the highly touted clinical trials, guys were non-compliant.

But now let’s talk about you. Should you PrEP?

Discounting for now the implication that PrEP poppers are promiscuous pigs and the dubious rep that may carry, you think it would be a forgone conclusion to use a med that could prevent you from getting HIV. I get the impression that younger guys under 30 who are still playing the field are lining up for their scripts; I think I would too if were 22 again.

But if what if you’re an older gay man, even retired like me, who by design or luck is still negative? Should you commit yourself to taking a med everyday ‘cause that’s the only way it’s gonna be effective.

Again it all depends.

Are you in a monogamous relationship or still sleeping around?

Do you exclusively top where your risk, while not zero, is pretty low?

Does it pay for that once-a-year whore vacation junket? Or that infrequent sexual encounter or if you’re at a stage in life where “getting it” ain’t that important anymore? (I ran into one guy who came out at 70 after his wife of 47  years died and got HIV on his very first encounter.)

What if your insurance doesn’t cover it or you have a high deductible?

Should you expose yourself to the possible side-effects of taking what after all was originally designed as a powerful HIV antiviral drug for poz guys, such as kidney function and bone loss?

I should also point out that respected POZ magazine/ recently reported on a case of a guy supposedly on PrEP who still contracted HIV – and a drug resistant variety  at that. One case does not a village make and maybe the guy was not as compliant as he says he was, but…

But getting back to my original question: Should you PrEp? Would you?

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