Thomas talks about: PrEP

By Thomas Whitfield

Pre-exposure prophylaxis, commonly called PrEP, is a once-daily pill made up of a combination of two antiretroviral medications used to prevent HIV-negative individuals from seroconverting (becoming HIV-positive). It’s been on the market since 2012 and has been shown to be over 99% effective when proper adherence is met.

Approximately 120,000 people are currently prescribed PrEP. However, research shows that more than 60% of gay and bisexual men have recently engaged in HIV-risk behavior (meaning butt-sex without a condom or PrEP). This means there are MILLIONS who could benefit from PrEP and yet aren’t using it. In NYC there are plenty of places where you can get it FOR FREE, one of the best being Callen Lorde in Chelsea—I can’t say enough positive things about this place. If you’re someone who has sex without condoms (even occasionally), had a recent STI or is an IV drug user, you might be a good candidate for PrEP. I’ve been researching PrEP for a few years, and taking PrEP isn’t just about details of how to get on it.

“I’m going to Fire Island this summer and thinking about going on PrEP. Can you just use it for the summer?”

Currently, about 50% of people who start PrEP don’t stay on it forever. PrEP works while you’re taking it, but not everyone is engaging in risk behavior at all times. Often people have “seasons of risk,” which is what it sounds like you might be planning for the summer. It’s not uncommon for people to go off and on PrEP, but it does take time to build up in your body (seven to 20 days). Remember, PrEP only protects against HIV, and the CDC recommends continued condom use. All sex carries an inherent amount of risk, but the amount of risk you’re OK with depends on you.

“I’m in an open relationship, and my boyfriend wants us to go on PrEP, but I don’t. What do I do?”

I’m wondering how much of a discussion you’ve had with your boyfriend about the rules around your open relationship. Are you both engaging in condomless sex with other people and each other? If so, PrEP is probably a good idea. If he just wants to use PrEP as a backup method because you’re both using condoms, then it’s more personal, and maybe he wants it for himself. Just because he goes on it doesn’t mean you have to. What does going on PrEP mean to both of you, and how might it change your relationship, if at all? Have that conversation.

“I want to go on PrEP, but I’m still on my parents’ insurance. Will they be able to see that I’m on it? I don’t want to have that discussion with them.”

This is a complicated question, unfortunately without a straightforward answer. Most insurance companies will cover the cost of PrEP, and doctors’ appointments are required to stay on the medication. However, what actually comes up on the bill or invoice that your parents might see can be a different story. There are two things I would recommend: 1) call your insurance company and ask them how this is handled, and 2) stop by Callen Lorde and talk to a “PrEP navigator.” They are geniuses with this stuff and will work their best to get you what you need and protect your privacy. I swear, I don’t work for Callen Lorde, I just love them.

Sex/Love/Relationship advice? Send your questions to: [email protected] Instagram: @ThomasWhitfield84