PrEP. It stands for pre-exposure prophylaxis, a drug that LGBT people – mostly men – take to reduce their risk of HIV infection.

And therein lies the problem.

Men in our community, including those who identify as transgender, are using this drug – most popularly marketed as Truvada – as a crutch to have unprotected sex because of its claims of a 99-percent success rate against HIV.

In fact, Truvada is highly effective. Its success rate is somewhere between 92 and 99 percent in the reduction of HIV risk for HIV-negative individuals, according to the San Francisco AIDS Foundation, based on "perfect use" – but PrEP is not a perfect drug. There is room for error, and that’s where the real trouble emerges.

Too many of us are using the drug as an excuse to be reckless and promiscuous, without any regard for the 1- to 8-percent rate of infection among "perfect" users. "I won’t be in the minority," we assume. Until we are.

If that thought has ever clouded your judgment when your Grindr guy takes his pants off in your bedroom, here are four reasons to recoil and take your health seriously – no matter what Big Pharma has promised you.

The most important aspect of PrEP that all potential users should recognize is that while the regimen prevents against HIV infection, it doesn’t prevent against other STDs – at all. The Center for Disease Control warns against relying on PrEP for full STD protection and still advocates for condoms. "PrEP doesn’t give you any protection against other STDs, like gonorrhea and Chlamydia," the CDC says. But combined with condom use, your risk of other STDs is exponentially reduced.

PrEP’s reported success rate is based on "perfect use," which equates to a daily dosage. Miss a dose or slack off for even a couple days – and have unprotected sex in between – and you’re putting yourself at risk for HIV and STD infection beyond the reported protection rate despite that you’re essentially "on" the drug. This is especially important to remember because we all forget to take our medicine from time to time – it happens – but in this case, if you’re "off" PrEP while engaging in unprotected sex, you could catch more than a cold.

Short-term effects of a PrEP regimen include nausea, abdominal cramping, vomiting, dizziness, headache and fatigue – the basics – but more serious, long-term effects include impaired kidney function and declining bone mineral density, which poses an inherent problem for those already dealing with or at risk of these issues.

Because those who prefer to have unprotected sex are using PrEP in our community so heavily, it’s giving the rest of us pause for caution. Tell somebody you don’t want to use a condom because you’re on Truvada and you may face a lonely night – not to mention the humiliation of being left abruptly in bed. "I’m on PrEP" is not a good enough excuse to avoid using other protections considering that PrEP only protects against HIV and not other STDs. Put on a condom as well. Your consideration of others’ health is not only smart but it’s also sexy; don’t ruin the mood by potentially putting someone else at risk for something you don’t even know you might already have.

Related Articles

Contributor Mikey Rox

Topic Advice | AIDS/HIV | PrEP | STD/STI | Truvada |