Following the impressive results of several studies around the world, we now know that PrEP (pre-exposure prophylaxis) offers another line of defense alongside condoms and regular testing to those most at risk of HIV. When the study’s surprising results confirmed the treatments’ high effectiveness last October,  the Trial Management Team of UK based Proud Study quickly offered participants of the deferred arm of the study – those who didn’t receive treatment – the opportunity to take Truvada sooner than planned.  Among those privileged few to have queue jumped the line for PrEP is Keith from Brighton.

Keith, how long have you been part of the Proud study?

I joined in March 2014 after being recruited by my doctor.

Why would your doctor recruit you for this trial?

After a regular check-up she told me my results were negative and she asked me about my sex life. I told her I have as many as five different sexual partners in a week. She went on to inquire how many of those I have unprotected sex with. I told her with one hundred percent of them. I fit the criteria, so she talked me through the details of the study.

You then joined the study and ended up in the deferred arm, means you would go on having unprotected sex without taking Truvada?

That’s correct.

Did you have any concerns, especially after realizing how much of a risk you are exposing yourself to?

No. I knew all along that I was at risk of contracting HIV and other STDs by having unprotected sex.

Why take that kind of risk in the first place?

I prefer sex without condoms and I always discuss status with the guys I meet. If someone doesn’t know their status I don’t meet with them. I’ve been in an open relationship with someone for the last year who is positive and undetectable. When playing together or apart this is also our criteria for sex partners, so we keep an eye on how much risk we are taking.

Where are you looking for sex partners and how often do guys agree to consensual barebacking prior to disclosing each others status’.

I meet men online, in bars or the sauna and I’d say about 95 percent of the men I approach consent to bareback sex. A good seventy percent of which know their status. As I said I won’t have unprotected sex with someone who doesn’t know their status.

And now you have been given Truvada, do you feel any better about yourself? Or any safer in your sexuality?

I was fast-tracked as well and have been taking PrEP since the beginning of November 2014. And strangely I don’t feel any better or worse. Although this probably should be the case. My lifestyle hasn’t changed. Only now I get tested every month.

Have you experienced any side-effects of the drug yet?

None so far.

Would you continue taking PrEP after the study?

Of course, but it’s not sure yet whether and how the NHS will cover for it. It’s something that should be discussed in this election period. The treatment is expensive. One pill costs about sixteen pounds sterling. I couldn’t afford taking one every day.

Do you feel it should be given out free to so called high risk groups?

Absolutely. If it helps to prevent HIV from spreading, which it obviously does, the government has no alternative but to provide free PrEP to those wanting to take it. Not providing those drugs to people at risk on grounds of defamatory labeling PrEP as a party drug like in the States is just as irresponsible as the bareback lifestyle itself.

Are you saying gay men are to blame if they become positive by consenting to bareback sex, but the government is to blame if they don’t provide free Truvada in the form of PrEP?

It’s a bit of conundrum, I admit, but it kind of sums up both, problem and solution. A decision whether to provide Truvada for high risk groups is expected to be made early in 2016. However, there is no set agenda yet. Right now figures are being updated and verified. The big issue is likely to be cost of Truvada, although this is expected to reduce. My discussions seem to indicate that the business case is actually beneficial financially to the NHS.

Exact results of the study were made available in early 2015. Participants who lost touch with their clinics were urged to get back in contact. Proud Study is only one of a few PrEP-studies across the world, all of which show the effectiveness in combating the spread of HIV.

Torsten Schwick 

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