Just*in Time: November 2016

Hi Justin—
I heard your dissertation is on pre-exposure prophylaxis (PrEP). Can you tell me what the side effects of PrEP are?

Photo by Don Harris © Don Harris Photographics, LLC. All rights reserved.
Photo by Don Harris © Don Harris Photographics, LLC. All rights reserved.

Thank you for e-mailing me. Currently, the antiretroviral therapy drug called Truvada is the only drug combination indicated as PrEP. Even as PrEP is becoming a driving force for HIV prevention, there are side effects to PrEP.

Public health professionals would like to make sure that we know the positives (prevention of HIV transmission) and negatives (i.e., side effects). When it comes to long-term treatment as prevention, there are long-term and short-term side effects.

While taking PrEP some of the short-term side effects you might encounter are nausea, abdominal cramping, vomiting, dizziness, headache, and fatigue. Since PrEP is a new entity to the body, it will take time to get used to it. The first time side effects may arise is within one to two weeks of starting PrEP; the side effects also take one to two weeks to subside. Whenever you start a new medication there is a risk of short-term side effects but at least with PrEP we know that they will eventually go away.

When looking at long-term side effects we have to look at a person’s behaviorial factors. For example, if a person smokes, drinks, or takes recreational drugs he or she is more likely to develop illnesses and that may lead to more susceptibility to the PrEP side effects. But the basic side effects of PrEP are bone density loss and chronic kidney disease. We also have to look at behaviors that might combat the long-term side effects, such as engaging in physical activity and increase in vitamin D intake.

What did it feel like when you got HIV? Did you notice your body change? And, if so, did you think it was nothing? Or can you just not tell at all if you are positive?

I’ve had a little time to think about your question. Please keep in mind I had to think back to 2006 and that was ten years ago.

So, by your first question, “What did it feel like when you got HIV?” I’m going to guess that you mean when did I start showing symptoms. In my opinion I believe I was infected in 2005 but I didn’t start showing symptoms until 2006. I can remember one night I was at a night club with four of my very good friends. I starting feeling warm as if I was getting a fever. I went outside to get some fresh air. When I went outside I felt the urge to throw up and so I did, but felt much better after that. I merely thought I had a stomach bug. Then a couple months later I was in my bed and woke up sick. I threw up five times and noticed that all my bedsheets were wet because I had sweated on them when I was sleeping the night prior to being sick. I went to the clinic with my best friend and that is when I found out that I was HIV-positive. My body did not change except for throwing up. The only way you can determine if you are HIV-positive or not is if you get tested for HIV. You can go to your doctor, a clinic, or buy an over-the-counter home HIV test. But I will inform you that going into a clinic you will have access to more resources if you find out that you are HIV-positive. The over-the-counter HIV test allows you to have privacy while you find out the results of the test, but the downside is that you will not have any resources at the tips of your fingers if you find out your test is HIV-positive (or HIV-negative). When I found out that I was HIV-positive I cried while at the clinic but I had a grief counselor and my best friend for support. All in all, get tested to know your status.

Justin B. Terry-Smith, MPH, has been fighting the good fight since 1999. He’s garnered recognition and awards for his work, but he’s more concerned about looking for new ways to transform society for the better than resting on his laurels. He started up in gay rights and HIV activism in 2005, published an HIV-themed children’s book, I Have A Secret (Creative House Press) in 2011, and created his own award-winning video blog called, “Justin’s HIV Journal”: justinshivjournal.blogspot.com. Presently, he is working toward his doctorate in public health. Visit his main Web site at www.justinbsmith.com. He welcomes your questions at [email protected].