Now that I’m a little over a month into my experience on PrEP, I wanted to provide a quick update on how it’s going.

My PrEP journey started February 12th but I wasn’t able to take my first pill until April 9th, nearly two months later. To hear about why it took so long, read the first installment of the PrEP diaries here.

My doctor warned me about possible PrEP side effects, including fatigue, nausea, digestive issues, and random blobs of fat appearing in strange places. I decided to keep a daily log of my first week to see how I felt. I took my Truvada pill in the morning on an empty stomach, along with my vitamins and Pure for Men tablets. My raw observations are below.

Day 1

9:34 AM – This is a big, fat pill! And very blue. There’s a funny capsule inside the pill bottle – I wonder if it’s to absorb humidity and keep the pills dry?

1:00 PM – Feeling great! No side effects so far.

3:30 PM – Feeling dizzy and a little fatigued. Is it because of the pill, or because I’ve been on my feet most of the day? I think it’s related to the pill because I haven’t had this particular variety of fatigue before, accompanied by a little nausea. I start to feel better after water and sitting down.

No further side effects.

Day 2

No side effects! High energy and mental focus all day. Went really hard at the gym today.

Day 3

7:00 AM – Moving slow after yesterday’s workout. Sore, but in a good way.

10:30 AM – Feeling pretty low energy. Struggling to stay engaged at work. Queasy stomach.

4:00 PM – Not feeling great. A little dizziness, lots of fatigue. Starting to reason myself out of working out.

6:00 PM – Definitely not going to the gym. Feeling exhausted and nauseous.

6:45 PM – Closing all curtains and watching TV the rest of the night. Bother me at your own risk. Cranky.

Day 4

Not feeling dizzy or nauseous. Stomach issues. Had a frustrating workout, struggled to focus and stay motivated. Feel bloated. Couldn’t fall asleep.

Day 5

Groggy from not enough sleep. No dreams that I can remember. Relatively good day. Feeling physically ok, and had a good workout with high focus.

Day 6

Great bike ride (72 miles!), but later in the evening starting around 6, felt stomach cramps and discomfort.

Day 7

Tired AF. Probably because of bike ride and late night yesterday, plus poor sleep and an early awakening this morning. Stomach cramps, feeling bloated.

Day 8

Nauseous in the afternoon. A little fatigued, but was able to brush it off and get in a good workout after work.

After the First Week

As you can see, my first week on Truvada was characterized by a good amount of fatigue and nausea. I stopped recording after that, mostly because the effects wore off. After the initial shock of the medicine, my body seemed to adjust quickly, and I felt no more side effects.

Additionally, I got some great advice from a friend to take the pill at night. That way, any PrEP side effects occur during sleep, rather than during the day. Once I made that switch, fatigue and nausea became a non-issue.

The ironic thing about this post is that I’ve had zero sex since starting the pill. In that sense, it has done its job as a preventative measure. Starting PrEP coincided with a dry spell in my romantic life.  I’ve been stressed at work, traveling lots, working evenings, and occupied every weekend. I don’t think Truvada has limited my libido, but perhaps some of the fatigue has reduced my motivation to seek out sexual partners.

The Right Choice?

Is Truvada the right choice for me? Absolutely. I know that I’ll be back in the sack soon (hopefully), and the empowerment and security that PrEP gives me feels great. I’ve also learned, by watching the PrEP Project, that the vast majority of gay men don’t use condoms. With a near perfect track record of preventing HIV, along with the stipulation that all users get screened for STIs every 3 months, I believe Truvada is a powerful tool in the battle against HIV, but also in helping reduce transmissions of STIs through more regular testing.

To effectively use this tool, however, the LGBTQ community must foster dialogue and openness about STIs. Many with HIV and/or other STIs don’t feel a responsibility to disclose that information to their sexual partners if not directly asked which, I believe, speaks to the stigma that still exists in our communities. A good approach when asking the question is to first disclose your own status before asking theirs.

Next time I find myself headed to bed with a guy, I’ll say something like, “I’m negative and on PrEP. I was last tested for STIs in _____, and the results were ______. How about you?” From there, we can make an informed decision about whether to use condoms.
Man holding PReP

If you’re sexually active with the potential of multiple partners, getting on PrEP might be a great choice. It puts you more in control of your health, and it makes you part of a growing community actively taking steps to end HIV. With a little practice and a bit of courage, maybe we can all learn to be more open about STIs, our sexual preferences, and our sexual health.

If PrEP can help move us in that direction, and prevent me from contracting HIV in the process, I’m all in.