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I’m tired and aching but sticking with PEP

The second part of a diary charting one gay man’s experience taking PEP, the cocktail of drugs which may save you from contracting HIV if taken fast enough after exposure to the virus
Sexual health clinics like 56 Dean Street in London can give rapid HIV tests and advise on the use of PEP.
Photo by Scott Nunn.

I ache. And not in that oft occurring post-workout self-righteous way or that occasional occurring post-coitus mixture of satisfaction, shame and regret. No, it’s PEP that has made me ache.

Most people haven’t heard of it but PEP (or post exposure prophylaxis) is a month-long treatment if you have been exposed to HIV to, hopefully, prevent you getting the virus. It’s not for the faint hearted.

And my experience of it over the last week has made me question sensible Susan status of continuing the course of drugs.

You see, as one commenter on my first column very wisely judged, I am at the lower end of the spectrum in terms of my risk of contracting HIV. It all started when a condom broke but my partner, whilst not strictly regular, attested to the fact that he had only recently received a negative result, as had I. With the advancement of science within the field of HIV and AIDS prevention allowing for immediate test results from a pinprick test, you can also be assured that your negative result is accurate to within six weeks of the test.

And, with the barrage of questions during my PEP consultation, I confidently asserted that neither of us were intravenous drug users or had recently entered the UK from a country with high rates of infection.

So why did I decide to get PEP in the first place? The course of drugs you are required to take during the four week course are quite expensive and, were I to live somewhere without a fully state-funded health service, such as the US, this cost would be to the detriment of my own bank balance. Would I have been so insistent upon undergoing the treatment then?

Ultimately the answer to this question has to be yes – no amount of money is worth the risk to your health. You see, and here is another example of why the benefits of anonymity allow me to break free of the shackles of worry or shame, this is not my first scare. The difference being the last time this happened I was not aware of PEP.

The other major difference was that, this time, there was no condom. I had allowed myself one too many gin and tonics at the bar and, with spurious judgement, found myself at the house of an acquaintance embarking upon, in hindsight, a hideous sexual encounter. The kissing was rough and abrasive, I could barely stand up and, when it came to it, I employed no protection as I actively ‘made love’ to him.

That next month was fraught with dread and worry. I got drunk. A lot. My behavior was increasingly erratic. My days started with thoughts of regret and self-loathing and ended, usually, on a similar note. This was completely my fault and I deserved the punishment. I was convinced I had contracted HIV. Worse was to come when I suffered a bout of shingles. The kindly pharmacist printed a leaflet out on it for me but the bottom fell out of me as I read it was one of the symptoms of HIV. It mattered not that it was December, I had been working long hours and had put an inordinate amount of stress upon myself.

Yet again I told a handful of trusted people who tried to reassure me that everything would be ok. I called the Terrence Higgins Trust, a leading sexual health charity in the UK, who spent 20 minutes on the phone with me, trying to reassure me and offering sensitive and non-judgemental advice. In the end, I had to play the waiting game to allow enough time to pass for any possible infection to show up on a test.

An incredible friend came with me to the clinic, 56 Dean Street in London’s Soho. Fortunately that particular clinic is totally dependable in their hospitality and comfortable environment for what is a relatively uncomfortable ordeal. My friend was not allowed to accompany me as I took the pinprick test. The waiting alone for the results was the longest two minutes of my life. I sat in the examination room, looking out of the window wondering how my life would be as a ‘positive’ guy.

And then he returned. The nurse with the negative result. I was out of the woods. My friend and I completed the cycle by returning to the demon which had begun my descent into maniacal behaviour, my trusty G&T. This, however, was celebration in moderation. I had been lucky.

So yes, I ache. I’m not being as sociable as I usually am. If sleeping was an Olympic sport I would have another gold medal to add to our burgeoning tally (Go GB!). But I’m doing the right thing. Yes, I am relatively low risk and each person’s situation will be different when it comes to deciding whether to access the PEP options available to them and, even, whether the doctor decides to prescribe them.

However, in my case, the doctor saw my helplessness and anxiety, harking back to those bleak midwinter nights just a couple of years ago when I put myself through the mill. For now I can concentrate on completing the course and getting my life back to normal, knowing I have done everything possible to prevent infection.

And just as a side note, I’ve had more tests done since starting the course, all negative. I fully expect to be saying the same thing in a few weeks time.

Learn more about PEP on the THT site.

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