This is probably going to be one of the most unpopular articles I will ever publish, as PrEP is often seen as the enemy when it comes to bug chasing or gift giving. There are times when PrEP can be useful to help a bug chaser on their journey of self-discovery. I have received some questions about PrEP from those who are sitting on the fence or wanting to psyche themselves up to take the next step, which is why I decided to publish this article. Bug chasers might decide to take PrEP for a number of reasons, particularly those who consider it to be more of a fantasy or fetish. If this topic interests you, then please keep reading to learn more about PrEP and the options available.
PrEP is the acronym for Pre-Exposure Prophylaxis, which is an antiviral drug that was approved by the U.S. Food and Drug Administration (FDA) in 2012 for those who are considered to be at high-risk of HIV infection. According to the Centers for Disease Control and Prevention (CDC), PrEP reduces the risk of getting HIV from sex by about 99% when the medication is taken as prescribed, but this rate drops to 74% for those who are injecting drugs. Understandably, the medication is less effective when it’s not taken as prescribed. Post-Exposure Prophylaxis (PEP) actually came before PrEP and was introduced in 2005, with the difference between the two medications being that PrEP contains 2 drugs and is used before potential exposure, while PEP contains 3 drugs and is used after potential exposure.
Many people still believe that PrEP is a pill that must be taken daily, because this was the recommendation that was reinforced when the drug was first approved and adherence is one of the most important requirements when it comes to maintaining its effectiveness. As further studies have taken place, advancements have been made, so there’s now a number of ways the medication can be taken, which means different personal circumstances can be taken into consideration for those who want to take it, which is important, as we are all unique. Before we explore the different delivery and dosage options, let’s consider some of the reasons why bug chasers might want to take PrEP.
Some people consider themselves bug chasers based on having a bug chasing mindset, but they might not be ready to take the physical step that leads them towards becoming infected with HIV. There could be a range of reasons for this, from not being ready, to those who consider bug chasing as a fantasy only. It’s important to note that some people who have bug chasing desires may want to remain HIV-negative in the long-term and consider HIV only as a fetish or fantasy and there’s nothing wrong with this, because we are all at different stages in our lives, so our thought processes may continue to evolve and things can change. Some bug chasers may also choose to put their chase on hold for personal or medical reasons.
PrEP is available in both pill and shot versions, with Truvada; a combination of tenofovir disoproxil and emtricitabine, the first type of PrEP that was approved for use, which involves taking a pill either daily or on-demand. Descovy is a combination of emtricitabine and tenofovir alafenamide and is also administered via a pill daily or on-demand, with both brands manufactured by Gilead Sciences. You can learn more about the different pill dosage options in the next section of this article. In late 2021, a long-acting injectable was approved for use in some countries called Apretude (cabotegravir), which does not require taking a pill, but the downside with injections is that they need to be administered by a healthcare professional each time, which can make this option inconvenient.
Daily PrEP (Pill)
If you have a high amount of unprotected sex, daily PrEP might work best for you, which involves taking 1 pill each day for as long as needed. If you are a cisgendered male who has sex with men, you can take 2 pills (a double dose) at least 2 to 24 hours before sex on day 1 to become highly protected, followed by a daily pill after this, but for other people, they need to take the pill daily for 7 days to reach the full level of protection.
On-Demand PrEP (Pill)
Also known as intermittent, non-daily or event-driven, if you are a cisgendered male who has sex with men, you can apply the 2-1-1 method, by taking 2 pills on day 1 (a double dose), which needs to be done 2 to 24 hours before sex, then take 1 pill on day 2 and 1 pill on day 3. If you are enjoying extended sexual encounters, then make sure you take 1 pill after the last day you had sex, followed by 1 more pill the day after this. It’s important to add that this method is not currently approved by the FDA and is not recommended by the CDC. In addition, more research has been done with Truvada using this method, so Descovy is not recommended for 2-1-1 at this time.
Periodic PrEP (Pill)
This is similar to the daily PrEP regime, where you take 1 pill each day for the required period of time. This could be seasonal, say summertime when you might be more sexually adventurous or for special events, such as pride. If you are a cisgendered male who is having sex with men, you can use the 2 pills on day 1 method to establish a high level of protection, then continue taking 1 pill each day until required. It’s important to continue taking PrEP for 2 more days following the last sexual encounter for it to be effective.
Injectable PrEP (Shot)
Long-lasting injectable PrEP was approved in 2021 and is taken every 2 months and is administered by a healthcare professional after the initiation injections have been given 1 month apart for 2 consecutive months. These shots need to be administered by a healthcare provider each time they are required and the injections must be given as scheduled. Anyone who misses a scheduled injection by more than 7 days needs to contact their healthcare provider right away. Injectable PrEP is not recommended for those who are injecting drugs.
PEP (Pill)
For situations where you weren’t taking PrEP and you were exposed to HIV following a high-risk sexual encounter, you can choose to take Post-Exposure Prophylaxis (PEP) within 72 hours of the event for a period of 4 weeks. It’s recommended that this course of medication be taken within 24 hours of the event for it to be most effective, but longer than this is fine, although it can only be prescribed up to 72 hours after the possible exposure to the virus, with 72 hours being the maximum length of time possible for the medication to work.
You might be wondering why the dosage is different for those who are not cisgendered males having anal sex. This is because there can be differences relating to hormones and also for those who are using gender-affirming hormones and having vaginal sex. The medication works more quickly when it comes to cisgendered males having sex with men, so it’s important to understand this difference when it comes to dosage. A healthcare professional will consider your personal circumstances when it comes to providing you with medical advice and please remember that the information here is general in nature.
It was confirmed during the PrEP trials that there can be some side-effects including headache, nausea, flatulence and the potential for renal injury. The side-effects reported in the trials were apparently uncommon and were usually resolved within the first month of taking PrEP, which is known as ‘start-up syndrome’. It’s also important to note that some of the symptoms can vary between Truvada and Descovy. The benefits of On-Demand PrEP can include less medication in your system and it could also be a cost-saving measure, considering you are not required to take as many pills. The injectable option is great based on not having to remember to take pills regularly or having to purchase the medication from a pharmacy, but you do need to visit a healthcare professional every 2 months after the initial phase, which could be an inconvenience for some.
There’s various ways PrEP can be delivered to your system and different ways the medication can be taken, which can be adjusted to your personal circumstances should you or a healthcare professional feel it’s suitable. This article has not been written to force you to take PrEP, but as this website discusses all aspects of HIV and considers the pros and cons of bug chasing and gift giving, it is important for this topic to be discussed. You need to do what’s right for you, as you are responsible for making decisions in your life, so this information has been presented for your consideration, along with external resources below to help you learn more, should you be interested.
Further Reading:
- Apretude – https://apretude.com
- Descovy – https://www.descovy.com
- Truvada – https://www.truvada.com
Featured Photo: Photo 85870384 © Marc Bruxelle | Dreamstime.com
Article ID: CC049
Version Control: 1.0 – October 1, 2022: Original article published.
This is a very good article. Prep is a good option that I would like to have in 2010. Jason, you are doing excellent work cause your not only giving support to the community but also educating us by informing the different options we have. Keep it up with this!
Thank you for your comment and kind words Enzo. PrEP wasn’t approved for use until 2012 in the United States, so you just missed out on being able to take it back in 2010. It’s a good option for those who enjoy having bareback sex, but not wanting to become infected with HIV or if they are still trying to work out whether bug chasing is something they want to experience on a personal level. I appreciate your nice feedback about my articles, I try to keep them as helpful as possible and I look forward to continue publishing articles that provide useful information and support in the future.
Since I have decided that this fall would not be a good time for me to transition to my desired Positive status, I am once again going back on PrEP but going to use the 2-1-1 on demand method. At my age it takes me at least two hours to prep for anal sex so two hours for PrEP seems reasonable and doesn’t get me in the habit of a daily pill (I take enough of those with my heart and my diabetes) I have such an on again off again history with PrEP that is Truvada (I’d love to try this with Descovy frankly but not sure about insurance issues) in that I went on it years ago until I realized I missed the excitement of not being sure. (PrEP is pretty fucking effective when taken daily or several times a week) and soon after going off it realized I actually wanted hiv and began to chase. After my false conversion thrill I feltrelieved for a bit and went back on it then realized I felt more disappointed than relieved and began a seesaw month on month off routine. Sometime in the Spring of this year I went off it for good and now…back on again. Once I am off it toward the end of this year I swear I am never going back on it again…maybe.
This is a really good article. I have always fucked raw and started taking PrEP when I discovered I had bug chasing feelings to protect myself until I could figure myself out. I’m really thankful for PrEP, because even though I decided to stop taking it over a year ago, it was there for me when I needed it. If I had decided to not start chasing, then I would have been even more grateful for PrEP. It definitely has a purpose in a bug chaser’s life, because our journey doesn’t start with chasing right away, it begins with us try to figure ourselves out, which is the time when PrEP works best. I also played with poz guys while taking PrEP to see how it felt, and in my head I pretended I wasn’t taking PrEP when poz guys were fucking me and cumming in me, because I wanted to eliminate the worry and it helped me overcome the feeling of regret and worry, so thanks for posting this article, because PrEP has it’s place in a barebacker’s life and also a bug chaser’s life.
Thanks for your comment Ayden. I’m hearing really good reports about how PrEP has been helpful for other bug chasers and I agree with what you’ve said about PrEP being a good option when you are trying to work out why you have this attraction towards HIV. It’s really hard to comprehend at first when you feel like you’re attracted to something that’s so risky, which is why PrEP can be really good to help keep you protected until you better understand yourself, then you can decide whether or not you want to continue taking it. I’m happy to hear that PrEP gave you the time you needed to figure yourself out. I’m still taking it, as I haven’t quite reached that point yet, but I feel like I’m beginning to understand myself much better now.
This has been a great article to post in the fact that there’s still many that want to take that plunge for having fun with taking the loads at most, but get that last minute jitter and have to crawl back, having that tinge of regret.
I fully decided to get myself on it and getting it was super easy through sites like Mistr and all. Only one thing of note, the part of mentioning for the flatulence and nausea, you’ll want to mention (at least on my end) that it can make you go more, not to the point of being like diarrhea, but you’ll have a more active colon to make you go a lot more. For this issue for bottoms, it’ll be a good thing since it helps clean themselves out a bit more in a natural way. ?
Great new article to post and great way to mention that despite many chasers wanting to go for it, everyone’s gotta at least start somewhere where they can feel comfortable to do the deed.
Thank you for your nice words about this article Esteban. I wasn’t sure about how well this article would be received, but speaking from my own experiences, I have found PrEP to be useful and it sounds like you have too. I do receive quite a lot of questions about PrEP, so I thought this article would be useful. PrEP is an excellent tool that can be used as you have described, to resolve last minute jitters and also for helping with timing if guys aren’t quite ready yet, but still want to have fun.
I have just updated the article based on your suggestion to note that there can be some side-effect differences between Truvada and Descovy, but I have only included the common ones for both brands in the article. The need to go frequently is a side-affect that was noted more in Descovy than Truvada and I can see that this can be a benefit for bottoms to help stay as empty and as clean as possible. I didn’t notice this side-affect myself, but I’m taking a generic form of Truvada and one of the side-effects with Truvada can have the opposite effect, but I think the side-effect you are experiencing is very helpful for a bottom, so I’m pleased to hear this.
That is so true about a bug chaser needing to be comfortable with where they are at, which is why PrEP can be helpful with this. I will continue to keep this article updated, as new products will come onto the market and health advice will change, but I’m really happy to hear that you found this article useful, so thanks for your feedback Esteban.
Good article Jason, I was very happy to be on PrEP for a long time, about since it first was introduced. At the time, any cost share to the patient could be waived by signing up with Gilead as an active PrEP user, they would send you a “co-pay card,” and that would pick up any remaining balance after the insurance. I know it’s all done differently in Australia and Europe which is a very real consideration for those in the USA considering PrEP – or those considering stopping PrEP, too.
I was very grateful to be on it for so many years as I’m sure I was taking poz loads and the thought of chasing hadn’t permeated my body and soul at the time.
Thanks Van, I wasn’t sure whether to publish this article or not, as I didn’t want anyone to think I’m trying to influence them one way or another, my aim has been to provide useful information to those who are interested. I do think PrEP can have benefits for bug chasers to help structure their chase for when they’re ready and if not, they have that high level of protection available to them. I’m taking PrEP myself at the moment and I am finding it really helpful so I can get my thoughts and mind in the right place before I take the next step. In Australia, PrEP is subsidised by the government, so it costs about $40 a month for those with a Medicare card and about $6 a month for those with a concession card. I have knowingly taken some poz loads whilst being on PrEP and I have remained negative, so it really goes come down to our personal circumstances so we can decide whether or not it’s for us and it’s good to hear that you found it useful when you were taking it before you reached the decision to take the next step.
I should point out that Discovy is not approved for the 2 1 1 plan. But if one wanted to be the experiment, I imagine one could choose to use Discovy in 2 1 1 and see if it works. That potentially would be a way to ease out of PrEP.
Thanks for mentioning this Jim. You are right, only Truvada has been recommended for the 2 1 1 method at this time, as not enough research has been done with Descovy yet, so I will update the article when I get home tonight, as I’m out and about with friends today and it’s too hard to edit the article on my mobile phone. I appreciate you pointing this out, as it’s important and I didn’t highlight this in the article.
Thanks for the post Jason. Indeed, being on PrEP is a good way to get used to receiving Poz jizz. You know you likely will not contract HIV but can still get used to receiving charged loads. I did that for a time myself.
Ultimately I decided to give up PrEP altogether; but that was my personal choice and I am very comfortable with it. No big financial things to account for like when I was younger. Certainly best to get things like whole life policies done before ripping the PrEP bandaid off and truly starting to enjoy charged loads.
One can liken PrEP to training wheels. Take all the poz loads you want.
Thanks for reading the article Jim and for your comment too. You have raised an excellent point about PrEP being a great way to ease into taking poz loads and I have found it useful for this myself. I have also taken poz loads whilst using PrEP to help me feel more comfortable with it (I was honest with the guys about being on PrEP, because I didn’t want to mislead anyone), and it felt amazing. So this is something PrEP can help with. You make another excellent point about getting whole of life policies and other financial issues in order first, which is why PrEP can be a great tool to help get the timing right. Thanks for your comment Jim.
So, is PrEP a “gateway” to taking raw toxic loads? Definitely. Is it a gateway to ditching the PrEP and chasing HIV? Maybe for some it is. I think for me it was, and I’m good with that 🙂
I do think that PrEP is a tool we can use to help figure ourselves out and some of us will take different paths. It could be a gateway for some I guess and I found an article that has revealed that 59 studies of PrEP from all continents found that 4 in 10 PrEP recipients stopped taking it after 6 months, which kind of supports this theory, although it’s important to point out that the discontinuation rates are higher in non-gay populations. A minority of studies also found that 47% of people who stopped taking PrEP started to re-take it again after a year, with one US survey reporting that the average time users spent on PREP was one year and another finding that only 40% took it for longer than two years.