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Truvada

Intermittent or Event-Driven Truvada for HIV Prevention

Hi Dr. Olson,

I’ve been on Truvada for about three years. Occasionally, I stop taking it when I’m not sexually active. I’ve stopped for as long as three months and then started back up again. My doctor says this is fine but I’ve heard from sex partners this approach lowers the efficacy. Your thoughts?

First, I must tell you I am not an expert in the prescribing of Truvada, so I consulted with some doctors who are.

Intermittent use of Truvada is called event-driven pre-exposure prophylaxis (ED-PrEP), and it has proven highly effective in reducing HIV men who have sex with men (MSM) who engage in anal intercourse (receptive or insertive sex). It is an alternative to daily PrEP dosing for some men. At this time, the data are only available for Truvada; data are not yet in for Descovy. But you need to know more.

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Alcoholics Anonymous and Honesty about Same-Sex Desires

I’m very conflicted now. I am in my midsixties and have been married since I was in my early twenties. I’ve struggled with depression, alcoholism, and drugs most of my life. The first twenty-five years of my marriage were a complete nightmare for my wife—infidelity, alcohol and drugs, and all the lies and false promises I made. For several years, I have been clean and sober with the help of AA.

My wife and I haven’t had a sexual relationship in several years. I have always had a high sex drive, and one day while surfing Craigslist I decided to try having sex with a man. I did, and I liked it. Honesty is a big part of AA and for staying sober. I am hiding this, and now all I feel is shame and guilt and it has ruined my sex life. Any advice?

Thanks for contacting me. First, congratulations on your sobriety. I know how difficult that struggle is. Substance use disorders are chronic conditions, much like diabetes, that can never be cured but must be managed on a day-to-day basis. Continue reading

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