[T-Plus 2 Days]
Two days and two doses into my first month of PrEP today. I took my first dose the night before last, and yesterday was pretty normal - no headache, no nausea. I thought I might have gotten a little dizzy that first evening, a couple hours after I took my first dose, but it could have as easily been that I was just tired.
Today was a slightly different story. Took my second dose last night (no dizziness afterwards), and woke up this morning with a slightly sour stomach. It wasn't much, just a little a little extra rumbling and a little lower appetite (which came back fast a couple hours later). The indigestion has persisted through the day, but it's still low-grade, and doesn't seem likely to get any worse.
My doctor prepared me for this possibility (and of course I had done my research about side-effects in advance); my doctor explained during my most recent appointment that if I experienced any nausea after starting PrEP and was concerned about it, he could prescribe medications to help. So far, I don't think that's going to be a concern, but it's good to know that there are options. As it is, my doc and my research all explained that typically any side-effects don't generally last more than a month.
It's really important to note here that if you're taking Truvada (for PrEP or otherwise), you should always consult with your doctor before adding another medication, including over-the-counter meds and even for side-effects. This is because Truvada, as with many meds, has some potential interactions with other medications (though in the case of Truvada, those are fairly few). A doctor familiar with your health and medication history can suggest the best options depending on the side-effects you're experiencing.
Okay, so I'm coping with the minor side-effect. Next step is adherence.
[Adherence describes how consistently a person takes their prescribed medications or treatments on-time. In this situation, "on-time" is generally accepted as being within two hours on either side of one's regular dosing time - so if you take your medication at 9pm normally, then as long as you're taking your next dose between 7pm and 11pm, you're considered on time. If you're consistently taking your doses on time, without missing, every day (in the case of Truvada), then you're considered fully adherent.]
Adherence can be tough. Life gets freakin' busy sometimes... which unfortunately means that things get forgotten, including medications. I've been guilty of this plenty - I'm supposed to take a blood pressure medication every day, but for a long time, I'd miss or nearly miss as many as a few doses each week. Not good. For both the blood pressure meds and Truvada, I need to have what's called a "therapeutic level" of the medication in my system for it to be properly effective. In the case of Truvada for PrEP, the more doses I miss in a week, the less protected from HIV I am. So yeah, adherence is super important.
Right now it's early in the process - I'm still pretty excited to have gotten on PrEP (I think I will always be amazed that I live in a time when something like this is even available) - so my adherence is probably going to be great at first. It's fresh in my mind, too. The bigger deal is keeping that up, because as I said before, the more I miss, the less protected I am. Perfect adherence is the goal. That doesn't mean I can't miss sometimes (it's pretty likely I'll miss a dose eventually), but I've gotta try to take it as consistently as possible. As it is, my doctor explained that I won't have a protective level in my system starting off for somewhere between five and seven days, so I really can't miss early on.
There are lots of ways to help with this. One suggestion I've gotten repeatedly is to use a weekly or monthly pill box; this lets me parcel out my meds for easy access, but also has the benefit of letting me track missed doses easily. The problem is I'm terrible at keeping up with those, not to mention I like having my medications in their bottles so if I have to travel with them, they're right there with all of the important prescription information. Other folks have suggested using a calendar near where I store my meds, but I'm terrible with (paper) calendars, too (you should see my office at work - I think the wall calendar there is on September of last year...)
The best bet for me has been to use either a reminder in my phone, or an app that lets me organize my meds. Both work really well for me, especially since I keep my phone with me more than any other calendar. For me, the apps are best, because they allow you to track missed doses in the same way a real pillbox does, but of course you should find a system that matches your schedule and preferences; the apps offer the most detailed adherence tracking, and can even let you transmit that information to your doctor, but as with any digital medium, there are potential privacy concerns that might turn some people off of apps. Whatever system works, take your meds!
And that's it for now. I'll check in again in a couple of days - with any luck the upset stomach will have faded by then!
Cheers, friends!
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