Milan is one of around 5000 men who took part in the international PrEP study DISCOVER to participate. The aim is to test whether the combination drug Descovy is just as suitable for HIV pre-exposure prophylaxis ("pills to protect against HIV") as its predecessor Truvada and the Truvada generics. In the IWWIT blog, we accompany the 27-year-old with Interviews.
Milan, the three-year PrEP trial has been running since April 2017. So you're halfway through. Has anything changed in your health?
No, everything is fine. During the last two routine checks, the practice that is looking after me as part of the study contacted me because they had registered abnormal values and I had to go back again.
"Luckily I'm completely healthy"
But it was a false alarm both times. Once they thought I had an acute syphilis infection, but they actually knew that I'd had syphilis before and therefore antibodies were still detectable. Another time they suspected I either had hepatitis C - or a severe muscle ache. The second was the case.
It's a bit annoying that there was almost always a reason why I had to go back to the surgery for my quarterly check-ups. But luckily I'm completely healthy.
Are you still tolerating the tablets?
I don't notice any side effects at all. I have got used to taking it very well.
Do you hear from other study participants or friends who use PrEP whether they have a similar experience with the checks?
Since our last interview, something very significant has changed in my life. At the time, it wasn't clear how things would develop, but I've now been in a steady relationship for almost a year. This has also had a big impact on my sex life and my contact with the scene. I don't actually see any of the people I know there who also take PrEP, so I hardly ever talk to others about PrEP any more.
PrEP provides security
Has the relationship changed the need for PrEP for you?
I definitely want to keep taking them, even if I no longer have sex with other men. After all, you never know what will happen.
If you unexpectedly meet someone on the street tomorrow and end up in bed with them ...
I don't actually do that, but I just feel better with PrEP. Just in case. Of course, I also want to protect my boyfriend by protecting myself.
"I also protect my boyfriend with PrEP"
We've known each other for almost a year now. Before we met, I had already bought my flight to Tel Aviv Gay Pride and travelled there in June. I also met up with someone there again. That alone made it worthwhile for me to continue taking PrEP. But I no longer go out to make out with other people.
Have you clarified your HIV status in the relationship?
We are both negative. And of course he also knows that I'm on PrEP. He doesn't take it. But he's never had sex without a condom before.
Was it a problem or unusual for him to skip the rubber during sex with you now?
No, I didn't feel any insecurity from him; he had built up trust in me very quickly. And he doesn't have sex outside of the relationship either.
One benefit of PrEP is regular health checks
And if you do, you are on the safe side with PrEP.
Right (laughs). I can't look into the future, but for now I'm in the trial and I'll definitely be taking PrEP for that long, even though I'm now actually in a monogamous relationship and don't have to worry about HIV.
The main benefit I now derive from PrEP is no longer primarily the protection against HIV, as it was at the beginning, but that I am regularly checked every three months and thus learn everything about my body.
The check-ups also check whether the medication affects the kidney values or bone density. Is that what you're worried about?
Not that I'm afraid of it, but I've been thinking about it more recently than I used to. Especially when you might actually be taking the medication for half your life - every day. And if there are long-term effects: Are they drastic, or can you put up with them because the benefits of PrEP far outweigh any potential long-term consequences?
"Before PrEP, I was burdened by fear and uncertainty"
If the trial ends next year, will you still continue with PrEP?
I think so - even if I'm still in a relationship. I've got far too used to this form of security for that.
Before PrEP, I fooled around a lot and took the occasional unintentional risk of contracting HIV. This fear and uncertainty really weighed on me. PrEP has freed me from this, and my fear now is that this fear could return if I stop PrEP at the end of the trial.
Partnership, PrEP and the party scene
A year ago, the opportunity to have sex in clubs casually and without a long run-up was still very important to you. What is your relationship with it today?
Yes, I had the desire to fulfil myself sexually, with many men. Now I'm going to enjoy what I have now: the relationship with my boyfriend.
I don't actually go to the scene any more. I now realise how much had simply become a habit. I still have my dating app on my smartphone. I don't actually need it any more because I don't want to meet anyone else. But I haven't deleted the app yet because it at least gives me the feeling that I'm still part of the scene in some way.
So you no longer use the app at all?
Only very, very rarely. When I'm travelling and have nothing to do, then I have a look again. Then I ask myself: Why actually?
To be honest, I was bored of the scene by then. But when you're single, you go out anyway. You simply don't notice or ignore a lot of things. I don't miss it at all. It's no longer all about the parties; I now use my time much more to experience the city and the culture.
"I really enjoyed the party scene, but now I'm at a different point"
If you're no longer in the scene or at the parties, you won't be missed there either. You've known people for three or four years, but they only contact me when they want to have sex. But I don't want that at the moment, which is why the interest in me has disappeared again.
Do you regret now, with this distance, that you spent so much time in the party scene?
No, it was definitely not time lost. It's all about enjoying life and I wouldn't want to miss these experiences. I really enjoyed the scene. But now I'm at a completely different point in my life.
When I do go back to the scene, and that happens maybe every three months, a lot of things seem ridiculous to me.
Can you give an example?
I was once in a club at midnight, so there were hardly any people there. Suddenly this young guy, who I actually knew, storms onto the empty dance floor and rips his T-shirt off. That was so absurd. Who did he actually want to show himself to at that moment? That's what it's all about.
Two hours later, the party is in full swing and half a dozen men are crowded onto this small platform. They are standing so close together that they can barely move, let alone dance.
"Maybe the desire for the scene and sex with others will return"
This little box is their stage at this moment to present themselves and their bodies. But hey, they're grown-up people! I then asked myself: was I perhaps like that too? It's little things, but I'm only realising them now.
At least at the moment, I don't need all that any more because it doesn't give me anything. But maybe this is just a phase and the desire for all this and for sex with others will come back. We'll see.
Thank you very much for the interview!
Do you want to know what PrEP involves, how to get it or how much it costs?
Everything you need to know about PrEP can be found at iwwit.de!
More interviews with Milan:
"The PrEP is only an tool, and you have to learn how to use it"
"PrEP frees you from always having to think about HIV"
Further articles on the topic:
"Pills to protect against HIV: DISCOVER study now also in Germany"
Interview: "My sex has been much more relaxed since I started taking PrEP"
How long does it take before you can start PrEP? From zero to one hundred in three weeks!
