Be a PrEP “Pro” with these healthy adherence habits

Pre = before
Exposure = coming into contact with HIV
Prophylaxis = treatment to prevent an infection

When I have conversations about pre-exposure prophylaxis (PrEP/Truvada), healthy lifestyle routines are an essential part of this commitment to self-care.

There are safety guidelines for PrEP in South Africa, this is especially important for gay and other men who have sex with men, who have a heightened risk for HIV infection. It is very beneficial for men who take PrEP  to know how other men are successfully incorporating this daily routine as part of their health and fitness lifestyle.

PrEP routines are self-loving health behaviours . . . “the more of them I have, the better I can live life,” says Samuel*, talking about his nightly dental hygiene “ritual”. I hear Sam’s broad smile in his voice, as he tells me he keeps his bottle of Truvada between his blue toothbrush and his blue mouthwash in the bathroom. “I brush my teeth, I swallow my blue pill, I gargle, I spit, I go to sleep. It’s my ritual-thing for the day, as a mindfulness practice, just before I put my mind to bed.”

Manu* educates himself about the best way to stay on top of his PrEP game at every opportunity: “I ask questions all the time.” Sexual health services that are accepting and supportive, are staffed with genuine, professional counsellors who are willing to talk about the challenges of developing a sustainable PrEP routine with you.

“I have to budget for my monthly PrEP; It’s an investment in myself; I invest in my future.”

Manu wants to get the best out of his investment. “To use a ‘finance’ analogy, asking questions is asset growth and development for me.” He speaks with the clinic nurses when he goes for his regular blood tests; he talks PrEP with his doctor every time he visits, whatever the reason; sharing with the men in his support group, Manu is always asking after tried and successful habits from his health care providers and other MSM who, like him, take PreP as part of their daily self-care routine.

“Every night, like clockwork,” Jacob* declares when I ask him how he prioritises his PrEP, “I keep a dream journal . . . My pillbox sits next to my journal beside my bed. I simply take my pill with a cup of rooibos, while reading.”

As PrEP is becoming more mainstream, as we bravely break through the prejudices that society project onto sex-positive health behaviours, we develop from strength to strength by prioritising sexual health and prosperity when we share our real life experiences with one another.

Here are some of the adherence habits men have shared from their daily PrEP routines that make remembering your daily dose super simple:

• Reminders are reported to be most helpful; Setting a daily repeating alarm on your mobile phone or wristwatch is the easiest step towards developing and settling into sustainable PrEP adherence

• Incorporating a regular activity with taking your PrEP, like brushing your teeth, reading before bed, making a nightly cup of tea, is a comfortable way of forming ritual and habit

• Setting out your daily PrEP routine in a pill box for the week ahead makes it easy to visually prompt yourself. Keep your pillbox visible, by the bathroom basin, next to your bed, wherever it will regularly catch your eye

• Buddy support can be a great help in getting your routine going and maintained. Men report that supporting a friend on PrEP is a great way to get support for maintaining their own PrEP routine

“The three of us helped each other,” says James*, who decided two years ago, together with two of his best buddies, to start a PrEP . “For the first few weeks we checked in with one another on [instant messaging] each night . . . We talked each other through the initial experiences with side effects . . . now, two years on, our daily pill is just another part of our day, so much so that I’m not sure I’d be able to fall asleep if I missed it.” James and his PrEP buddies continue to support each other’s PrEP adherence today, “I’m so grateful I have friends who understand and appreciate what I am committed to, just as much as I understand and appreciate their commitment to themselves in turn.”

Prioritising your PrEP routine is a self-loving commitment to yourself, and also to the men you enjoy having sex with.

*Names have been changed to protect those brave enough to share their experiences with us.

Jacsman is a research psychologist, consultant, mentor and writer who wants to ensure men who have sex with men and LGBTQ communities keep their hearts, minds, bodies, and desires healthy and sustainably developing. On his public platforms @man4menofmerit and @sexlifelearning4living, Jacsman promotes holistic authenticity that furthers understanding of masculinities and femininities, sustainable sexuality, and Queer and MSM relationships.

about.me/jacsman  Jacsman is a contributing writer for Anova Health Institute.  These views are his own, which may or may not reflect those of Anova and its afilliates.