Poz’s Trenton Straube has published the first interview with the 44-year-old Canadian gay man known as “Joe,” who is the first recorded person to contract HIV while using PrEP with evidence of strict adherence.
Regarding that adherence, Joe tells Straube, “I was on it the entire time,” a story that remains consistent with that of Dr. David Knox, who presented this finding at last week’s Conference on Retroviruses and Opportunistic Infections (CROI), and with whom Gawker ran an interview earlier today.
Joe says he takes the drug daily and doesn’t “disco dose,” which means he doesn’t to take the drug only intermittently, timing with potential sex. (The method has shown a high rate of efficacy, though not as high a rate as daily use.) “I don’t believe in disco dosing because I think it’s better to maintain the same level of medication in the bloodstream,” says Joe.
Joe, who identifies as “mostly a bottom,” also reports that he went from using condoms “off and on” before starting PrEP in early 2013, and then abandoned condoms entirely while on PrEP. “I was such as big proponent of PrEP that if I was chatting with someone on a hookup site who wanted to use condoms, it was a deal-breaker for me,” says Joe. “I was having sex to enjoy it. And if I was wearing a condom or the other person was wearing a condom, I wouldn’t enjoy it.”
Regarding how PrEP changed his outlook on sex, Joe says:
I became more sexually liberated. It took away the fear. I mean, that’s really one of the reasons why people behave themselves [sexually]. It’s not because of morals or religion or society; it’s just the fear of getting sick—especially the fear of HIV. But once you’re on PrEP you’re more comfortable. You feel safer.
Thanks to the blood tests he was given that were able to point to the relative time of HIV transmission, Joe says that he knows the guy he contracted it from:
He’s in a relationship and “discreet.” We met on bbrt [a bareback community], and he says he’s negative. I prefer to be with people who are positive and know it and are on meds—I’m on PrEP, you’re undetectable, the chances of transmission are like negative 10 percent—but I broke my rule with this guy. So it was with him, I think—it was a bit of a busy period. I reached out to him and he says, “Well, I’m not worried, I’m OK. But I’ll go see a doctor.” And I checked in with him again: “Have you gone? What are the results?” “Oh I’m really busy and haven’t had a chance.” I checked in again. “Oh, I’m out of town on work.” Checked again, and he stopped replying to me. To be honest, I gave up. I don’t need to be vindicated or have him say I’m sorry or whatever. I just wanted to let him know. It’s being socially responsible.
As to why he thinks it’s important to share his story, Joe says:
Because knowledge is power; the more we know, the better we’re prepared. PrEP’s a calculated risk. It’s important for people to know that there is the possibility as opposed to the fantasy that there have been no recorded infections on PrEP. At least now there is one, so it makes it more real. And I tell people, “It didn’t work for me, but I still think it’s great.” If I had to do it all over again, I would still go on PrEP. I just wouldn’t have sex with that specific person.
Joe initially posted his story of HIV contraction while on PrEP on the PrEP Facts Facebook group last year, which is how Straube got in touch with him. Joe also reported to Straube that he had just gotten a “great blowjob” when one of the interviews for Poz’s piece was conducted. “I’m open and upfront with all sexual partners, from my status to my dislike of condoms,” says Joe.