I had to visit the sexual health clinic to pick up my PrEP (Pre Exposure Prophylactics – a pill that can be taken to make one HIV resistant). They need to perform a few tests – most noticeably kidney function because PrEP can stress the kidneys if taken too often. Of course, there were also one tests for various STDs and a couple of vaccines (for gonorrhoea and monkey pox).

I was there twenty minutes before my appointment – I get twitchy unless I am comfortably where I need be. I wasn’t nervous, just interested and perhaps a little excited to see how things would be different on this second visit.

A lady came and called me into her room, where she introduced herself and said that she was a trainee. I’m not fussed – I was sure she’d be very conscientious.

The first things were checking over my details and the medications I take. Its a much longer list now thanks to the heart meds. She used an app on her phone to check for interactions between them and PrEP. There were a few things that worried her: the vortioxetine (anxiety/depression) had possible interactions with some of the heart medications (risk of bleeding), and there was a risk of bleeding between two of the heart meds themselves.

She put the questions over medication down for the moment and said that she’d come back to them later.

She then asked me questions about my sexual activity. When was the last time, with whom, was I active or passive and which acts did I participate in. I didn’t get a hint of judgement from her, except that she seemed quite keen on me taking some free condoms.

I asked “would it make you feel better?”

“Can you explain why you don’t use them?”

“Often they kill the moment – most guys I’ve been with seem to lose their erections when the condoms come out; besides, everything but HIV is curable, and I have PrEP for HIV. If its not curable, is treatable.”

She thanked me for my honesty. It doesn’t make any sense not to be honest – it just wouldn’t occur to me to lie. She added that genital warts and herpes were not curable, but can be treated.

I suppose I have to own that I risk not only my own health, but the health of my partners by not insisting on “safer practices”.

One thing she did confirm was that I needed to allow at least a 2 week window for Chlamydia; I think I manually tested two weeks after the exposure, so that was reassuring and gives me a little more confidence in my own test results.

I then had to go and do the swabs for gonorrhoea and Chlamydia – the same yukky throat , bum, and wee tests as I did the other week. This time the wee was more willing.

When I returned to the room, a nurse was there to take bloods and administer vaccines, and my trainee’s supervisor was also there. The blood drawing was painless enough.

The supervisor was worried about the aspirin that I was given for my heart and an interaction with PrEP. She said that she was trying to get hold of an on-duty doctor to check things out, but she wasn’t happy to allow me to take PrEP without the say-so of a more senior medical professional.

The supervisor explained that aspirin is a non-steroidal anti-inflammatory (NSAID) and can have interactions with PrEP. I knew that I couldn’t take ibuprofen on PrEP. I wasn’t aware that aspirin was also a problem.

During the course of things, I also learnt that PrEP carries a risk of a decrease in bone density by 1.5% to 2%, however they only tend to worry about people with a history of breaking bones.

I was afraid that I wouldn’t get a fresh stock of the drug – if I can’t get PrEP, I have to use condoms, which many a top seems to struggle with.

However, they managed to find somebody to confirm that it was OK. Relief!

There was a strong recommendation to move to a “per event” protocol rather than daily, as that would involve less risk of drug interactions and is kinder on my kidneys, which are already taxed by the testosterone and heart medication.

When I think on it, I would expect to feel more concern about the increasing vulnerability in my body and the plethora of drugs required to keep me healthy and safe, but instead I seem to feel interested – as though its happening to Somebody else – maybe that’s a neuro-divergent thing?

I’ll continue to use the daily protocol until I get back from visiting Cicero in London, which I hope will be a very busy time! I don’t have sex so often that a daily dose is worth taking really – I shall just have to be more careful – and possibly make sure that I am carrying some pills with me at all times.

I apparently now need at least two hours notice before sex!

I shall have to create a booking system.

Click here for NHS Information on taking PrEP.