PrEP’s Unexpected Gifts: A Q&A with Adam Zeboski
When 26-year-old Adam Zeboski decided to start PrEP, he expected to ramp up his medical visits, figure out an adherence routine, and fit PrEP into his life. What he didn’t expect is that his 16 months on PrEP would change him in important ways and turn him into a steadfast advocate of this HIV prevention strategy as an empowering new tool for gay men’s health and wellness.
In this frank Q&A, Adam shares his personal experience accessing and using PrEP, how he talks about PrEP with friends and with people he sees in his role as an HIV test counselor, and what surprised him most about making PrEP part of his life.
What got you started thinking about PrEP and whether it might be right for you?
Mostly because some of my own sex partners told me they were on PrEP, and I was curious: “How does it all work?” Over time, I kept seeing the same people who were all on PrEP, so I did my research to learn more about it.
Also, I was in a serodiscordant relationship at the time—that was another motivation to start PrEP. When that partner and I first met, we talked about PrEP a little bit; I was already considering it but wasn’t sure I was ready. He was very encouraging. We had a lot of talks, and we both did our research about the different PrEP studies.
Then I heard that San Francisco City Clinic was enrolling people for the Demo Project. As soon as they started enrolling, I popped in and got the ball rolling. I’ve now completed the study. I learned a lot from the Demo Project.
So your experience was unique in some ways, because you initially accessed PrEP through a study. How did you stay on PrEP when you finished the Demo Project?
My primary doctor at Kaiser was already familiar with PrEP and thought it would be great for me to continue using it, so he connected me with another provider who set me up with the prescription.
At first, I had to go in every month to get tested for HIV and other STIs [sexually transmitted infections]. It was a commitment and lot of work at first; I think if it was easier to get, a lot more people would be interested in PrEP. But it was a pretty seamless transition. I think I went one day without taking PrEP, during the switch from the Demo Project to Kaiser.
What was it like taking a daily pill, coping with any side effects, and incorporating this relatively new HIV prevention tool into your life? Did anything about it surprise you?
It was really easy for me to take it every day. I think I missed it one or two days when I went to my boyfriend’s house and forgot the pill bottle. I really didn’t have any side effects. In the first month, I had a couple of unexplainable headaches, but after that it was fine!
Lately I’ve been thinking a lot about my PrEP experience being a huge factor in my transition from adolescence to adulthood, from “boy” to “man.” I really have changed so much since I started; I am a different person, in so many great ways.
It was rough growing up in a homophobic environment, being told I’m “evil” and a “fag” by peers, and having that reinforced at a private Catholic school. Today I’m allowing myself to follow what I truly know is best. I’m so much more confident. Starting PrEP really gave me the sense of self-worth I needed to decide what is best for me and for my health going forward.
Given your personal experience, how do you talk with people about PrEP, both on the job and outside of work?
I’m definitely an advocate for giving people resources and information about PrEP. If I have a friend I think would benefit from PrEP, I encourage him to look into it—I’ve urged a lot of friends to get information about PrEP. When the Demo Project was still enrolling, I also encouraged them to make an appointment, and few of my friends started PrEP that way.
Just in the past year or so, I’ve been meeting so many different guys who are on PrEP, through either the Demo Project or their primary care provider. It’s interesting to see how PrEP is getting popular in San Francisco.
The reasons people give for being interested in PrEP are really just their preferences around their sexual behavior, and the realities of their lives. It happens; sometimes people just don’t use condoms. For me, PrEP was a way to take charge and address those issues in my own life.
I always have a bunch of PrEPfacts.org cards when I’m doing counseling, either here at the foundation or in the mobile testing unit. If someone is interested in PrEP, I talk to them about it and give them a card so they can check out the site and learn more about it.
If they already know a little about PrEP and want more information about how to get it, I’ll ask, “Do you have insurance? What kind? Or do you go to SF General Hospital or City Clinic?” It’s easy to get PrEP through Healthy San Francisco. If they’re with Kaiser here in San Francisco, I tell them their doctor should know about PrEP. If your provider doesn’t know about PrEP, tell them to go to PrEPfacts.org!
I understand you chose to take a break from PrEP. Can you talk about how you made that decision?
There was a month that was kind of rough for me, with a lot of issues coming up all at once involving relationships, housing, family, and depression. I wasn’t taking very good care of myself, and the things I was doing sexually—I probably wouldn’t have been doing them if I hadn’t been in that kind of headspace. I realized I wanted to take better care of myself, relax for a while, and reconnect with friends. Sex just wasn’t as important. I wanted to take a break.
PrEP worked for me. I felt safer and more comfortable with the kinds of sex I like to have, with the sex partners I am attracted to the most. But I think the best part about PrEP is that it’s not forever; it’s not like taking medications to treat HIV. If you want to keep taking PrEP, you keep taking your pills; if you want to take a break, you can. That flexibility is one of the best gifts PrEP can give you.
And now I am about to start PrEP again! I did all the labs last week, mostly to make sure I was still HIV negative. This Friday I’ll meet with my provider at Kaiser to chat and to pick up my prescription.
I am also trying to get set up with Kaiser’s prescription assistance program. I qualify based on my income, but I still have to be approved. According to the website, the application process can take up to 60 days. Hopefully, that will lessen my monthly co-pay, which is $35 with my current insurance.
Anything you think you will do differently this time around?
I plan to take the pills in the evening before bed, then maybe switch to mornings after I get used to it again. I’ve never really had any adverse side effects, so I’m just going to be eating well, exercising (AIDS/LifeCycle training rides!), relaxing, relieving stress, and being creative. I haven’t been drinking over the past few weeks, and that coupled with the spring weather has really made me feel great.
I’m also finding myself more of a PrEP advocate. I think people here in San Francisco are more accepting and aware of the realities of life and people’s preferences, and are less likely to stigmatize you for being who you are, but that’s not true everywhere. Instead of stigmatizing men who are interested in adding another layer of protection with PrEP, we should be empowering them to take initiative and make healthy changes in their lives. It’s all about health and wellness.
In my own life, I keep finding the same people who are all on PrEP; it’s like a brotherhood. It’s really nice to be able to talk to people about your experiences with PrEP and what it’s like to be in relationships, whether they’re serodiscordant or with people who don’t know much about PrEP. I’m ready to start again and see where things go in this new world of PrEP activism. I hope to be a leader in this movement and a resource for folks in the community.
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Want to keep up with Adam’s PrEP advocacy and his work to promote sexual health? Follow @pupbones on Twitter! Have your own PrEP story to share? Let us know in the comments below, or write to us at firstname.lastname@example.org.
Reilly O’Neal is a freelance writer and former editor of BETA.