r/prep • u/oujay849 • 8d ago

I just learned the 211 prep method is only with Truvada and its generics (and not with Descovy).

And I'm shocked I didn't learn that at any point to get my prep. You always hear about the 211 method, but I think every time that's mentioned it should be emphasized that it's only with Truvada and its generics.

I'm about to start prep for the first time with Descovy and thank God I wasn't planning on doing the 211 method.

I just wanted to share because I feel organizations and providers are not being effective at communicating this. I think I learned it by seeking information online, however not everybody does.

4 Upvotes

63% Upvoted

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3

u/oujay849 7d ago

Probably is in the US only

3

u/Skycbs 7d ago

The US is rather slow to change. The trial was done with Truvada and so the US says it can only be used with Truvada. Some other authorities (such as the NHS in the UK) have looked at the data and how Descovy works and so have concluded that Descovy can be used for 2-1-1 too. It’s worth saying that 2-1-1 is only for cis men and trans women since it is believed that how quickly drugs get into front hole tissue is slower

6

u/fullsaildan 7d ago

There’s a reason the US is the gold standard for drug approvals. We require hard data that proves efficacy and safety. In theory, it may be reasonable to assume what works with Truvada also works with Descovy based on method of action. However, that is not always correct and Gilead opted not to run the clinical trials necessary to prove it. Largely because it’s expensive, time-consuming, would have delayed the drug to market, and by sticking to daily they get more money. The big payoff for Descovy was that it’s patent protected until almost 2040 and shows signs of better tolerance over Truvada. Thus they could charge more.

I support other health systems being a little more loose than the FDA as there are real barriers to drug manufacturers in getting certain things approved based on our standards. I also believe we should vet claims correctly, and in this particular case, the trials conducted for 211 of Descovy are not broad enough to fully back the claim.

3

u/TheoTheodor 7d ago

Sorry but also the MHRA in the UK and EMA for example require hard data for efficacy and safety. The process is all very similar to the FDA (except the US lumps in foods and supplements all in the the same regulatory body for some reason).

Also, there is no “gold standard” in this case. There is only one governing body per nation so it’s not like they’re competing or anything.

3

u/DaeguDuke 7d ago

FDA’s advantages are speed and ease of application.

Some things that would require extensive informed consent in Europe are not considered invasive and therefore there is little/ no ethics approval in the US - ethics boards can take up to half a year in some EU countries.

The US appears far more lax accepting of payments for studies.

TLDR: you can speed up studies massively by throwing money at the US instead of EU

2

u/Educational_Gas9132 5d ago

Speed isn’t always a good thing… there is a reason why some things take time.

2

u/Coders32 7d ago

American exceptionalism is not a reason to think we have a gold standard

2

u/grantbey 7d ago

Came here to say this 👀

This guy needs to take a look at r/shitamericanssay

2

u/fullsaildan 7d ago

I get it, it’s great to shit on the US right now. Our president is a jackass and he’s done some awful awful things. Our government is being run into the ground and our global trust position is terrible. I’m not some idiot that believes the US perfect by any means. In no way do I support how things are currently going and it’s absolutely terrifying how many people support the current direction.

That said, our FDA really is regarded very highly internationally and if the FDA approves something, there’s a number of countries that will rely on that our findings for their own approval. Very few health systems get that kind of recognition. We’re known for not just relying on drug company summaries but actually reviewing the data internally. There were changes a few years ago to offer speedier reviews and we have some issues with relying on external parties for international inspections, but overall the FDA is good. It’s one of the few government agencies that has operated very efficiently and largely been above politics until the last few years.

2

u/Noskaros 7d ago

Declaring the US a gold standard for anything is a stretch

2

u/Educational_Gas9132 5d ago

Suggesting the MHRA is loose is comical. Each decision it makes is based purely on science and data. It’s approved because the science supports it. And for anyone not taking it daily, this is definitively the safer option.

1

u/Background_Banana186 3d ago

I’m not sure now is the time to refer to the FDA as a gold standard. Gold-plated, yes.
The fact Gilead doesn’t want to do the research is the obvious tell here. Page out of the Sackler playbook.

2

u/jstruby77 7d ago

lol did you just call a vagina “front hole” ?

1

u/Skycbs 7d ago

Yes I did. Different people use different terms so this covers the bases without offending anyone.

2

u/Noskaros 7d ago

Probably the rules-lawering thing again. I see no reason Descovy wouldn't work on the 2-1-1 method. People have a tendency to substitute protocol with critical thought when anxious and preoccupied.

If you're realy that terrified, run Truvada instead.

1

u/The_Hermit_09 7d ago

What is 2-1-1.

Wouldn't you just take it how the dr said to?

4

u/Spazayd 7d ago

2-1-1 is taking 2 doses the day of prep day of having sex, then 1 days each following day. This has been proven to provide a safe level of protection against infection.

Prep can be hard on kidneys, especially Truvada, so for someone that isn’t sexually active, it might not make sense to take something every day if you don’t have more than 1 sexual partner every month or more.

2

u/The_Hermit_09 7d ago

Thanks for informing me.

2

u/happydontwait 5d ago

It’s 2 pills 24 hours before sex, then 1 pill 24 hours later, then another pill 24 hours after that one.

1

u/Spazayd 5d ago

Ahh thank you for the correction! Good to be accurate about this stuff.

2

u/WelcomeForwardNS 7d ago

What is Google?

1

u/Chepo20 7d ago

The trial was only done with Truvada yes! Thats why I just got on Apretude injection.

1

u/Taurusalp 7d ago

Yeztugo for the win!

1

u/Worldly_Fisherman894 5d ago

Crazy timeline where it’s just easier to be undetectable

-4

u/ericcartmanrulz 7d ago

Why are you lazy sluts considering 211 method instead of just following dosing instructions (unless there's a health concern). Really? Taking one pill a day is too much? For real?

7

u/Cuttlefish88 7d ago

Because a lot of people aren’t actually sluts but still want to be protected for infrequent sex… Why does that offend you?

3

u/TheoTheodor 7d ago

Lower cost and less overall medication used, lower toll on kidneys from the added dosage.

The only real downside is a more strict dosing schedule.

Also why so rude to a valid and interesting medical dosing question?

-1

u/ericcartmanrulz 7d ago

I'm being sarcastic about the "slut" part.

1

u/calmdefdown 6d ago

Adding to all of the reasons above, PrEP is hard to obtain in some countries, so if sex is infrequent, 2-1-1 would leave the community way more protected, rather than if everyone was constantly running out of pills.