The first person cured of HIV is back on antiretroviral treatment -- but this time, he's taking pre-exposure prophylaxis (PrEP). That man -- Timothy Ray Brown -- shared his experience taking daily PrEP to prevent HIV infection at the annual meeting of the Association of Nurses in AIDS Care (ANAC) in Portland, Oregon.
Brown, who was cured of HIV in 2007 through a bone marrow transplant, says that today he is taking care of his health with daily emtricitabine/tenofovir disoproxil fumarate (Truvada) for PrEP.
The first PrEP regimen, Truvada, was approved in 2012. Brown told the ANAC audience that PrEP has transformed his life, because it has allowed him to have a healthy sex life without worrying about HIV reinfection.
For Brown, who had persevered through numerous serious health scares and near-death experiences, PrEP is an exciting new intervention that he can use to feel empowered and protected.
"I take PrEP daily, and it's because I do not want this crap any more," he said. "I want a full sexual life, and I have that."
Like many PrEP users, Brown is now debating the merits of switching to a new PrEP regimen called emtricitabine/tenofovir alafenamide (Descovy), which has fewer bone and kidney side effects but is also correlated with weight gain.
"I did tell my doctor I would like to switch to Descovy, because I didn't want any complications [with] my kidneys," Brown said. "But then my boyfriend read an article saying there were some complications with Descovy."
After learning more about the drug's overall side effect profile, he decided against switching.
"I'm sticking with Truvada for a while, unless I have kidney problems," Brown said.
Brown's HIV advocacy journey began in 1995, the year he was diagnosed. At the time, Brown thought it was a death sentence. And in a one-two punch, he was diagnosed with leukemia a few years later.
The resulting cancer treatment -- a bone marrow transplant from a donor who was naturally resistant to HIV -- cured Brown of his infection in 2007. It also sent his cancer into remission. At the time, Brown remained anonymous, known only as "the Berlin patient." He tried to enjoy a quiet life without HIV.
But in the subsequent years, his leukemia came back. This time it was worse. Brown fought to survive his second transplant, and worked for years to recover from brain damage incurred from a complication during his after-care.
In the wake of the neurological damage, Brown said his doctors "had given up -- it was like the experiment didn't work."
But his ex-boyfriend, who still loved and supported him, wouldn't accept that Brown was dying. He found a rehabilitation center for patients with severe brain damage and cared for Brown for months during his long recovery.
"He showed that he really loved me, even though we weren't together any more," Brown said, speaking of his ex-boyfriend.
After recovering, Brown decided to reveal his identity as the Berlin patient.
"I didn't want to be the only one to be cured of HIV. I wanted there to be more. I wanted to show the world who I am and become an advocate," he said.
Today, Brown works as an advocate and activist, hoping to use his story to bring awareness of the urgent need for a practical, easy-to-administer HIV cure for the world's 38 million people living with HIV.
Until the science evolves, Brown is leading by example, by taking PrEP and advocating for its use among people who could benefit from the HIV prevention pill.
He also still gets regular HIV tests. In 2013, after moving to San Francisco, his doctor, Steven Deeks, M.D., of the University of California, San Francisco, tested his blood and informed Brown that he did not have any HIV antibodies.
Shortly after, Brown attended the Pride Parade in Oakland and sought an HIV test.
"I didn't tell the person testing me who I was," he said. "It came back negative."