Here’s an idea, however it will require the ability to make custom SQL queries – with $wpdb.
Since you want to get posts followed by a user, you can create a view, with the following structure:
id user_id post_id post_title post_content ... (all other post fields)
don’t worry about duplicating posts.
When you select, you just have to do a simple select * from the_view where... .
Later you can cache results from this view using memcache or other object cache technique to make it faster.
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