Protecting yourself from HIV (human immunodeficiency virus), is a big part of taking pride in yourself and your health. While there’s currently no vaccine to protect against HIV, if you’re HIV-negative there are steps you can take to help protect yourself. One pill, taken every single day can lower your risk of getting HIV by up to 99 percent.
PrEP is a pill that can help prevent HIV
PrEP is the common name for a medicine that can help reduce a person’s risk of getting HIV, the virus that causes AIDS. The clinical term for this treatment is Pre-Exposure Prophylaxis, which means “prevention before exposure.”
PrEP is used to reduce the risk of HIV infection in people at higher-than-average risk. This includes men who have sex with men, people who don’t use a condom every time they have sex, people who inject drugs, and anyone who has a partner living with HIV whose viral load is detectable. Currently, the only FDA-approved medicine for this purpose is Truvada. Truvada is a combination of 2 medicines used to treat active HIV infections called tenofovir and emtricitabine.
Who's a high-risk of contracting HIV?
- Those in a relationship with a person living with HIV who has a detectable viral load (meaning their HIV treatment is not optimized).
- Men who inconsistently use condoms when having sex with men.
- Men who’ve been diagnosed with a sexually transmitted infection (STI) in the past six months and who aren’t in a mutually monogamous relationship with an HIV-negative partner.
- Heterosexuals who don’t always use condoms for sex with partners who are themselves at
- Anyone who, in the past six months, has shared equipment when injecting non-prescribed drugs or has been in an injection drug treatment program.
How effective is PrEP?
When taken every day, Truvada has been shown to reduce risk of HIV transmission by up to 99 percent.
- PrEP becomes much less effective if it’s not taken every day. PrEP is not a vaccine and people who use it must commit to taking the medicine every single day.
- PrEP becomes even more effective when combined other prevention methods, like condoms. Condoms will also protect you from other sexually transmitted infections. PrEP does not prevent other infections.
How much does PrEP cost?
Cost is usually covered by insurance. In cases where it’s not covered, there’s a co-pay coupon program that can greatly reduce the cost. After you receive a prescription for PrEP from your provider, apply for the co-pay coupon program online, then a card will be sent in the mail. Present this card at the pharmacy when you fill your prescription.
How can I get a prescription for PrEP?
You’ll need to make an appointment with a healthcare provider to receive a prescription for PrEP. Your provider can answer your questions, assess your risk, and help you understand prevention options. It’s not always easy to talk about sex and HIV but healthcare providers are trained to be knowledgeable and respectful and help you get the support you need.
What are the side effects?
Side effects are rare, but may include:
- Nausea or headache. This usually goes away within a month.
- Kidney problems. This side effect is rare. Even so, blood tests for kidney function are required at least every 6 months. You may need them more often if you have other risk factors.
- Decreased bone density. This side effect is also very rare. The effect is mild and has been seen to reverse if Truvada is stopped.
Less is known about long-term effects. However, no major issues have been seen in people taking Truvada for 5 years.
Do I still need to be tested for HIV?
Yes. You need to be tested for HIV every 3 months and here’s why:
- Even though the risk of getting infected with HIV is greatly reduced while on PrEP, there’s still a small chance you could get infected.
- If you were to get infected with HIV, you’d need different medicines. A person who has an active HIV infection needs at least 3 or 4 anti-HIV medicines.
- If you only take Truvada after being infected, you won’t have all the medicines you need allowing the virus to develop resistance to the medicines you’re taking.
- Developing resistance to medicines would limit your treatment options in the future.
You’ll need to get an HIV test every 3 months while taking Truvada. Only 3 months’ worth of pills are given at a time and you’ll need an HIV test every 3 months to get refills.
PEP versus PrEP
PEP (post-exposure prophylaxix) differs from PrEP because it involves taking a short course of antiretroviral drugs – usually for one month – after a high-risk HIV exposure while PrEP is a daily medication that will be taken in an ongoing basis prior to exposure. To be the most effective, PEP should be started within 72 hours after a possible exposure.
If you’re not currently taking PrEP and suspect a high-risk exposure to HIV such as semen leaking out of a condom during sex with an HIV-positive partner, anal sex without a condom with a partner who is either HIV positive or whose status you don’t know or you’ve shared drug-injection equipment with someone who is either HIV positive or whose status you do not know, contact your healthcare provider or local hospital emergency room as soon as possible. Ideally, PEP is started within 72 hours of exposure.
Things to keep in mind
- Only people who are HIV negative should use PrEP or PEP.
- You must be tested for HIV and have a documented negative test result before starting PrEP.
- PrEP and PEP are available by prescription from a medical provider such as a physician, nurse practitioner, or physician assistant. You can also get PEP at your local emergency room or urgent care clinic, although these locations may provide just the first two or three days’ doses to get you started (for example, until your medical provider’s office reopens on a weekday). You’ll need to talk with your provider to see if PrEP or PEP is right for you.
- PrEP is more than just taking a pill every day; it also involves regular medical visits and lab tests to check for HIV, other STIs, and any changes in kidney health.
- Neither PrEP nor PEP protects against other STIs or pregnancy, and they’re not cures for HIV.
- PEP is taken for 28 days while PrEP is taken daily in an ongoing basis.
- PrEP does not have to be taken forever and can be stopped at any time under the supervision of your medical provider. When stopping PrEP, individuals should continue using it for four weeks after the last significant exposure.
- If you’ve used PEP in the last year, it might be a good idea to talk to your medical provider about PrEP.