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PrEP stands for Pre-Exposure Prophylaxis. PrEP is a medication taken by people who don’t have HIV, but who are at high risk of getting infected. When taken as prescribed, PrEP is very effective (estimated 99%) at preventing HIV infection.

What is PrEP?

PrEP is a combination of two anti-HIV medications, tenofovir and emtricitabine, sold under the brand name “Truvada.” It is one pill, taken once a day taken by HIV negative people to prevent HIV infection. Other anti-HIV drugs are being studied to find out if they can be used as PrEP.

How effective is PrEP?

When taken every day as prescribed, PrEP is estimated to provide at least 99% protection against HIV infection for sexual transmission among men who have sex with men. PrEP also has demonstrated efficacy in protection against HIV transmission for injection drug users and for heterosexual men and women. PrEP does not protect you from other STDs.

Is PrEP for me?

The federal guidelines recommend PrEP for certain HIV-negative persons who are at elevated risk for exposure to HIV. These include the following:

If you are in a sexual relationship with a person of unknown HIV status and you don’t regularly use condoms
If you are in a sexual relationship with an HIV-positive person, whether or not you consistently use condoms
If you are in a sexual relationship with a person that you know is at risk for exposure to HIV (such as someone who injects drugs or has sex with other people besides you)
If you are male and have anal sex with men without condoms
If you inject drugs
If you’ve recently had a sexually transmitted infection, such as gonorrhea or syphilis
If you have an HIV-positive partner and are considering getting pregnant
 

What are the side effects and safety?

PrEP is generally well-tolerated. About 40% of patients may experience minor side-effects in the first month, such as upset stomach, but for most patients these symptoms resolve within 1-2 months Most people taking PrEP do not experience substantial side effects, although it is important to have your doctor monitor for rare instances of kidney function problems, which can be easily resolved. In terms of safety, one study has estimated PrEP is as safe as aspirin.

How soon does PrEP start working?

According to the CDC, when taken every day as prescribed, “PrEP reaches maximum protection from HIV for anal receptive sex at about seven days. For other sexual activities, including insertive anal sex, vaginal sex, and for injection drug use, PrEP reaches maximum protection at about 20 days of daily use.”


PrEP (Pre-Exposure Prophylaxis): A Powerful Tool for HIV Prevention

Overview:
PrEP stands for pre-exposure prophylaxis, a preventative strategy in which HIV-negative individuals take medication to significantly reduce their risk of acquiring HIV. By taking PrEP as prescribed, individuals can enjoy a high level of protection against the virus, making it a crucial component in the fight against the HIV epidemic.

How PrEP Works:
PrEP involves the use of antiretroviral medications that are also used in the treatment of HIV. The primary drugs used for PrEP are Tenofovir and Emtricitabine, which are combined in a single pill marketed under the brand name Truvada, while a newer option, Descovy, is also available. These medications work by establishing a protective barrier in the bloodstream that prevents the HIV virus from establishing a permanent infection.

Effectiveness:
When taken consistently as prescribed, PrEP has been shown to reduce the risk of HIV infection from sexual contact by over 99% and from injection drug use by at least 74%. Consistency in taking the medication daily plays a crucial role in maintaining its effectiveness.

Who Should Consider PrEP:
PrEP is recommended for individuals who are at higher risk of contracting HIV, including:
- Men who have sex with men (MSM) and engage in unprotected sex.
- Heterosexual individuals with a high likelihood of exposure to HIV.
- People who inject drugs and share needles or other drug paraphernalia.
- Individuals in serodiscordant relationships, where one partner is HIV-positive and the other is HIV-negative.

How to Get Started with PrEP:
1. Consultation and Assessment: Begin by discussing PrEP with a healthcare provider who can assess your risk and determine if PrEP is appropriate for you.
2. Testing: Prior to starting PrEP, you will need an HIV test to confirm you are HIV-negative and screen for other sexually transmitted infections (STIs). Kidney function tests are also essential before initiating PrEP.
3. Prescription: If PrEP is deemed suitable, your healthcare provider will prescribe the medication, typically taken once daily.
4. Follow-up Appointments: Regular follow-up visits every 3 months are necessary for ongoing HIV testing, adherence counseling, and monitoring of side effects and kidney function.

Potential Side Effects:
PrEP is generally safe and well-tolerated, but some users may experience minor side effects such as nausea, headaches, or weight loss. These symptoms often resolve over time. Serious side effects are rare but can include kidney or bone density issues, which are monitored through regular healthcare visits.

Cost and Access:
The cost of PrEP can vary, but many insurance plans, including Medicaid, cover its prescription. Assistance programs are also available to help offset costs for those without insurance or with financial constraints.

Conclusion:
PrEP represents a significant advancement in HIV prevention, offering a reliable option for individuals at risk of HIV exposure. By empowering users with control over their sexual health, PrEP not only helps reduce new HIV infections but also supports broader public health efforts aimed at ending the HIV epidemic. For those considering PrEP, consultation with a healthcare provider is the first step towards making informed decisions about their health and safety.