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What is Pre-exposure Prophylaxis (PrEP)?

Pre = before.
Exposure = coming into contact with HIV
Prophylaxis = treatment to prevent an infection from happening
Pre-exposure prophylaxis (PrEP) is an HIV prevention strategy where HIV-negative individuals take anti-HIV medications before coming into contact with HIV to reduce their risk of becoming infected. The medications work to prevent HIV from establishing infection inside the body.
PrEP has been shown to reduce risk of HIV infection through sex for gay and bisexual men, transgender women, and heterosexual men and women, as well as among people who inject drugs.
It does not protect against other sexually transmitted infections (STI) or pregnancy. It is not a cure for HIV.
 
Medications approved for PrEP

TRUVADA (also called FTC/TDF)
Truvada for PrEP is taken once a day, at the same time each day. You can take it with or without food. In order to benefit from this medication, adherence is critical.
The U.S. Food and Drug Administration (FDA) approved Truvada for PrEP use in 2012. This medication is taken as a once-daily oral pill, which combines two medicines in one: Emtriva (also called emtricitabine or FTC) and Viread (also called tenofovir disoproxil fumarate or TDF). Truvada works by blocking an enzyme called HIV reverse transcriptase. By blocking this enzyme, it prevents HIV from making more copies of itself in the body.
 
Effectiveness

Truvada for PrEP provides 92%-99% reduction in HIV risk for HIV-negative individuals who take the pills every day as directed. However, it only works if you take it. Current research shows, people who use PrEP correctly and consistently have higher levels of protection against HIV.
There are not enough data available to provide guidance on non-daily use, so the FDA recommends PrEP be used daily to achieve the highest level of protection.
 
A few things to note:

When starting PrEP, it takes at least seven days to reach high levels of protection against HIV.
When stopping PrEP, individuals should continue using PrEP for four weeks after the last significant exposure.
PrEP does not protect against other sexually transmitted infections (STI) or pregnancy. It is not a cure for HIV.
Cost

Truvada is available with or without insurance.  With insurance, the cost will depend on your insurance coverage.  In many cases, this medication cost no more than other medications you may be taking.  In some cases, this medication cost you nothing at all.  Co-pay cards, discount cards and pharmaceutical assistance are available for uninsured individuals.
 
Side Effects

Truvada for PrEP is generally safe and well tolerated. Most people on PrEP report experiencing no side effects, but some side effects were reported in clinical trials. Participants in the iPrEx study reported side effects that fall into four main categories (ordered here as most to least common):

  • Nausea
  • Headaches
  • Weight loss
  • Like many other medications, Truvada is filtered through the liver and removed by the kidneys. There is the possibility of changes in your liver and kidney function.  However, the majority of patients do not experience problems and lab testing will alert your provider if a problem occurred.
  • For most people, these side effects went away on their own after the first few weeks of taking Truvada, or when the medication was stopped.

 
PrEP FAQ

What is the difference between PrEP and PEP?

Post = after
Exposure = coming into contact with HIV
Prophylaxis = treatment to prevent an infection from happening
Post-exposure prophylaxis (PEP) is an HIV prevention strategy where HIV-negative individuals take HIV medications after coming into contact with HIV to reduce their risk of becoming infected. PEP is a month-long course of drugs and must be started within 72 hours after possible exposure.
 
Am I a good candidate for PrEP?

People who may be good candidates for PrEP include those who can’t or don’t use male or female condoms regularly; don’t know the status of their partners, use drugs, or have been diagnosed with STIs; or exchange sex for money, food, or housing. Someone who expresses interest in PrEP is also a good potential candidate. The Centers for Disease Control and Prevention released guidelines in May 2014 that instruct clinicians on provision and management of PrEP. Read the CDC guidelines at com/CDCprepguidelines.
Who is considered at substantial risk for HIV infection?

We consider someone who does not regularly use condoms while engaging in sexual intercourse to be at substantial risk of HIV infection. Having a sexually transmitted disease (like gonorrhea, syphilis, etc.), or having sex with people who’ve recently had a sexually transmitted disease, puts you at even greater risk.
What other options can I use to lower my risk of getting HIV infection?

Today, more tools than ever are available to prevent HIV. In addition to abstinence, limiting your number of sexual partners, never sharing needles, and using condoms the right way every time you have sex, you may be able to take advantage of newer medicines such aspre-exposure prophylaxis (PrEP) and post-exposure prophylaxis(PEP).
How often do I need to take PrEP for it to be effective?

The CDC recommends taking Truvada every day. If you don’t, there may not be enough medicine in your bloodstream to block the virus. People taking PrEP should also see their health care provider every 3 months for regular monitoring of their HIV status and potential side effects of the medicine
Can you prescribe PrEP for me here?

Yes we can prescribe PrEP. Contact our office to set up a free PrEP consultation http://novusacs.com/contact-us/
Are there ways to help me to pay for PrEP if I need assistance?

During your free PrEP consultation, we can discuss and assist getting you enrolled in a medication assistance program.
How often will I have to be tested for HIV and other STDs?

When you are using PrEP, you are advised to get tested for STD/HIV every three months to make sure this HIV prevention strategy is working for you.
I think I’ve been exposed to HIV. Can I start PrEP right away to prevent infection?

If you haven’t been on PrEP and you have a high-risk sexual experience, there is a better option called post-exposure prophylaxis, or PEP. It must begin as soon as possible, within 72 hours of exposure at the latest.
 

Sources:
http://prepfacts.org/
http://men.prepfacts.org/the-basics/
http://www.projectinform.org/pdf/prep_msm.pdf
http://www.cdc.gov/hiv/pdf/PrEP_GL_Patient_Factsheet_PrEP_English.pdf
To find out more, please contact us or visit http://www.cdc.gov/hiv/basics/prep.html