Pre-Exposure Prophylaxis (PrEP)
What is PrEP?
PrEP stands for Pre-Exposure Prophylaxis: a medication for daily use that can help high-risk patients who are HIV negative continue to stay negative by reducing the chances they could become infected with HIV.
How does PrEP work and what does it involve?
Patients will be screened to determine if they are a good candidate for PrEP. Those who qualify (see below) will be given a prescription to start taking a daily medication. This pill, called Truvada™, was approved by the FDA during the summer of 2012 for use in patients who are HIV negative but are at high risk of being exposed or infected. when Truvada™ is taken daily and combined with the use of other sexual safety precautions, it can significantly reduce a person’s chances of being infected with HIV. PrEP patients will need to return to their provider about every three months for follow-up care that will involve needed bloodwork, HIV and STD screenings, assessment of any negative side effects and a new prescription to refill their medication.
How do I know if I am someone who should get a prescription for PrEP?
A medical provider who has a full understanding of your sexual risk can help you decide if PrEP is right for you. Truvada™ has only been approved to prevent infection among HIV negative adults (over age 18) who are considered high risk for HIV infection through sexual contact. More specifically, the use of Truvada™ for PrEP is most recommended for key populations such as:
- HIV negative men who have sex with men (i.e. gay and bisexual men)
- HIV negative heterosexual men and women who are in a relationship with an HIV positive partner
Is PrEP safe? Are there any risks to consider?
As previously mentioned, Truvada™ is not a new drug. It has been used globally and safely for a number of years. However, there is a risk of medication side effects. A provider who is experienced with PrEP will be able to educate you about side effects and address any problems or questions you may have prior to and while you are taking the medication.
How long does a person have to take this medication?
A patient taking PrEP should never stop taking their medication without first talking to their provider. Researchers’ current understanding is that a person who is taking PrEP should continue to do so daily for as long as they remain at high risk of sexual exposure and remain HIV negative. This is why it is important to have regular visits with the provider who prescribes PrEP for you.
If you become HIV positive, your provider can immediately stop your PrEP medications and assist you in transitioning into HIV care and treatment. If you believe you no longer need to use PrEP after starting treatment (because there is a change in relationship status or sexual behaviors/risks), your provider will be able to offer guidance about your options.
After a person starts PrEP is it safe to stop using condoms or other forms of safer sex?
It’s important for patients to know that all current recommendations suggest that patients interested in PrEP take the medication and do one or more of the following to most effectively reduce their risk of HIV:
- Use barrier prevention (condoms, female condoms, etc.) consistently and especially for anal and/or vaginal sex.
- Reduce overall number of sexual partners.
- Get tested regularly for HIV and other STDs and encourage sexual partners to do so as well.
- Talk openly and honestly with sexual partners about HIV status and about past and present sexual risks.
If PrEP is effective, why do I still need to use condoms?
We still recommend using both condoms and Truvada™ because the highest level of protection was observed in HIV negative patients who were using PrEP with condoms. For those at the highest risk of HIV infection, using just one or the other may not work as well as using both together. To be as safe and healthy as possible, the Health Education Risk Reduction program at Positive Care provides patients with safer sex supplies (condoms, lubricant, female condoms, etc.), and the staff is also willing to meet with patients who are interested in learning about how to better protect themselves from HIV and other STDs. For more information call: 612-873-7784.
What happens if I forget to use condoms or miss a pill? Will I get infected?
Forgetting to use condoms or missing doses of PrEP will increase your risk of becoming infected with HIV. These are both reasons why doing your best to combine medication and risk reduction behaviors is the key to PrEP’s success. Talk openly and honestly with your provider so that you can decide together what is best for you and your health.