"There is a pill you can take every day that severely reduces your risk of contracting HIV."
What is PrEP?
PrEP stands for Pre-Exposure Prophylaxis. This is a combination of two HIV treatment medications (tenofovir and emtricitabine, sold as Truvada®) that can also be used as a prevention tool for HIV-negative persons. When taken daily, PrEP can lower the risk of contracting HIV sexually by over 90% (for people who use injection drugs, the risk is reduced by over 70%). PrEP is not a vaccine; rather, if enough PrEP medication is present in an HIV-negative person's bloodstream, HIV is not able to infect that person's cells.
PrEP does NOT protect against other sexually transmitted infections, including syphilis, gonorrhea, chlamydia, or viral hepatitis, and should be used in conjunction with other harm reduction methods, such as the use of condoms and other safer sex supplies, and a reduction in the number of sexual and needle-sharing partners.
Should I take PrEP?
Federal guidelines suggest PrEP for people who are HIV-negative and at high risk for HIV infection, including:
- Those who are in a relationship with an HIV-positive person.
- Gay and bisexual men who have had sex without a condom and/or have been diagnosed with a sexually transmitted infection within the last six months.
- A man who has sex with both men and women.
- A man or woman who does not regularly use condoms during sexual activity with a person of unknown HIV status or with those at substantial risk for HIV (people who use injecting drugs or men who have sex with both men and women).
- Any person who has used injecting drugs in the past 6 months and has shared needles/syringes, or has been in drug treatment for the past 6 months.
To get tailored information on how to assess and reduce your level of risk for HIV see the CDC's risk reduction tool at https://wwwn.cdc.gov/hivrisk/.
(Preexposure Prophylaxis for the Prevention of HIV Infection in the United States – 2014 Clinical Practice Guideline; US Public Health Service, Centers for Disease Control and Prevention http://www.cdc.gov/hiv/pdf/PrEPguidelines2014.pdf)
How do I get PrEP?
PrEP can only be prescribed by a healthcare provider. If you think you might be a good candidate for PrEP, schedule an appointment with your doctor and be ready to discuss why you think PrEP is a good option for you.
Talking to your doctor
Before your visit, prepare a list of reasons why you think you may be eligible for PrEP. Also be ready to explain any past illnesses, current medications, or health concerns with your doctor.
During your visit:
- Ask questions and take notes. Be sure you understand everything your doctor is telling you.
- If your doctor seems unaware of PrEP, ask if he/she's ever heard of PrEP or prescribed it before. You may need to consult another physician who has had more experience with prescribing PrEP.
- Don't be shy – be honest with your doctor about your level of risk and be clear and concise when discussing your sex life. Share all the details that may need to be considered before your doctor prescribes PrEP.
For more information on talking to your doctor about PrEP, see the Centers for Disease Control and Prevention brochure online at http://www.cdc.gov/hiv/pdf/risk_PrEP_TalkingtoDr_FINALcleared.pdf.
If you're HIV negative but worry you may be at risk for HIV infection, talk to your doctor about PrEP.
Is PrEP Safe?
Currently, there have been no significant or long-term health effects observed in HIV-negative people who have been on PrEP for up to 5 years. Short-term side effects may include nausea, gastro-intestinal pain or irritation, mild headache, or loss of appetite, but they usually disappear within a few weeks.
Nonetheless, those on PrEP must follow up with their doctor every 3 months and are closely monitored for any changes in health, including kidney function and bone density.
Isn't PrEP Expensive?
PrEP is covered under most insurance plans, and your doctor may even have more information on how to find and apply for monetary assistance.
If you have insurance, some programs, including the Gilead Advancing Access® co-payment coupon card, help to cover most or all of the cost of patient co-pays for Truvada. These programs, however, are not available for all patients, such as those enrolled in Medicare or Medicaid programs.
Find more information about your eligibility for the Gilead Advancing Access® co-payment coupon card here: https://www.gileadadvancingaccess.com/copay-coupon-card.
For more information regarding PrEP in the Kentuckiana area and accessing medication contact us at 502-635-4505 or at HIVprevention1@voamid.org.
To find a PrEP prescribing physician near you, check out this wonderful tool - preplocator.org.
For additional assistance in paying for PrEP or talking with your doctor, Project Inform has a fantastic cheat sheet to help. - http://www.projectinform.org/pdf/PrEP_Flow_Chart.pdf
For more information, contact our HIV Services team at 502-635-4505 or email us at HIVprevention1@voamid.org.