Let’s talk about – PrEP!

You might have come across the term “PrEP” when looking for an HIV prevention method and wondered what it means. Well, you’ve come to the right place, because at aHnonymous we are here to give you real information that you can use to keep yourself and your partner(s) healthy and safe.

PrEP stands for “pre-exposure prophylaxis.” In medical terms, “prophylaxis” means “prevention.” It is not the name of a particular drug. This HIV prevention method uses anti-HIV drugs —emtricitabine and tenofovir—in the form of pills to reduce the risk of an HIV-negative individual contracting HIV.

Approved Drugs

At present, there are only two medications approved for PrEP:

• Emtricitabine (F) 200 mg, in combination with tenofovir disoproxil fumarate (TDF) 300 mg (F-TDF; brand name Truvada). This is recommended for everyone at risk of HIV through sex (anal/vaginal) or injection drug use.
• Emtricitabine (F) 200 mg, in combination with tenofovir alafenamide (TAF) 25 mg (F-TAF; brand name Descovy). This is not recommended for people at risk of HIV through vaginal sex.

Taking PrEP

Anyone can take PrEP without regards to their gender or sexual orientation – whether male, female, straight, gay, bisexual, cisgender, or transgender. Adults as well as adolescents can take PrEP. And oh! It has to be prescribed first, because it is not an over-the-counter drug. This is not just like any contraceptive or painkiller.

If you feel the need to take PrEP, please discuss this option with your healthcare provider, as there are vital things to take into consideration, including your sexual activity, HIV risk, as well as you and partner(s) and your health conditions, before you start any PrEP medication. You will also be required to take tests for HIV, STIs, hepatitis B and C, and kidney functions, among others. It is therefore extremely important for you to see a doctor or healthcare provider before you take PrEP.

For cisgender gay and bisexual men, another approach known as event-based dosing or on-demand PrEP can be employed. With this, PrEP is taken around the time of having sex. Here, it is recommended that two pills are taken between 2 and 24 hours before sex, one pill 24 hours later and another pill 24 hours after that. If you’re engaging in sexual intercourse for several days in a row, you will need to take a pill continuously until 48 hours after your last sexual engagement.

Effectiveness

Numerous medical studies have shown the effectiveness of PrEP to be as high as 90% and even more if you engage in sexual intercourse. This holds true especially when the pill is taken daily and combined with other HIV-prevention methods such as the use of condom. For individuals who inject drugs, PrEP is known to reduce the risk of being infected by at least 70%. So yes, it is that effective!

Side effects

Bet you might be wondering if there are any side effects to the medications, especially since it has to be taken daily. It happens that there are. But hey, don’t be alarmed! The side effects are mild and usually experienced within the first month. They include cases of stomach upsets, headaches, nausea, tiredness and appetite loss. There have been rare cases of long-term side effects. If your side effects persist for more than a month, talk to your healthcare provider.

Resistance

Does the effectiveness decrease over time? There comes a time where your body’s system should get used to it, right? To be honest, drug resistance is caused by taking some, but not adequate, doses of a drug or a drug combination. With regards to PrEP, drug resistance can be caused by:

• starting PrEP without having an existing (perhaps very recent) HIV infection diagnosed
• taking PrEP in a non-continuous pattern
• stopping it but having an HIV infection soon after stopping so that drug is still present in the body.

However, resistance is rare for individuals who test negative for HIV before starting treatment. There is still ongoing research on PrEP drug resistance. Remember, it is essential for you to talk to your healthcare provider first!

Availability and cost

PrEP is available in numerous– but not all- countries across Europe, Africa, North America, Asia and Australasia and Latin America. Unlike anti-retroviral drugs, PrEP isn’t free. How much you need to pay depends on the country you live in and its health system.

Other facts

• PrEP does not prevent other Sexually Transmitted Infections or pregnancy.
• PrEP vaginal rings are in development.
• Different PrEP delivery methods such as injectables and implants are being researched.

So there you have it. Look for more resources on PrEP and do well to discuss with your healthcare provider on what treatment suits you best, before starting any sort of medication. If you think you are not ready for the use of PrEP just yet, that’s okay! Use a condom regularly when having sex. Make an informed decision. Join us next time for another topic. Wrap it up!

This article was written with the aid of resources from www.aidsmap.com, http://www.cdc.gov, http://www.hiv.gov, and www.unaids.org. The paper ‘Should We Fear Resistance from Tenofovir/Emtricitabine PrEP‘ by Parikh et al. was also consulted.