As not too long ago because the Nineties, it was unthinkable that treatment might sometime stop the unfold of HIV. But in 2012, the U.S. Food and Drug Administration (FDA) authorised the primary treatment generally known as pre-exposure prophylaxis, or PrEP, which may stop HIV from taking maintain in your physique.
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Now, PrEP has turn out to be an necessary software in combating the unfold of HIV. Internal medication specialist James Hekman, MD, explains what PrEP is, the way it works and whether or not it’s best for you.
What is PrEP?
Human immunodeficiency virus, or HIV, is a sexually transmitted illness that assaults your immune system, which may make it troublesome in your physique to struggle off sickness. The commonest manner folks get HIV is thru vaginal, oral or anal intercourse, however you can too get it by sharing needles to take medication.
But taking PrEP can stop you from contracting HIV by blocking the virus from taking maintain inside your physique.
The title says all of it: “Pre-exposure” means “before you get exposed,” and “prophylaxis” is a typical medical phrase that refers to actions you’re taking to stop a illness from creating or spreading. PrEP, then, is treatment you’re taking to maintain you secure from HIV — earlier than you’ve ever been uncovered to it.
Should you’re taking PrEP?
“PrEP is for people who don’t have HIV but are at an increased risk of contracting it through sex or injection drug use,” Dr. Hekman explains.
Your physician might suggest you go on PrEP should you:
- Have a sexual companion with HIV.
- Have intercourse with out utilizing condoms.
- Have been recognized with a sexually transmitted disease within the final six months.
- Inject medication with somebody who has HIV.
- Inject medication by sharing needles or syringes.
- Have been uncovered to HIV previously and proceed to have interaction in high-risk conduct.
How to take PrEP
PrEP isn’t a selected model; quite, it’s a class. Right now, there are three sorts of PrEP:
- Truvada® is a each day capsule that mixes two medication known as tenofovir disoproxil and emtricitabine. It’s for anybody who’s susceptible to contracting HIV by means of intercourse or injection drug use, and it’s additionally out there in generic type.
- Descovy® is a each day capsule that mixes two medication known as tenofovir alafenamide and emtricitabine. It’s for sexually lively cisgender males and transgender ladies who’re in danger for HIV; it’s not for individuals who have vaginal intercourse. The generic type isn’t at the moment out there within the U.S.
- Apretude® is the model title of treatment known as cabotegravir, which is an injection you obtain each two months out of your physician. The FDA approved it for use in December 2021, and no generic type is at the moment out there.
How lengthy does it take for PrEP to work?
You must be on PrEP for one to 3 weeks to ensure that it to start out working. But to maximise your safety from HIV, it’s important to you’ll want to take each dose. Simply put, Dr. Hekman says, “PrEP is incredibly effective, but only if you take it as prescribed.”
HIV.gov reports that when taken accurately, the capsule types of PrEP scale back the danger of getting HIV from intercourse by about 99%, and it reduces the danger of getting HIV from drug use by at the very least 74%. But the treatment isn’t almost as efficient if it isn’t taken constantly, so you’ll want to set these each day reminders.
Side results of taking PrEP
PrEP is taken into account secure, however it’s possible you’ll expertise some negative effects at first. They ought to go away on their very own, however speak to your physician should you proceed experiencing them:
- Nausea.
- Diarrhea.
- Headache.
- Fatigue.
- Stomach ache.
If you’ve gotten kidney disease or a historical past of hepatitis B, you’ll want to inform your physician. It might impression whether or not you’re capable of go on PrEP.
Does PrEP stop STDs?
Condoms are simply as necessary as they’ve all the time been. “PrEP does not prevent the spread of STDs,” Dr. Hekman says. You can (and will) pair PrEP with condom use for one of the best probabilities of decreasing your threat.
Will PrEP intrude with hormone remedy?
If you’re on gender-affirming hormone therapy, it’s possible you’ll be apprehensive about whether or not and the way PrEP will intrude.
Trans ladies have been reported to have decrease ranges of PrEP of their bloodstream than different folks, Dr. Hekman says, however there’s not but sufficient analysis to say why. And as a result of the transgender inhabitants is at excessive threat for HIV, it’s necessary to work with a physician who can guarantee that you may stay on hormone remedy and protect yourself towards HIV.
“We know that when trans women are under medical care, doctors can monitor their levels of both HIV control and hormones,” Dr. Hekman explains. “We can adjust doses to make sure that they achieve appropriate levels of gender-affirming hormone therapy while also remaining protected from HIV.”
Can you’re taking PrEP after HIV publicity?
PrEP is a pre-exposure treatment, which signifies that to ensure that it to do its job, you’ll want to be taking it earlier than you’re uncovered to HIV. That means PrEP isn’t the suitable treatment to take should you’ve been uncovered to HIV and wish to scale back your likelihood of an infection.
If you’ve been uncovered to HIV and aren’t already on PrEP, see a physician — whether or not your major care doctor or at an emergency room or pressing care facility — inside 72 hours. They can prescribe post-exposure prophylaxis (PEP), treatment to stop HIV after publicity. Unlike PrEP, PEP is utilized in emergency publicity conditions.
Talking to your physician about PrEP
PrEP is just out there by prescription, so should you’re concerned about beginning it, make an appointment to talk together with your physician. “They’ll give you an HIV test and talk you through any concerns you have about going on PrEP,” Dr. Hekman says.
Looking for a healthcare supplier who’s educated in well being points particular to the LGBTQIA+ neighborhood? Many nationwide health services and state clinics are open and affirming, and there are different methods to search out an LGBTQIA+ physician’s workplace close to you.
If you’re involved about the best way to pay for PrEP, you’ll want to ask your physician about that, too. Most insurance coverage corporations and state Medicare plans cowl PrEP, and different choices can be found for many who qualify.