Pre-Exposure Prophylaxis (PrEP) is one of the newest and most effective ways of preventing HIV, and there has been a lot of hype, excitement, and misinformation surrounding the idea of pre-exposure prophylaxis. But what really is PrEP? Who can take the pill? What are the risks, and what are the benefits?
What exactly is PrEP? To understand what PrEP is, it is important to understand what Pre-Exposure Prophylaxis means. Pre-Exposure, in this case, meaning before one is exposed to the HIV infection. Prophylaxis means to prevent the spread of a disease/infection. So in this case Pre-Exposure Prophylaxis means, to prevent the spread of HIV, before one is exposed to it. The PrEP pill is being prescribed under the brand name Truvada. Truvada is used in two different ways: 1) To treat HIV, in combination with other medications, in those over the age of 12, and 2) To reduce the risk of contracting HIV in at risk adults. It is important to understand that Truvada is not a vaccine, but instead works by blocking HIV replication, thus preventing the establishment of infection in the body of HIV negative individuals. Studies have shown that the use of PrEP can decrease an individual’s risk of contracting HIV by up to 99%.
But who can take Truvada for PrEP? According to the CDC, ‘at-risk’ people include “HIV-negative men who have sex with men and who are at high risk of getting infected with HIV through sex, and male-female sex partners when one partner has HIV and the other does not.” There are other situations that may make one at-risk, such as injection drug use, sex work, or having recently been diagnosed with a sexually transmitted infection. At the moment, Truvada for PrEP is only recommended for those 18 years of age or older, and that are determined to be at-risk by their doctor. You must also be HIV-negative to start a Truvada for PrEP plan. Once you have started taking PrEP you must commit to HIV, STD, as well as other tests and doctor visits every three months, to ensure you maintain your HIV negative status. The Center for Disease Control “recommends that PrEP be considered for people who are HIV-negative and at substantial risk for HIV.” (PrEP 101) The World Health Organization “strongly recommends men who have sex with men consider taking antiretroviral medicines as an additional method of preventing HIV infection (pre-exposure prophylaxis) alongside the use of condoms.” (WHO: People Most at Risk)
What are the Risks of PrEP? Many opponents of PrEP are expressing their concerns about the risks associated with taking Truvada for PrEP. A primary concern is the risk developing a resistance to Truvada, an important drug used to treat HIV; however, the iPrex study on PrEP found little to no evidence of resistance when the drug was taking as advised. A variety of side effects are possible, so be sure to discuss any potential
side effects with your doctor when deciding whether PrEP is right for you. PrEP also has a variety of benefits as well. When taking correctly and daily as prescribed, PrEP has been shown to reduce the risk of contracting HIV by up to 99%. These rates are extraordinary, but PrEP should still be used with safe sex practices, as it does not offer any protection against other sexually transmitted infections such as syphilis or gonorrhea.
AIDS Resource Center Ohio (ARC Ohio) and The Ohio AIDS Coalition (OAC) have been working diligently to promote education, research, and the use of Truvada for PrEP. Both organizations believe that with proper education, medical supervision, and the addition of safe sex practices, PrEP could be the next major step in the fight against HIV.