Despite Interventions Black And Hispanic Men Are Contracting Hiv At The Same Rates As 10 Years Ago
The new CDC guidelines have the potential to catalyze movement in these areas. They now acknowledge that many people can benefit from PrEP not just those believed to be at high risk of HIV infection. The guidelines also recommend a far more inclusive approach to PrEP care. Specifically, they recommend that health care providers tell any adolescent or adult who is having sex about PrEP, and patients who request PrEP should be offered it even in the absence of specific risk behaviors. In other words, even if a health care provider isnt sure why a patient is asking for PrEP because they dont disclose risk factors for getting HIV, the provider should offer PrEP anyway.
This may also increase the uptake of PrEP: Because of the overwhelming and consistent evidence of PrEPs benefits, in 2021 the federal government required Medicaid and many insurance companies and to cover the costs of PrEP medication, lab tests, and clinic visits with no out-of-pocket charges to patients.
Of course, guidelines are just guidelines. For these recommendations to have teeth, policies and structures must be put in place that push providers to talk to patients about PrEP. These preventive pills must be made accessible, even for people who are uninsured and living in areas with less HIV prevention infrastructure. After people get on PrEP, they need support to stick with it so it is as effective as possible.
New Drugs Arent Enough
Yet public health experts warn that new drug approvals alone wont improve health equity among the minority groups who suffer the most from HIV infections. One reason is the dismantling of health services offered to them.
In 2019 nearly 900 health clinics under the federal family planning program Title X lost fundingslashing their services by halfas part of a so-called domestic gag rule prohibiting funding if staffers referred patients to abortion providers. Many family planning and womens health clinics provide preventative services, including HIV counseling and testing, that many poor women might not be able to get elsewhere, says Jewel Mullen, associate dean for health equity at Dell Medical School at the University of Texas at Austin.
There is some good newsand potential fundingon the horizon. As part of the 2022 fiscal year budget, President Joe Biden requested $275 million for HIV prevention and testingan increase of $100 million over the previous year. The White House initiative would include efforts to increase access to HIV testing and PrEP in sexual health and Title X clinics. The new HIV strategy talks about the missed opportunities to provide HIV services in these settings, Harold J. Phillips, director of White House Office of National AIDS Policy, told National Geographic in an email. We must scale up these services to better close the disparity gap, especially among minority women.
Who Can Take Prep
PrEP is for people who are HIV-negative and more at risk of HIV infection. PrEP can be used by men and women, both trans and cisgender.
PrEP may be a good option for you if:
- youre in an ongoing sexual relationship with a partner living with HIV who does not have an undetectable viral load.
- youre a gay or bisexual man who has multiple sexual partners and you don’t always use condoms.
- youre a gay or bisexual man in a new sexual relationship but not yet aware of your partners HIV status and dont always use condoms.
- youre not using condoms with partners of the opposite sex whose HIV status is unknown and who are at high risk of HIV infection
- you have sex for money, or receive gifts for sex
- youve shared injecting equipment or have been in a treatment programme for injecting drug use.
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Pills Before And After Sex Can Help Prevent Hiv
For the first time, a study shows that a drug used to treat HIV infection also can help prevent it when taken before and after risky sex by gay men.
The results offer hope of a more appealing way to help prevent the disease beyond taking daily pills and using condoms, although those methods are still considered best.
The study, done in France and Canada, is the first to test “on demand” use of Truvada, a pill combining two AIDS drugs, by people planning to have risky sex. The uninfected men who took it were 86 percent less likely to get HIV compared to men given dummy pills.
“That impressed me,” Dr. Scott Hammer said of the size of the benefit. He is an Aids specialist at Columbia University in New York and heads the Retrovirus Conference going on in Seattle, where the results were discussed Tuesday.
Daily Truvada pills are used now to prevent HIV infection in people at high risk for it, and studies show the drug helps even when some doses are skipped. Health officials have been leery of billing it as a “chemical condom” out of fear that people will not use the best prevention methods, but many won’t use condoms all the time or take daily pills.
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The study of Gilead Science’s Truvada was led by the French national HIV research agency.
The drug was safe, but nausea and diarrhoea were more frequent among men who used it. Only one stopped using it because of side effects.
Alternatives solutions needed
How Often Do I Take The Prep Medication

You and your healthcare provider can work together to decide the best way for you to use PrEP. There are two different ways that people take PrEP:
Daily PrEP: Daily PrEP involves people of any gender identity taking 1 pill once a day, every day. With daily PrEP, a person can feel protected from HIV whenever they have sex or inject substances. It is for people who have possible exposure to HIV on a frequent basis, or an unpredictable basis. An important benefit of daily PrEP is that the person is always protected and can establish a daily habit of taking the medication. Daily PrEP with Truvada is the only method proven to be effective for cis-gender women and transgender men who have vaginal intercourse.
It is important to talk with your healthcare provider about whether daily PrEP or on-demand PrEP is right for you.
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Protecting Women Against Hiv Just Got 9 Times Easier
“This injection, given every two months, will be critical to addressing the HIV epidemic in the U.S., including helping high-risk individuals and certain groups where adherence to daily medication has been a major challenge or not a realistic option,” Dr. Debra Birnkrant, director of the Division of Antivirals at the FDA, said in a statement.
Taking PrEP as an oral pill has actually been highly effective in recent years. The FDA says that in 2020, about 25% of people for whom PrEP was recommended were ultimately prescribed it, compared to just 3% in 2015.
But what makes the injection such a game-changer is not just that it can be easier to adhere to it’s also more effective.
Clinical trials showed that Apretude taken by cisgender men and transgender women who have sex with men had 69% less risk of getting infected with HIV. For cisgender women, they had 90% less risk.
Mayer points out, though, that during the trials, there were some individuals who didn’t like the experience of the injection and stopped their treatment, so the new drug may not be an across the board solution for everyone.
Are There Any Risks
We talk about PrEP not being a lifelong preventive approach, but rather it’s used during what we call ‘seasons of risk,’ like when you’re dating an HIV-positive person, or perhaps you’re newly single, Dr. Buchbinder explains. People who are on Truvada need to visit their health care provider every three months, in part so that they can be tested for HIV. An HIV-positive person should not be on Truvada, because taking the drug can lead to resistance. It’s also recommended that people also use other HIV prevention methods, including condoms, while taking the drug.
The other big concern with this drug is really about kidney function, Dr. Buchbinder explains. It can’t be taken by people who have pretty severely impaired kidney function, and also kidney function needs to be monitored over time.
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Nucleoside Reverse Transcriptase Inhibitors
Brand Name |
---|
abacavir sulfate |
* Cimduo, Combivir, Descovy, Epzicom, Temixys, Trizivir, and Truvada are combination medicines.
For more information about the risks and side effects for each medicine, check
This information does not give the specific side effects or warnings for each medicine. Check the medicine label and talk to your healthcare provider about the side effects and warnings for the combination HIV medicines you are taking.
IMPORTANT TIPS
- Talk with your healthcare provider about being tested for HLA-B*5701 prior to taking abacavir or medicines containing abacavir.
- These medicines may cause lactic acidosis .
- These medicines may cause serious liver, pancreas, or kidney problems.
- If you have kidney problems or liver problems, such as hepatitis, talk to your healthcare provider before taking these medicines.
- These medications are taken by mouth. Retrovir can also be given as an intravenous infusion.
WARNING SIGNS
- Stomach pain with nausea and vomiting
- Feeling very weak or tired
- Problems breathing
nevirapine |
For more information about the risks and side effects for each medicine, check
This information does not give the specific side effects or warnings for each medicine. Check the medicine label and talk to your healthcare provider about the side effects and warnings for the combination HIV medicines you are taking.
IMPORTANT TIPS
WARNING SIGNS
- Flu-like symptoms
nelfinavir mesylate |
* Evotaz, Kaletra, and Prezcobix are combination medicines.
IMPORTANT TIPS
How Would I Know If Prep Is Right For Me
PrEP is one of many options for preventing HIV. HIV is passed from one person to another through sharing injection drug equipment or through anal or vaginal sexual intercourse. People can avoid getting HIV by: 1) not sharing drug injection equipment , 2) avoiding anal or vaginal intercourse 3) having only one monogamous sex partner whose HIV status is known to be negative: 4) having only one partner who is living with HIV and has an undetectable viral load. It is important to be aware that a person living with HIV who is on HIV treatment and is virally suppressed for six months or longer cannot pass HIV to a partner through sex. If you have sex with more than one partner, taking PrEP or consistent and correct use of condoms each time you have sex, can prevent you from getting HIV.
New York HIV State Clinical Guidelines indicate that healthcare providers should discuss PrEP as an HIV/STD prevention option for adults or adolescents who:
It is important to weigh the pros and cons and have an open and honest conversation about PrEP with your healthcare provider before beginning PrEP. PrEP is always voluntary and only you can determine if PrEP is right for you.
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Hiv Protection And Epidemic
Strub said this year marks the 26th anniversary of a pamphlet “How to Have Safe Sex in an Epidemic,” first calling for the use of condoms to protect against HIV, written by community activists. Since that time, controversial additional behaviors, such as serosorting have evolved.
But, unlike the condom, a pre-exposure pill comes with many more nagging medical details.
“The important thing to realize is that it’s not just an evening-before pill that people pop,” said Liu, who is currently directing the Prepare trial of a combination drug called Truvada among 3,000 men in the United States, South America, Asia and Africa.
Liu said the current testing is for a daily pill. Doctors still are checking for side effects of liver or kidney damage. Moreover, people in the study need routine HIV testing and follow-up care.
“These are men who are at risk for HIV, and since we don’t know yet whether this approach works, we want to keep them on the best prevention,” he said.
Costs of the drug may also be an issue.
“The medications that are involved are costly, and depending on whose paying for them, different payers or insurance, it could be a problem,” said Dana Van Goder, executive director of Project Inform, a community-based HIV/AIDS awareness program in San Francisco.
Van Goder estimates the drugs, as they are sold now, would cost $500 to $900 a month. That would presumably go down if the drugs were made more widely available.
Important Questions To Ask Your Doctor
Ask your doctor to tell you what you should know about your HIV medicines.
- What medicines am I taking to treat HIV?
- When should I take each medicine?
- Should I take my medicines with food?
- Which prescription medicines, herbs , over-the-counter medicines , or vitamins can affect my HIV medicines? Can my HIV medicines affect any of the other medicines I take?
- How should I store my HIV medicines? What about when I am away from home or go out of town?
- What are the side effects of the medicines I am taking?
- What should I do if I start having bad side effects?
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Can Hiv Live Outside The Body
The HIV virus does not live for very long outside of the human body. It cannot reproduce outside a human host. HIV is not transmitted by:
- Air or water
- Saliva, sweat, tears or closed-mouth kissing
- Insects or pets
- Vaginal fluids
- Breast milk
HIV in these fluids must enter the body to cause an infection. Body fluids containing HIV can enter through a mucous membrane , damaged tissue like a cut or scrape, or can be injected into your bloodstream .
Avoid exposure to blood from injuries or nosebleeds where the HIV status of the bleeding person is unknown. Protective clothing, such as gloves, gowns, masks or goggles may be appropriate when caring for people who are injured.
The risk of HIV infection through blood transfusions or blood products is extremely low in the United States. The blood supply is well screened and is considered safe. Unfortunately, this is not always the case in other countries. If an emergency requires that you receive blood or blood products in another country, get tested for HIV as soon as you return home.
When Should I Start Pep And How Long Do I Need To Take It

PEP must be started within 72 hours after a possible exposure to HIV. The sooner you start it, the better every hour counts.
You need to take the PEP medicines every day for 28 days. You will have to see your health care provider at certain times during and after taking the PEP, so you can have an HIV screening test and other testing.
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How Is Hiv Passed
HIV is only passed through five bodily fluids:
- blood
- vaginal fluid
- breast milk
HIV can be passed when the virus in one of these fluids containing HIV gets into another persons body. The two main ways that HIV can be passed are:
- through vaginal or anal sex
- by sharing needles or other equipment to use drugs
There are many options to choose from to help prevent you from getting HIV through sex and when using drugs.
What Are The Side Effects Of Prep
PrEP is very safe. No serious problems have been reported in people who are taking PrEP.
PrEP may cause side effects like nausea, loss of appetite, and headaches. These side effects arent dangerous and they usually get better with time, once your body gets used to PrEP. Most people on PrEP have no side effects at all.
If you do have side effects that bother you and dont go away, talk with your doctor or nurse. They can help you figure out ways to deal with side effects and make sure everythings ok.
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Seven Ways To Prevent Hiv
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You likely know about tried and true methods to help you prevent getting HIV, such as using condoms when having sex and new equipment when using drugs. But did you know that there are also newer approaches like using HIV medications to prevent HIV? With so many choices, its not always easy to know which prevention method to use and when.
This resource can help you decide which HIV prevention method will work best for you.
Impact On The Culture Of Men Who Have Sex With Men
PrEP is used predominantly by men who have sex with men, often as an alternative to condoms. For the first time since the outbreak of the AIDS crisis, PrEP makes somewhat HIV-protected sex without condoms possible, and since its availability, sex without condoms has increased. PrEP does not prevent the transmission of sexually transmitted infections other than HIV, and is not 100% effective.
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Prep: Hiv Prevention With Truvada Or Descovy
In July 2012 the U.S. Food and Drug Administration approved the use of Truvada, an antiretroviral medication to prevent HIV infection in certain high-risk individuals. Truvada is a combination of two drugs and can be used in high-risk HIV-negative persons to lower their risk of infection. The medication works by preventing the virus from making copies of itself. Truvada is expected to become generically available in September 2020.
In October 2019, the FDA approved Descovy as the second drug for PrEP. Descovy is used in at-risk, HIV-1 negative adults and adolescents weighing at least 35 kg to reduce the risk of sexually acquired HIV-1 infection, excluding individuals at risk from receptive vaginal sex. In studies, Descovy was as effective as Truvada in HIV-1 prevention, but advantages were observed with regard to renal and bone laboratory secondary endpoints.
With oral PrEP, you must take the medication daily. It’s important not to miss any doses to help prevent resistance to these medications. It is used in combination with safer sex practices such as use of a condom. It can lower your risk of contracting HIV from sex by up to 99%, if taken correctly. However, you must be HIV-1 negative to start PrEP everyone is screened for HIV-1 infection before initiating PrEP. Regular tests for HIV status are required with PrEP.