How Does Prep Work
Both Truvada and Descovy “have essentially the same drugsemtricitabine plus tenofovir,” Jamie Alan, PharmD, PhD, associate professor of pharmacology and toxicology at Michigan State University, tells Health. “They differ in that they contain slightly different formulations of tenofovir,” she adds.
The medications target a unique enzyme in HIV called reverse transcriptase, which then prevents the virus from replicating and infecting cells in the body, Alan explains. “The levels of the antivirals in the blood and mucosa interfere with HIV’s ability to set up an infection,” infectious disease expert Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, tells Health.
Pros And Cons For Hiv Prep Therapy
There can be many factors to consider when starting a new medication. Here are a few things to take into consideration when deciding if PrEP may be right for you:
PrEP is highly effective at preventing HIV when it is taken on a regular schedule as prescribed by a doctor.
According to the CDC , these medications when taken regularly lower the chances of contracting HIV from sex by around 99 percent and around 74 percent in people who inject drugs.
However, the medications above are not effective right away. You need to take them daily for at least for maximum protection from HIV with receptive anal sex.
With injection drug use or receptive vaginal sex, maximum protection occurs after around 21 days with daily use.
Keep in mind that the effectiveness of Descovy among females who have receptive vaginal sex has not been proven.
Can You Take Prep If You Are Already Hiv Infected
PrEP is a medical strategy used by HIV uninfected individuals to protect themselves from contracting the virus. Many people think PrEP provides them with adequate protection, stopping or reducing the use of other proven HIV-1 infection prevention measures such as condoms.
This puts them at high-risk of virus infection. Some people may assume theyre protected and continue using PrEP without adhering to safe sex measures or regularly visiting a doctor for follow-up, putting them in danger.
Before administering PrEP, consult with a doctor. Openly discuss your sexual life and all the high-risk ways you might be infected with HIV. Remember, youre aiming to protect yourself and the doctor knows how best to prescribe the right medication for you.
An indicator of high risk of HIV exposure is a diagnosis with rectal chlamydia while using PrEP. This infection poses a high risk for HIV infection as it increases the transmission of HIV. If this happens, its important to further examine your PrEP and your sexual behavior.
As earlier stated, PrEP does not always work as expected. Some PrEP users may be resistant to HIV PrEP medication and they end up being infected with the virus. Others may never adhere to the drug prescription or add another layer of protection, like safe sex measures, and end up being infected while using PrEP, like Joes PrEP failure .
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Tops Bottoms And Prep: What You Need To Know About Hiv Prevention
Nearly 70% of people living with HIV are homosexual and bisexual men and thankfully the use of PrEP for HIV prevention is increasing among this group. According to a recent study, the number of gay and bisexual males taking PrEP increased by 500% from 2014 to 2017. However, only 35% of gay and bisexual males who were at high-risk of HIV transmission were taking the medication.
It is important that everyone takes the proper precautions to protect themselves from HIV transmission. While some people are at more risk than others due to lifestyle choices or other practices, there is a common misconception that your risk of HIV transmission is higher or lower depending on your sexual orientation or preferred sexual position.
PrEP is designed to help protect any person regardless of sexual orientation from HIV transmission. But, you may be wondering if PrEP could affect you differently or be more or less effective depending on if you are a top, bottom, or vers.
For instance, many tops assume they do not need to take PrEP since they are at a lower risk of contracting HIV than a bottom since they are not penetrated.
So, does PrEP work differently for tops and bottoms?
Well first, lets explain what puts you most at risk for HIV transmission and why you should consider taking PrEP in the first place regardless of sexual orientation.
Does Prep Have Risks
People with HIV have used Truvada, tenofovir and emtricitabine, for several years. They are generally easy to take. Possible long-term side effects include loss of bone mineral density and kidney damage.
Some people worry that people taking PrEP might think they are totally protected. They might be less careful about their sexual behavior. So far, this does not appear to be true.
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What Happens Once I Start Prep
Once you start PrEP, you will need to take PrEP every day. PrEP is much less effective when it is not taken every day.
Continue to use condoms while taking PrEP. Even though daily PrEP can greatly reduce your risk of HIV, it doesnt protect against other STDs, such as gonorrhea and chlamydia. Combining condom use with PrEP will reduce your risk of HIV even further, as well as protect you from other STDs.
You must also take an HIV test every 3 months while taking PrEP, so youll have regular follow-up visits with your health care provider. If you are having trouble taking PrEP every day or if you want to stop taking PrEP, talk to your health care provider.
What If I Miss One Dose Will My Viral Load Become Detectable Again
If you are undetectable, and have been taking your medications every day recently, your viral load will very likely stay undetectable even if you miss one dose. The HIV medications are so good these days that it can take a week or even sometimes up to several weeks or more for peoples viral loads to become detectable after medications are stopped.
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Who Should Not Take Truvada For Prep
Do not take TRUVADA for PrEP if you:
- Already have HIV-1 infection or if you do not know your HIV-1 status. If you have HIV-1, you need to take other medicines with TRUVADA to treat HIV-1. TRUVADA by itself is not a complete treatment for HIV-1. If you have HIV-1 and take only TRUVADA, your HIV-1 may become harder to treat now and over time.
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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Prep Prevents Hiv So Why Arent More People Taking It
- By Robert Goldstein, MD, PhD, Contributor
Each year, 1.7 million people globally are newly infected with HIV more than 38,000 in the United States alone. This year, President Trump announced a 10-year initiative aimed at reducing new HIV infections in the US, and ultimately ending an epidemic that has plagued this country, and the world, since HIV first emerged in the early 1980s. A key part of that plan is pre-exposure prophylaxis or PrEP, a daily medication to help prevent HIV that is recommended for people at high risk. Recently, the FDA approved a new formulation of PrEP for many but not all of those at risk.
Prep Is A Pill That Can Help Prevent Hiv
PrEP is a combination of two antiretroviral medications, tenofovir and emtricitabine, that, if taken every day, can now prevent HIV. The pill is FDA approved. Truvada works by blocking an enzyme so that HIV cannot reproduce and establish infection in the body.
The pill is taken by mouth with or without food. It is best if taken at the same time every day, as this helps establish a routine. Skipping days isnt recommended. If you forget a dose, take it as soon as you remember. If it is almost time to take the next dose, skip the missed dose and continue the regular dosing schedule. Truvada takes full effect seven to 20 days after starting the medication. It can be discontinued whenever the protection it offers is not necessary . Do talk to your doctor when stopping or starting any medication.
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Will Prep Work If I Might Already Have Hiv
For PrEP to protect you, it needs to be taken before you come in contact with the virus. PrEP isn’t a cure for HIV.
If you think you’ve been exposed, call your doctor right away or head to the emergency room. If you start taking a different kind of medication called PEP within 72 hours, it can lower your odds of HIV infection.
Can I Still Get Hiv If Im On Prep
When PrEP is used correctly, the effective rate of preventing HIV through sexual transmission is 99%. This preventive treatment option involves taking Truvada or Descovy, a once-daily pill to reduce your risk of contracting HIV. It is meant for people who are HIV-negative but have a higher risk of contracting the virus due to their lifestyle or sexual habits.
The risk of becoming infected with HIV while using PrEP is very low. Therefore, its a beneficial option for those who dont always practice safe sex practices or are sexually active with an HIV-positive partner. If youre at a higher risk of contracting HIV and youre trying to get pregnant, are currently pregnant, or are breastfeeding, using PrEP can also reduce the risk of you and your baby becoming infected with the virus.
If you skip any doses of the medication, your risk of HIV goes up. Its important to make sure to take it exactly as directed. Using condoms every time you have sex can also lessen the risk of contracting HIV. Its important to remember that PrEP does not protect against any other sexually transmitted infections, such as chlamydia or gonorrhea. The use of condoms along with PrEP can help you reduce your chances of contracting any STIs, including HIV.
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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.
Since Prep Medication Alone Is Not Effective At Treating Hiv Is It Possible That Taking Prep Could Lead To My Developing Drug Resistant Hiv If I Become Infected Could It Lead To Higher Levels Of Drug Resistant Virus In The Community
HIV testing is a critical component when using PrEP for HIV prevention. HIV testing is done before a person begins PrEP to ensure that only HIV negative people are prescribed PrEP. Periodic HIV testing for everyone taking PrEP ensures that anyone who gets HIV will be identified quickly so they can be put on an effective treatment regimen. If a person on PrEP gets HIV, drug resistance testing is done to determine an effective treatment regimen. There is no evidence that PrEP can lead to higher rates of drug resistant virus in the community.
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Prep Facts: Introduction & Faq Learn More About Pre
PrEP, or pre-exposure prophylaxis, is a prescription medicine that you take before you come in contact with HIV that will prevent HIV infection. There are two medications approved for PrEP: Truvada and Descovy, plus a generic version of Truvada. These medications are highly effective when taken as prescribed, and are very safe and generally well-tolerated by most people.
Anyone can use PrEP to prevent HIV infection. If condoms arent or cant be used during sex, or if using clean syringes is not possible, then taking PrEP is an effective way to help prevent HIV. PrEP does not prevent other sexually transmitted infections or pregnancy.
In this series of articles well introduce you to the basic facts about PrEP:
Frequently asked questions about PrEP
There are no known interactions between the two. Taking PrEP outside the times you drink can help you avoid missing doses.
Recreational drugs are not known to interact with either Truvada PrEP or Descovy PrEP. Both medicines belong to a class of HIV meds called NRTIs that generally do not interact with drugs such as marijuana, cocaine, or MDMA. Search the HIV Drug Interaction website for more information.
No cases of this kind of transmission have been reported. PrEP stops HIV from reproducing in the body, so it cant establish an infection and eventually dies. If your partner has sex with someone living with HIV with a detectable viral load, they will not pass on HIV to you.
More PrEP Facts:
A New Hypothesis Of How Hepatitis C Is Transmitted During Sex
In 2016 and 2017, a team of researchers at the Icahn School of Medicine at Mount Sinai in New York published two research studies challenging the idea that blood needed to be present during sex for hepatitis C transmission to happen. Prior to that point, it was widely believed that only traumatic sex acts like fisting that produced blood put people at risk for hepatitis C.
Their first study showed that about one third of HIV-positive men who have sex with men, with recent HCV infection, have hepatitis C virus in their semen.
About one-third to one-half of men with HCV shed HCV into their semen, Daniel Fierer, MD, the lead investigator of the study explained to BETA. And some men just dont. The message is that if HCV is in someones semen, and the semen gets into a persons rectum, that person may acquire hepatitis C.
In the journal article, Fierer and colleagues explain that because 10 to 20 HCV particles is enough to establish a parenteral infection, an average ejaculate of virus) could plausibly be enough to establish an infection. These seemingly low HCV levels could play a significant role in sexual transmission of HCV when deposited into a rectum whose surface epithelial layer has been disrupted through anal intercourse, they said.
The results of this study explain how men who bottom without a condom might acquire hepatitis C. But what about when men topare they at risk for acquiring hepatitis C if they top without a condom?
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How Prep Helps Defend Against Hiv
PrEP works by setting up fortified walls around CD4 cells. These walls keep HIV from crossing into the healthy cells and replicating. If HIV enters your body, it will be unable to breach the walls to gain access to the CD4 cells.
It is estimated that PrEP protection begins 7 to 20 days after the first dose. PrEP therapy requires periodic monitoring by your healthcare provider, usually once every one to three months.
Keep in mind that PrEP therapy is just an additional tool in the HIV prevention toolbox.
It is highly recommended that you combine additional strategies such as safe-sex practices with PrEP to lower your risk even further.
Just like any other medicine, PrEP is not for everyone and it may also produce side effects and even long-term consequences in some people.
The health care providers at FamilyCare of Kent include board-certified family nurse practitioners who are licensed by the state of Washington. They can help your family with most of the health concerns for which you might see any other provider, such as a primary care physician. Call us to ask about how PrEP may help you. Call or use our online appointment request form to get started.
How Well Does Prep Work
PrEP is very effective when you take it every day. It reduces the risk of getting HIV from sex by more than 90%. In people who inject drugs, it reduces the risk of HIV by more than 70%. PrEP is much less effective if you do not take it consistently.
PrEP does not protect against other STDs, so you should still use latex condoms every time you have sex. If your or your partner is allergic to latex, you can use polyurethane condoms.
You must have an HIV test every 3 months while taking PrEP, so you’ll have regular follow-up visits with your health care provider. If you are having trouble taking PrEP every day or if you want to stop taking PrEP, talk to your health care provider.
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