Is Prep Right For You
PrEP may benefit you if you test negative for HIV and
- you have had anal or vaginal sex in the past 6 months, and you:
- have a sexual partner with HIV ,
- have not consistently used a condom, or
- have been diagnosed with an STD in the past 6 months.
- have an injection partner with HIV, or
- youve beenprescribed PEP and you
- report continued risk behavior or
- have used multiple courses of PEP
If you are a woman and have a partner with HIV and are considering getting pregnant, talk to your doctor about PrEP. PrEP may be an option to help protect you and your baby from getting HIV while you try to get pregnant, during pregnancy, or while breastfeeding.
What Does Prep Not Do
It is important to clarify that PrEP does not cure HIV it prevents a person who is HIV negative from contracting the virus if they are exposed to it.
PrEP does not protect anyone from other STDs, such as chlamydia, gonorrhea, herpes, or syphilis. It is also recommended that you continue to use condoms during sexual intercourse while on PrEP to provide the highest amount of protection from HIV transmission and STD/STI prevention.
Taking PrEP is the best way to protect yourself and your partner from HIV transmission. However, even if you take the medication, you should also do anything that you can to lower your HIV transmission risk by:
- Always using condoms during sexual contact.
- Getting regularly checked for STIs and STDs.
- Requesting sexual partners to be checked for STIs and STDs and knowing their HIV status.
- Never sharing needles or syringes with others.
While taking PrEP should not by any means deter you from using a condom during intercourse, it can actually be quite empowering for homosexual men who prefer to bottom during intercourse.
Bottoms are typically at a higher risk for HIV transmission, since they rely on the top to wear a condom and HIV is transmitted more commonly through anal intercourse. This gives the bottom less control over protection. However, by taking PrEP, bottoms can be significantly more empowered to protect themselves from HIV transmission.
Where Can I Get Prep
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You need a prescription for it, from any health provider — doctor, nurse practitioner, or physician assistant — who is qualified. You might need to contact your local health department or a local AIDS organization to find someone who understands what it is and is comfortable writing the prescription for you.
You’ll also need to get an HIV test first to make sure you don’t already have the virus.
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What Happens Once A Person Starts 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 does not protect against other STDs, such as gonorrhea and chlamydia. Combining condom use with PrEP will further reduce your risk of HIV, as well as protect you from other STDs.
You must also take an HIV test every 3 months while taking PrEP, so you will 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 Does Prep Do
PrEP is a medication that helps to reduce the risk of HIV transmission by preventing the virus from multiplying or growing within the body. PrEP is a combination of two drugs which help to fight off infection and also stop HIV from reproducing within a healthy host.
Before a person can be prescribed PrEP by their doctor, they must first be tested for HIV. PrEP is intended to be taken before a person is exposed therefore, if they already have HIV, they need to seek another HIV treatment as opposed to PrEP.
PrEP must be taken daily for at least seven days before it is effective at preventing HIV transmission through anal sex. This is because PrEP tends to collect in the colorectal tissue first before it is more present in other bodily tissues. However, it is still recommended that condoms are used during intercourse for additional protection.
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What Else Do I Need To Know About Being On Prep
Once youre on PrEP, youll need to go back to your doctor or nurse at least every 3 months to get tested for HIV. Theyll talk with you about any side effects or symptoms you may be having. They may also test you for other STDs, and test you to make sure your kidneys are working well. If pregnancy is possible for you, you might get a pregnancy test too.
Its really important to go to these follow-up appointments to make sure youre healthy and HIV-free. Its really unlikely youll get HIV if youre using PrEP consistently. But if you do happen to get HIV while using PrEP, its important for your health to stop using PrEP right away. PrEP is not a treatment for HIV in fact, taking PrEP when you have HIV can actually make the virus harder to treat.
What If I Dont Have Health Coverage Or Still Cant Afford Prep
Dont have insurance or Medicaid coverage? There are resources that may be able to help you pay for PrEP and your necessary clinic visits and tests.
One source is the U.S. Department of Health and Human Services Ready, Set, PrEP program that provides PrEP at no cost for people without prescription drug coverage. For more information, and to find out if you qualify, see the blue box below.
Another source is Gileads Medication Assistance Program for PrEP . You can apply for this program to see if you can get PrEP at no cost, based on your income. For more information call 505-6986.
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How Effective Is It
Skipping a dose or not taking PrEP regularly lowers the pill’s ability to protect you. If you take it:
- Every day, your level of protection is around 99%
- 4 days a week, your level of protection is around 96%
- 2 days a week, your level of protection is around 76%
It can take 7-20 days from when you take your first pill until it’s most effective.
Descovy is the newer of the approved drugs and, unlike Truvada, it is not yet known if Descovy will protect HIV-negative women who have sex with an HIV positive man,
Who Prep Is For
Anyone can get HIV. Your sex, age, sexual orientation, race, and ethnicity do not independently factor into your risk.
PrEP is for those considered to be at a high risk of HIV.
Reasons that put you at high risk include:
- You have a sexual partner with HIV or whose status is unknown
- You do not consistently use condoms
- You have sex in a region or network in which HIV is common
- You have been diagnosed with a sexually transmitted infection in the past six months
- You have a drug-injecting partner with HIV
- You share needles, syringes, or other equipment, such as cookers, to inject drugs
PrEP can be used by women trying to get pregnant or who are pregnant or breastfeeding and have a partner with HIV.
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Who Can Use Pep
PEP is for people who may have been exposed to HIV in the last 3 days. PEP might be right for you if:
You had sex with someone who may have HIV and didnt use a condom, or the condom broke
You were sexually assaulted
You shared needles or works with someone who may have HIV
If you were exposed to HIV in the last 3 days and want PEP, see a nurse or doctor or go to the emergency room immediately. Timing is really important. You must start PEP as soon as you can after being exposed to HIV for it to work.
PEP is for emergencies. It cant take the place of proven, ongoing ways to prevent HIV like using condoms, taking PrEP , and not sharing needles or works. If you know you may be exposed to HIV often , talk to your nurse or doctor about PrEP.
If youre a health care worker and think you may have been exposed to HIV at work, go to your doctor or the emergency room right away. Then report the incident to your supervisor. HIV transmission in health care settings is extremely rare, and there are procedures and safety devices that can lower your chances of coming into contact with HIV while caring for patients.
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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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.
Cases Of Hiv Seroconversion On Prep With Verified Adherence
Location: Toronto, CanadaReceived resistant strain? YesAdherence confirmed by dried blood stain test? YesDescription: A 43-year-old gay man seroconverted after two years on PrEP. Dried blood spotting tests demonstrated greater than adequate adherence at the time of seroconversion. His strain suggested that he acquired a virus resistant to the same medications found in the drug Stribild .
Received resistant strain? NoAdherence confirmed by DBS? YesDescription: A 50-year-old gay man in a PrEP demonstration project seroconverted HIV eight months after starting PrEP. Dried blood spotting tests demonstrated greater than adequate adherence at the time of seroconversion. He did not acquire a strain of HIV that is resistance to medications.
Received resistant strain? YesAdherence confirmed by dried blood stain test? Yes, as well as hair samplingDescription: A 21-year-old Latinx man acquired HIV between months 10-13 of using PrEP. He had been confirmed as HIV negative at initiation, as well as months 3, 6, and 10. Through hair sampling it was verified he had more than adequate adherence from the previous 6 months. His strain of HIV was resistant to the same medications as his primary partner. His viral load was quickly brought down to undetectable.
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If I’m Taking Prep Do I Still Need To Use Condoms
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PrEP can stop you from getting HIV, but it doesn’t protect you from other sexually transmitted diseases like syphilis, chlamydia, and gonorrhea, so you’ll still need condoms for that. PrEP also doesn’t prevent pregnancy.
You should visit your doctor every 3 months for an HIV test and follow-up care while you’re taking PrEP.
Who Should Consider Taking Prep
PrEP is for people without HIV who are at very high risk for getting it. This includes:
Gay/bisexual men who:
- Have an HIV-positive partner
- Have multiple partners, a partner with multiple partners, or a partner whose HIV status is unknown and
- Have anal sex without a condom OR
- Have been diagnosed with a sexually transmitted disease in the last 6 months
Heterosexual men and women who:
- Have an HIV-positive partner
- Have multiple partners, a partner with multiple partners, or a partner whose HIV status is unknown and
- Don’t always use a condom when having sex with people who inject drugs OR
- Don’t always use a condom when having sex with bisexual men
People who inject drugs and:
- Share needles or other equipment to inject drugs OR
- Are at risk for getting HIV from sex
If you have a partner who is HIV-positive and are considering getting pregnant, talk to your health care provider about PrEP. Taking it may help protect you and your baby from getting HIV infection while you try to get pregnant, during pregnancy, or while breastfeeding.
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What Are The Next Steps If You Think Prep Is Right For You
Make an appointment with your doctor and talk about why you think you would like to take this medication. Your doctor will run tests to check for HIV and other sexually transmitted infections as well as hepatitis A, B, and C, and check your kidney function before starting PrEP. Usually your provider will need to get prior authorization for the medication. Most insurances cover the cost. If your provider is uncomfortable prescribing this medication, ask to be referred to an HIV specialist in your area.
You will need to see your doctor initially after one month and then every three months, when HIV and sexually transmitted infection testing will be repeated. Your kidney health will be monitored via a blood test once within six months, and PrEP must be stopped if the kidneys are adversely affected.
Is Prep Really Effective
An HIV-positive person can lower their risk of contracting the disease by taking PrEP every day. In addition to regular HIV testing, it is best to use it as part of a preventive program. The combination of two antiretroviral medicines has been shown to prevent HIV more than 90% of the time in recent research.
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How Is Hiv Transmitted Through Needles
HIV isnt transmitted only through sexual contact. Sharing needles also puts a person at higher risk of contracting HIV.
When a needle is injected into a persons body, it breaks the skin barrier. If the needle has already been injected into another person, it can carry traces of their blood, along with any infections they have. The contaminated needle can introduce these infections into the second persons body.
Researchers dont know if having an undetectable viral load reduces the risk of HIV transmission through shared needles, but its reasonable to assume it may provide some risk reduction.
HIV can affect anyone. Whatever their age, gender, sexuality, ethnicity, or race, everyone should take steps to protect themselves. But due to socioeconomic factors, some demographic groups have higher HIV transmission rates and generally are more affected by HIV.
According to the CDC , the general demographic traits most affected by HIV are:
Transgender women are also highly impacted by HIV transmissions as a population, reports the CDC .
These groups are disproportionately affected by HIV, but they arent inherently at greater risk of contracting HIV. An individuals personal risk depends on their behaviors, not on their age, gender, sexuality, ethnicity, race, or any other demographic factor.
How Effective Is Prep
If you use it correctly, PrEP can lower your chances of getting HIV from sex by more than 90%. And using condoms and PrEP together helps you stay even safer. PrEP can also lowers your chances of getting HIV from sharing needles by more than 70%.
Its really important to take PrEP every day. PrEP doesnt work as well if you skip pills. If you dont take it every day, there might not be enough medicine in your body to block HIV.
PrEP doesnt prevent other sexually transmitted infections, like gonorrhea and chlamydia. So use condoms along with PrEP to help you avoid other STDs and give you extra protection against HIV.
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How Can Alcohol Put You At Risk For Getting Or Transmitting Hiv
Drinking alcohol, particularly binge drinking, affects your brain, making it hard to think clearly. When youre drunk, you may be more likely to make poor decisions that put you at risk for getting or transmitting HIV, such as having sex without a condom.
You also may be more likely to have a harder time using a condom the right way every time you have sex, have more sexual partners, or use other drugs. Those behaviors can increase your risk of exposure to HIV and other sexually transmitted diseases. Or, if you have HIV, they can also increase your risk of transmitting HIV to others.