More Frequently Asked Questions About Prep
How do I find a doctor who can prescribe PrEP?
Any doctor can now prescribe PrEP. When choosing a doctor, it is important you find someone who you feel comfortable discussing your sexual history with as this is required for the eligibility and ongoing screening for those who take PrEP.
If youre searching for a doctor who can prescribe PrEP for you or want to talk to someone about PrEP before you see your doctor, you can call the NSW Sexual Health Info Link on;.
Can anyone get PrEP?
PrEP is available for people who are at risk of acquiring HIV.
For gay and bisexual men the risk criteria can include having condomless sex with a partner who doesnt know their HIV status, having a regular partner with HIV who is not on treatment, having a recent STI in your arse such as gonorrhoea or chlamydia or if you occasionally party and play.
There may be cases where someone can be prescribed PrEP without meeting these criteria, but this will require a discussion with a doctor.
I am interested in taking PrEP, what do I need to do?
If you are thinking about starting PrEP, you will need to make an appointment with a doctor or sexual health clinic. During your first appointment they will discuss your eligibility for PrEP, complete the required testing for HIV and STIs, and check your kidney function.
I dont have Medicare, what does that mean for me?
What if I want to import PrEP myself?
Can I Get The Prep Medication From My Regular Healthcare Provider Or Do I Have To Go To A Special Doctor
It depends on your doctor. Any physician, nurse practitioner or physician assistant can prescribe PrEP. It is important to have a healthcare provider who you can work with to individualize PrEP to your needs and circumstances. The New York State Department of Health has prepared a directory of healthcare providers that prescribe PrEP that can be found online.
Is It True That There Is A Medication That Can Actually Prevent Someone From Getting Hiv
Yes. PrEP involves working with a healthcare provider to make an individualized plan to take medication to prevent HIV. Clinical trials have shown that PrEP is 99% effective at reducing sexual transmission of HIV. As of January 2019, the U.S. Food and Drug Administration has approved two medications as PrEP for HIV: Truvada , and Descovy . ;Note: Descovy is not approved for use by cis-gender women.
Key Points About PrEP:
- PrEP medication is prescribed by a healthcare provider. People interested in PrEP can work with a healthcare provider to determine how PrEP can be tailored to their individual needs and circumstances.
- PrEP is only for people who are not living with HIV. HIV testing should be conducted before starting PrEP and repeated every three months to make sure the person is not living with HIV. Testing may be done by the healthcare provider or at a conveniently located community-based organization , healthcare facility or lab.;
- Some people benefit from counseling and support for taking the medication regularly. If this is needed, the person can talk with the healthcare provider, a trusted CBO, a peer worker, or other provider.
- People at risk for HIV are also at risk for sexually transmitted infections . Counseling about using condoms to prevent STIs and periodic screening for STIs is important and may be provided by the healthcare provider, a trusted CBO, or other provider.
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Is It Safe To Take Prep For Hiv
Truvada and Descovy are generally safe, but some people may experience side effects. Some of these side effects may be serious.
Before starting Descovy or Truvada for PrEP, talk with a healthcare professional about any health conditions you have and the side effects and benefits of PrEP. For example, if you have serious kidney conditions, these medications may not be safe for you to take.
Also, if youve contracted hepatitis B in the past, let your doctor know. Stopping Truvada or Descovy may worsen a hepatitis B case.
A healthcare professional will monitor your liver function and can treat the hepatitis B case if it flares up.
Its important not to take PrEP medications if you live with HIV. This is because the drug may become resistant to the virus if you take it while you live with HIV.
You will have a blood test done before starting the medication and will retest at least every 3 months while youre taking it.
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.
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Is Prep Covered By My Insurance
In most cases, yes! Under the Affordable Care Act, PrEP must be free under almost all health insurance plans. That means you cant be charged for your PrEP medication or the clinic visits and lab tests you need to maintain your prescription. There are no out-of-pocket costs for you.
This applies to most private health insurance plans you get through your employer or purchase yourself, individual plans you purchase through HealthCare.gov or state-based Marketplaces, and state Medicaid expansion coverage plans. In some states, the traditional Medicaid program also covers PrEP at no charge.1 This does not automatically apply to Medicare.
To find out whether your health plan covers PrEP medications without charge:
- If you have private health insurance through your employer or have purchased it yourself: Check with your health insurance company about coverage for PrEP medications, or look on their drug formulary online to find information about coverage for the drugs approved for PrEP.
- If you purchased your health plan through HealthCare.gov or a state-based Marketplace: This NASTAD tip sheet can help you verify whether your plan covers PrEP medications.
- If you are on Medicaid: Check with your benefits counsellor.
- If you are on Medicare:Find which plans cover your drugs.
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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How Often Are Medical Appointments For Prep
People who want to take PrEP to prevent HIV can work with their healthcare provider to determine the schedule of medical appointments that best meets their needs. Here is a general description of the schedule of medical appointments for PrEP.
- Initial Medical Appointment:; This first appointment includes education about PrEP, a discussion about readiness to take PrEP, a review of daily versus on-demand PrEP, HIV testing, and other lab work. If the person is ready to start PrEP, the medication can be started right after the initial medical appointment.
- First Follow-Up Contact: The healthcare provider and person should make a plan for a follow-up appointment or call at a convenient time, usually within 2-4 weeks, to:
- Check in on how things are going, including side effects;
- Troubleshoot any problems with payment or access to support services.
- HIV testing: The person should have an HIV testevery three months to make sure they have not acquired HIV. The healthcare provider can order the testing which can be done at their office, a conveniently located CBO, health facility or lab. It is important that the results of the test are provided to the healthcare provider who prescribed PrEP.
- Follow-Up Appointments and Prescription Refills: The frequency of follow-up appointment is established jointly by the healthcare provider and the person.
When Can I Stop Taking It
It isn’t a pill you have to take forever. You get to decide when to start and stop PrEP. Just remember that if you don’t take it regularly, you aren’t as safe.
Once you’ve started taking PrEP, you should stay on it for at least a month after you were last exposed to HIV.
If you think that you’re no longer at risk of getting HIV, talk with your doctor before you stop taking PrEP.
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What Should I Tell My Healthcare Provider Before Taking Truvada For Prep
- All your health problems. Be sure to tell your healthcare provider if you have or have had any kidney, bone, or liver problems, including hepatitis.
- If you are pregnant or plan to become pregnant. It is not known if TRUVADA can harm your unborn baby. If you become pregnant while taking TRUVADA for PrEP, tell your healthcare provider.
- If you are breastfeeding or plan to breastfeed. Do not breastfeed if you think you may have recently become infected with HIV. HIV can be passed to the baby in breast milk. Talk to your healthcare provider about the risks and benefits of breastfeeding while taking TRUVADA for PrEP.
- All the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. TRUVADA may interact with other medicines. Keep a list of all your medicines and show it to your healthcare provider and pharmacist when you get a new medicine.
- If you take certain other medicines with TRUVADA, your healthcare provider may need to check you more often or change your dose. These medicines include certain medicines to treat hepatitis B or C infection.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch, or call .1-800-FDA-1088.
Figure Out The Finances
Truvada can be extremely expensive if you have to pay full price. But, seriouslywho does that? The good news is most health insurance policies cover Truvada.
If your insurance has expensive co-pays that make it tough to afford Truvada, help is available. Gilead, the company that makes Truvada, has a co-pay card that helps you cover your lab, visit, and medication co-pays to access PrEP.
The company that makes Truvada also has a program to reduce the cost if you have no insurance coverage or government assistance. Follow this link to find out more about Gileads co-pay card and medication assistance program . ;
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How Well Does Prep Work For Different Types Of Sex
Evidence from RCTs suggests that daily PrEP is extremely effective for vaginal and anal sex when it is used consistently and correctly, but that adherence may be more important for people having vaginal sex.
For PrEP to work optimally, drug levels in the body need to be high enough to prevent HIV infection. There is some evidence showing that the drugs in PrEP take longer to reach maximum levels in vaginal tissues compared with rectal tissues and that drug levels are lower in vaginal tissues. This suggests that daily dosing of PrEP may be more important for cisgender women or transgender men potentially exposed to HIV through vaginal or frontal sex to maintain sufficient drug levels to help prevent HIV infection.
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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Can Adolescents Consent To Prep On Their Own Does A Healthcare Provider Need The Consent Of A Parent Or Guardian In Order To Prescribe Prep To An Adolescent
2017 amendments to NYSDOH regulations allow minors to consent to their own HIV treatment and HIV preventive services, such as PrEP and PEP, without parental/guardian involvement .; The FDA has approved the use of Truvada for adolescents regardless of gender, and Descovy for adolescent cis-gender males. These developments, along with updated New York State Clinical Guidelines, mean that adolescents who are at risk for HIV may consent to PrEP without the involvement of the young persons parent or guardian.;
Side Effects And Safety
Both forms of tenofovir are effective in preventing HIV, but they come with different side effects.
Compared with TDF, TAF causes fewer side effects involving the kidneys and bones, but it may lead to weight gain and high cholesterol.
Experts consider PrEP to be safe, but any medication can cause side effects.
Side effects that people may experience include:
- changes in a personâs life that reduce their chance of contracting HIV
- lack of adherence to taking one pill a day
- side effects interfering with activities of daily living
- blood test results indicating that the body is responding negatively to PrEP
In these cases, a person can discuss alternative options with their healthcare provider.
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>>can Prep Replace Condoms
PrEP is an additional level of protection against HIV.
The FDA recommends that you use PrEP with condoms to maximize your protection against HIV and other STIs. However, PrEP can help lower your risk of contracting HIV even in situations where you dont use a condom. PrEP does not protect you against other STIs, such as Hepatitis C.
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.
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>>how Much Does It Cost
For most people, PrEP is inexpensive or even free.
The amount you pay for PrEP will depend on whether you have health insurance and the specifics of your insurance plan. Even if you dont have health insurance, there are opportunities through Medicaid, Gilead , and other agencies to get you PrEP at a reduced cost or no cost at all. We have staff who can help you figure out how to get started with PrEP in the most affordable way. Email to get started.
Are There Any Other Hiv Prevention Options
There are many easy and effective ways to prevent HIV. Other than PrEP, HIV transmission can also be prevented by:;
- Using condoms with water or silicone-based lubricant during anal or vaginal sex.
- Although there is a low risk of HIV transmission during oral sex, using male condoms on penises;or dental dams on vulvas and anuses. This can also help to reduce the risk of other STIs from being passed on.
- Using clean, sterile injecting equipment.
- Achieving; and maintaining undetectable HIV viral loads if you are HIV-positive by taking HIV antiretroviral treatment as prescribed.
- Getting regular sexual health checks.
- Taking post-exposure prophylaxis if you have potentially been exposed to HIV.
Depending on your risk factors and life circumstances, you may be more suited to other HIV prevention methods. It is important to find the right prevention method, or combination of methods, that works for you and your sexual partners.
Speak to your GP or sexual health clinician for more information.
has more information on PrEP.;
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