How Hiv Attacks The Body
The human body has no natural means of fighting and getting rid of HIV. HIV targets your immune system directly, aiming at a specific type of white blood cell. White blood cells are immune system cells tasked with shielding the body against infection and disease.
The group of specific white blood cells attacked by HIV are called CD4 cells. Also known as T-cells or helper cells, CD4 cells help coordinate your bodys immune response, organizing protection against harmful invaders. HIV tricks CD4 cells into becoming a safe haven in which the virus can reproduce and spread throughout your body. HIV depends on CD4 cells to survive and thrive. Without helpful CD4 cells, HIV may not stand a chance.
Who Is Prep For
PrEP is recommended for people who are considered at risk of getting HIV. You may be at risk if you:
- Are a man or transgender woman who has anal sex with men and does not always use a condom
- Have a heterosexual partner who has HIV and you want to have a baby
- Have a partner who is HIV positive but has not achieved an undetectable viral load, and you dont always use a condom
- Are a person who injects drugs
Can You Get Help Paying For Pep
- If youre prescribed PEP after a sexual assaultYou may qualify for partial or total reimbursement for medicines and clinical care costs through the Office for Victims of Crime, funded by the U.S. Department of Justice .
- If youre prescribed PEP for another reason and you cannot get insurance coverage Your health care provider can apply for free PEP medicines through the medication assistance programs run by the manufacturers. These requests can be handled urgently in many cases to avoid a delay in getting medicine.
- If youre a health care worker who was exposed to HIV on the jobYour workplace health insurance or workers compensation will usually pay for PEP.
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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?
How Much Does Truvada Cost
Much has been made about the pricing of Truvada, since there is no generic version available here in the United States . No doubt this has a lot to do with varying quotes of the cost of the medication, ranging from $1,500 to $2,000 for a months supply. This is certain to scare many off who are considering Truvada for treatment, but much more so for those who might take PrEP, since they are considering it for HIV prevention.
Truth is, if you have insurance, monthly copays for Truvada typically run between $10 and $50, depending on the plan, though some people may pay a percentage of the actual pharmacy price . The manufacturer of Truvada has a copay assistance program to help people with commercial health insurance defray these out-of-pocket costs. For those who dont have insurance and meet certain income requirements, the manufacturer also has a patient assistance program that provides the drug for free.
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Is It Ok To Switch Between Daily Prep And On
On-demand PrEP is only for cis-gender MSM. Other individuals are not eligible for on-demand PrEP because studies have not demonstrated that it is effective for other populations. Before switching from daily PrEP to on-demand PrEP, or vice versa, a cis-gender MSM should consult with their healthcare provider.
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.
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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.
What Are Prep And Pep
PrEP and PEP are medicines to prevent HIV. Each type is used in a different situation:
- PrEP stands for pre-exposure prophylaxis. It is for people who don’t already have HIV but are at very high risk of getting it. PrEP is daily medicine that can reduce this risk. With PrEP, if you do get exposed to HIV, the medicine can stop HIV from taking hold and spreading throughout your body.
- PEP stands for post-exposure prophylaxis. PEP is for people who have possibly been exposed to HIV. It is only for emergency situations. PEP must be started within 72 hours after a possible exposure to HIV.
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How Do Truvada And Descovy Compare For Prep
Truvada and Descovy both contain emtricitabine and tenofovir, and both are FDA-approved for PrEP. The two medications are very similar to each other, yet there are subtle differences.
Descovy is a newer medication, and it contains a different form of tenofovir. Truvada has been around for longer, so theres more research regarding its use for PrEP.
Both medications are effective options for PrEP, but one may be better suited for certain individuals. Here well take a look at the differences between the medications.
Truvada As A Preventive For Hiv
Just last week, the FDA approved the use of Truvada as a pill to reduce the risk of infection in a high risk-population. This news was received with much excitement and caution. In lay terms, Truvada, manufactured by Gilead Sciences is being touted as an HIV vaccine that the world has been waiting for. But is it?
Truvada is a combination of two drugs, Viread and Emtriva, and has been used to treat HIV infection since 2004. It is taken in oral form, once a day. It works by targeting the HIV reverse transcriptase in the body, preventing the virus from multiplying. It is not a cure for an existing infection it does not eliminate the virus completely. But by limiting how the virus reproduces, it reduces the viral load in the system. Lower viral load means that the immune system is less compromised and there is a lower risk of acquiring infections. Truvada may also increase the CD4 cells in the blood stream. This combination of effects makes the drug a good candidate to control the viral load in the body. Now, the same treatment is being prescribed for reducing the risk of acquiring infections. Clinical studies showed that using Truvada in a high-risk population for HIV infection reduced the risk of infection significantly. This is a very important milestone for couples where one partner is infected and the other is not.
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How Long Do I Need To Be On Prep
Talk with your doctor about your personal circumstances. There are several reasons that people stop taking PrEP:
- If your risk of getting HIV infections becomes low because of changes that occur in your life.
- You don’t want to take medication every day or often forget to take your medication other ways of protecting yourself from HIV infection may work better for you.
- You have side effects from the medication that are interfering with your life.
- Blood tests show your body is reacting to PrEP medication in unsafe ways. Your doctor may decide there are other options for you.
Talk with your doctor if you are having trouble remembering to take your medication or if you want to stop PrEP.
It is important to make sure that you continue taking PrEP for 28 days after your last potential exposure to HIV before ceasing it.
Who Is Prep Meant For
PrEP is not the right fit for everyone. Only the group of people with an increased risk of contracting HIV are qualified. In the Netherlands this group mainly consists of men who have sex with men with additional risk factors for HIV infection. Only people who are HIV-negative can use PrEP. Sometimes the use of PrEP is also not permitted if you have certain diseases.
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Which Medication Is Less Expensive
If were talking about a medications cash price, Truvada is the less expensive option since a generic version is available. GoodRx can help you save on generic Truvada, with prices as low as $45 at certain pharmacies with a free GoodRx discount.
If you have insurance, your out-of-pocket costs and coverage usually depend on your specific plan. However, recent federal guidance now requires insurers to provide PrEP at no cost. This change removes a significant barrier for people who are insured.
But if you dont have insurance, Gilead the manufacturer for both Truvada and Descovy has assistance options available to help make your prescription more affordable. For example, you may be able to get Truvada at no cost if youre uninsured and qualify for their Medication Assistance Program. Click here to learn more about the Gilead Advancing Access program for ways to save.
The CDC also lists a few programs to help you get PrEP for free or at a lower cost. Learn about your options here.
How To Take Pep
PEP must be taken exactly as instructed and for 28 days.
- Do not skip a dose or fail to complete the full month as this makes it less likely to work.
- Do not double a dose if you miss one.
- If you do miss a dose and you remember in less than 24 hours, take the next one as soon as you remember.
- If you miss more than 48 hours of PEP it will be discontinued.
The medication now used for PEP is a single tablet called Truvada and two tablets of raltegravir.
Side effects from PEP are likely to be mild ones in the first few days, such as nausea, headaches or tiredness.
Do not take recreational drugs while on PEP as there can be dangerous interactions.
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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.
The Availability Of Prep
Currently PrEP is available in many countries in Europe, east Africa, North America, east Asia and Australasia. It is also available in some countries in Latin America, south-east Asia, and west Africa.
How you can access PrEP and how much you will need to pay for the treatment depends on where you live and the health system in your country. For example, you can access PrEP through private insurance in the US and through the NHS in the UK. You can find the full list of countries with PrEP programmes here.
You can ask your healthcare provider if there are any PrEP programmes or trials through which you can access PrEP without any charge.
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Eviplera Treatment For Hiv United States Of America
Eviplera is a single-pill regimen targeted at human immunodeficiency virus-1 .
Another Phase III clinical trial on the drug was also considered for the FDA approval. It is known as partners PrEP trial which enrolled 4,758 heterosexual couples, where one partner was HIV-infected and the other was not.
It was sponsored by University of Washington and Bill and Melinda Gates Foundation. It was conducted between May 2008 and June 2012. It was a randomised, double-blind and parallel assignment. The trial evaluated the safety and efficacy of truvada in comparison with a placebo.
The results of the partners PrEP trial showed that truvada reduced the risk of becoming HIV-infected by 75% when compared to the placebo. The general side effects of the drug included pain, weight loss and diarrhoea.
Gilead conducted Phase IV clinical trials on truvada between July 2008 and April 2011. It was an open label, randomised, multicentre and parallel assignment. It evaluated the safety and efficacy of the drug in the treatment of HIV-1 infected subjects.
The primary outcome measure of the study was finding the percentage of participants with HIV-1 Ribonucleic Acid after 48 weeks. The secondary outcome measures included finding the percentage of people with Pure Virologic Response and change from baseline in cluster determinant 4 after 48 weeks.
How To Take Truvada
Truvada, whether taken for treatment or as PrEP, is FDA-approved in the United States to be taken once daily, with or without food. Food does not impact absorption of either medication, but some may find that taking Truvada with food is easier on the stomach.
In some other countries, Truvada is also approved to be taken as PrEP in an on-demand fashion, so people can take two tablets anywhere from two to 24 hours before sex, then another pill 24 hours after the first two, and another pill 48 hours after the first two. Despite more recent evidence suggesting the effectiveness of on-demand PrEP in the United States, it has yet to receive FDA approval for this dosing strategy.
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How Well Does Pep Work
PEP is effective in preventing HIV infection when its taken correctly, but its not 100% effective. The sooner you start PEP after a possible HIV exposure, the better.
While taking PEP, its important to use other HIV prevention methods, such as using condoms the right way, every time you have sex and using only new, sterile needles and works when injecting drugs
Can Prep Be Used By Everyone
PrEP works, and can be used by everyone.
Globally, PrEP has been most commonly used among gay and bisexual men – but it’s increasingly being used by other groups of people too.
Some of the early international PrEP trials were only conducted among gay men and bisexual men. And in some of the trials that did include other groups, uptake of PrEP has been lower.
PrEP in a pill formulation using TDF/FTC has been tested in lots of groups of people – including cis and trans women. TAF/FTC has only been tested in cis gay men and trans women and so we don’t yet know if it works in cis women.
PrEP needs to be used in different ways by different groups of people for it to work. See the information on stopping and restarting PrEP and on different ways of taking PrEP.
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How Does Pep Work To Help Prevent Hiv
PEP interferes with the pathways that HIV uses to cause a permanent infection in the body. For HIV to cause infection the virus must enter the body, infect certain immune cells, make copies of itself within these immune cells, then spread throughout the body.
When PEP is taken, the HIV drugs get into the bloodstream and the genital and rectal tissues. If there is HIV in the body, the drugs can prevent HIV from replicating within the bodys immune cells, and help to prevent a permanent infection from developing.
PEP drugs need to start working against HIV as soon as possible after the virus enters the body, meaning that PEP should be started as soon as possible after a potential exposure and not more than 72 hours afterwards. Drug levels must also remain high during the month of treatment to help prevent infection. If the pills are not taken consistently, as prescribed, there may not be enough medication in the body to prevent HIV infection.