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.
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.
If you do have health insurance that still requires a co-pay but you cant afford it, you may receive co-pay assistance from drug manufacturers, state programs, or patient advocacy foundation.
Need help paying for your clinic visits and lab tests?
- You can get them at HRSA-funded Health Centers, where the sliding scale fees are based on your ability to pay. There are more than 12,000 health centers nationwide.
If I Drink Alcohol And/or Use Recreational Drugs Is It Safe To Take Prep
Alcohol and recreational drugs are not known to interact with PrEP medications. It is safe to take PrEP before, after and on days when you are “partying.” In fact, it is important to take extra steps to make sure you take PrEP according to the healthcare providers directions when you are “partying.”
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Expert Panel Recommends Wider Use Of Daily Pill To Prevent Hiv Infections
“We don’t have universal health insurance in the United States,” Krellenstein said. “So the real challenge today, the next challenge in prep access, is going to figure out what policies the CDC and the Department of Health and Human Services can put into place to ensure that those people can also access PrEP as easily as people with insurance.”
The CDC tells NPR it is working on “multiple fronts” to ensure access to PrEP including “focused funding to help deliver” the treatment to those who need it the most.
This story originally appeared on the Morning Edition live blog.
Should I Consider Taking Prep
PrEP is for people without HIV who are at very high risk of getting it from their sexual behaviour or their potential exposure to HIV infection, so if you are HIV negative, and donât always use condoms, then PrEP could help reduce your risk of getting HIV.
Signs that you may be at higher risk of HIV, other than behaviour, are that you have recently had a sexually transmitted infection or that you have used post-exposure prophylaxis .
Trials among men who have sex with men, transgender women, heterosexuals, and injecting drug users have shown that PrEP can reduce HIV infection risk quite significantly â when PrEP is taken consistently, and if other safer sex methods are used as well.
However, prior to starting PrEP, you must be certain that you are HIV negative. A confirmed HIV-negative test is absolutely necessary to start on PrEP. Also people on PrEP need to get re-tested for HIV every three months. You can get an HIV test at your local Integrated Sexual Health Clinic.
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More Research Is Needed To Understand The Benefits And Risks Of Sti Prophylaxis
Both the potential benefits and the potential risks of STI prophylaxis could be significant. At this time there is not a consensus about STI prophylaxis in the scientific and medical community. There are many questions that are unanswered, including whether the prevention benefits justify the risk of potential antibiotic resistance. Other questions that need to be answered relate to the eligibility criteria for recommending STI prophylaxis and the best dosing schedule.
There is wide agreement that more research is needed before STI prophylaxis can be broadly rolled out. An international team of health experts from academic, clinical and community settings met in March 2019 to review the evidence. They concluded that STI prophylaxis shows promise but much more research is needed before it can be used broadly.1 Public Health England has released a position statement saying that it does not endorse the use of STI prophylaxis outside of research studies.18
Patient Education And Monitoring
When prescribing emtricitabine/tenofovir for PrEP, health care providers must do the following :
Prescribe emtricitabine/tenofovir as part of a comprehensive prevention strategy because this drug combination is not always effective in preventing the acquisition of HIV-1 infection
Counsel all uninfected individuals to strictly adhere to the recommended emtricitabine/tenofovir dosing schedule because in clinical trials, the combinations effectiveness in reducing the risk of acquiring HIV-1 correlated strongly with adherence, as demonstrated by measurable drug levels
Confirm a negative HIV-1 test immediately prior to initiating emtricitabine/tenofovir for a PrEP indication
If clinical symptoms consistent with acute viral infection are present and recent exposure is suspected, delay starting PrEP for at least 1 month and reconfirm HIV-1 status or use a test approved by the FDA as an aid in the diagnosis of HIV-1 infection, including acute or primary HIV-1 infection
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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.
What Drug Is Being Investigated For Sti Prophylaxis And Why
Although there is limited evidence as far back as the 1940s on the effectiveness of STI prophylaxis, there is renewed interest in the use of an antibiotic drug called doxycycline to prevent getting certain STIs.1,4 Doxycycline works by preventing certain bacteria, including some that cause STIs, from reproducing. This antibiotic and others from the same family have also long been used preventively by people at risk of being exposed to other infections such as malaria5 and Lyme disease.6 In addition, it is used to treat various skin conditions, including acne, often for long periods of time .7
In Canada, doxycycline is commonly used to treat syphilis and chlamydia,8 and researchers have suggested that it could similarly be used to prevent these infections. However, doxycycline is not a recommended treatment for gonorrhea, because up to 50% of gonorrhea infections are resistant to the drug.9 Therefore, it is expected that this drug will be less effective at preventing gonorrhea infections, although it may provide protection from strains of gonorrhea bacteria that are not resistant to doxycycline.
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Possibility Of Increased Risk
While PrEP appears to be extremely successful in reducing HIV infection, there is mixed evidence that there might be a change in use of condoms in anal sex, raising risks of spreading sexually transmitted infections other than HIV. In a meta-analysis of 18 studies, researchers found that rates of new diagnoses of STIs among MSM given PrEP were 25.3 times greater for gonorrhea, 11.2 times greater for chlamydia and 44.6 times greater for syphilis, compared with the rates among MSM not given PrEP. Unlike HIV, these three STIs can be cured with antibiotics. However, the increased rates of such infections and their treatment can lead to antibiotic-resistant mutations of the pathogens antibiotic-resistant gonorrhea is already a major concern.
A systematic review conducted in 2019 was unable to find conclusive evidence that PrEP use increases sexual risk behaviors, and found that PrEP may provide an opportunity for MSM to access sexual health care, testing, treatment and counselling services.
New Drugs To Treat Cystic Fibrosis Hiv Will Be Covered By Manitoba
The Manitoba government is adding new drugs to the provincial formulary, allowing patients to access medications for cystic fibrosis and HIV.
Premier Kelvin Goertzen and Health Minister Audrey Gordon announced the additions on Friday, saying Trikafta for cystic fibrosis and HIV pre-exposure prophylaxis will be added to the provincial drug program.
Trikafta has helped tens of thousands of people with cystic fibrosis live their lives normally instead of having to struggle for every breath, Gordon said.
PrEP is an anti-retroviral drug that greatly reduces the risk of HIV infection.
Patients will be able to access these drugs if they meet provincial eligibility criteria and are eligible for pharmacare or receive health coverage from Employment and Income Assistance.
This is an important announcement for Manitobans, Gordon said.
Adding these two drugs to the provincial formulary will dramatically change the lives of Manitobans living with cystic fibrosis or who are at risk of HIV exposure.
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Does Prep Protect Me Against Other Stis
PrEP does not prevent against the transmission of other STIs â you need to use condoms to protect against STIs. PrEP trial participants and clients of PrEP programmes generally do have high rates of STIs, but as these participants and clients are inclined to risky sexual behaviour, this is true at the outset before they start on PrEP. Most studies indicate that men at highest risk for HIV – which includes those who already do not use condoms – are most likely to seek PrEP. In many cities where demonstration projects have taken place STI rates were on the rise well before PrEP became widely available.
Are There Other Types Of Prep
An injectable form of PrEP, using a drug called cabotegravir, has been tested in gbMSM, transgender women and cisgender women. This long-acting form of PrEP is injected into muscle every two months. Preliminary studies have found long-acting cabotegravir to be generally safe and effective at reducing the risk of getting HIV. Long-acting injectable PrEP is not currently approved for use as PrEP in Canada but is likely to be available in the near future.
Other types of PrEP, including vaginal or rectal gels, intravaginal rings and implants, are currently in experimental stages. These forms of PrEP have not been approved for use by any regulatory agency in the world, and we do not expect them to be available for use in Canada in the near future.
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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.
Can You Take Prep If You Are Hiv Positive
No. PrEP is a once-daily pill that is designed to reduce the risk of HIV before you are exposed to it. It does not treat HIV and should not be used if you have already tested positive for HIV. However, if you have been exposed to HIV in the last 72 hours, you may be able to take a similar type of medication, referred to as PEP , for a month to reduce the likelihood of being infected.
PrEP stands for pre-exposure prophylaxis. It is designed for those who are not living with HIV and would like to reduce their risk of contracting the virus. There are two brand name medications for PrEP: Truvada, which received approval from the FDA in 2012 for HIV prevention, and Descovy, which was approved in 2019. There is also a generic PrEP medication, emtricitibane/tenofovir diproxil, that is now available. All of these medications containemtricitabine and tenofovir, which can work together to dramatically reduce your chance of contracting HIV.
If you are HIV positive, its important to begin treatment with your healthcare provider as soon as possible. Although PrEP isnt the treatment for you, a number of options are available that can reduce your viral load .
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How Do I Get Prep
You can get PrEP from some health clinics or Planned Parenthood health centers, local health departments, and doctors offices.
Your nurse or doctor will talk with you about the sex you have, the protection you use, and your medical history to see if PrEP is right for you. Theyll also give you tests for HIV, Hepatitis B and C, and other STDs. And they’ll test your kidneys to make sure theyre working well.
Some nurses and doctors dont know about PrEP, or they dont want to prescribe it because they dont have all the facts about PrEP. If you dont have a doctor, or your regular doctor or nurse doesnt prescribe PrEP, you still have options. The doctors and nurses at your local Planned Parenthood health center can provide up-to-date, accurate, non-judgmental information about PrEP, and help you get a prescription if PrEP is right for you.
There are also other organizations that can help you get and pay for PrEP. Greater than AIDS has a tool that can help you find PrEP near you.
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.
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What Drugs Are Approved For Prep
The following medications approved for daily use as PrEP. They are combinations of two anti-HIV drugs in a single pill:
- Emtricitabine 200 mg in combination with tenofovir disoproxil fumarate 300 mg is recommended for all adults and adolescents at risk for HIV through sex or injection drug use. A generic version of Truvada® is also available.
- Emtricitabine 200 mg in combination with tenofovir alafenamide 25 mg is recommended for adults and adolescents at risk for HIV through sex, excluding people at risk through vaginal sex. Descovy® has not yet been studied for HIV prevention for receptive vaginal sex.
Is Prep For You Using Prep To Prevent Hiv
PrEP, which stands for pre-exposure prophylaxis, is an FDA-approved way for people to prevent HIV infection by taking a pill every day. The pill is called Truvada, and it contains two kinds of medicine that are also used in combination with other medicines to treat HIV. When used consistently, PrEP greatly reduces the risk of HIV. PrEP is a powerful prevention tool and can help reduce anxiety and stress for people at risk of contracting HIV. Also available in Spanish.
- Provides an overview of what it means to be on PrEP to reduce the risk of HIV
- Discusses how to decide if PrEP is the right choice
- Notes that PrEP is available by prescription only
- Explains that PrEP requires a commitment to a program of services
- Answers some common questions and concerns
- Includes information on how to pay for it
- Explores the difference between PrEP and PEP
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