How Would I Pay For Prep
Medicaid will cover the cost of PrEP without co-pays. This includes the medication, medical appointments and lab tests associated with PrEP. Many health insurance plans with prescription drug coverage also cover all costs associated with PrEP without co-pays. For people without access to health insurance with prescription drug coverage, a number of options for financial assistance are available. If you need information about financial assistance options for PrEP, visit the NYSDOH website.
What Medication Is Available
There are currently two medications approved by the FDA for PrEP: Truvada and Descovy.
Both of these medications can be up to 99% effective at HIV prevention when taken correctly. However, the notable difference between these medications is that Descovy is currently only approved for use in cisgender males and transgender females, while Truvada is approved for all genders.
PrEP does not have any significant health effects even with long-term use, but you may experience some side effects, such as:
- Abdominal pain
- Changes in weight
Some more severe side effects that may occur can be kidney issues, liver problems, or bone density loss. But these often occur in people who had health issues prior to taking PrEP. Ultimately, it is between you and your doctor to determine whether or not PrEP is the best choice for you.
Access Prep Through Personal Importation
If you are not able to access PrEP through Medicare, another option is to purchase a generic version of the drug from a reliable overseas supplier. You still require a script from a doctor before ordering online. There are multiple suppliers who export PrEP into Australia at a range of costs. Visit the PrEP Access Now website for more information. You can buy a few months of PrEP at a time to save on shipping costs, and make sure to have a look at different websites to get a good price. There are lots of different medications that you can buy online, so be sure that the medication you order is the same one that is on your script that the doctor has written for you.
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How Will I Know If I Am Undetectable
You cant tell if you have an undetectable viral load simply by how healthy you look and feel. The only way to know that your viral load is undetectable is by regular viral load monitoring.
Viral load monitoring involves a simple blood test to measure how many particles of HIV there are in a small sample of your blood . From this you and your healthcare worker can understand how well your ART is working.
A low viral load means that your ART is working well and controlling your HIV. If you have an undetectable viral load, it means that the amount of HIV in your body is so low that you can’t pass it on to other people through sex.
The point at which a viral load is classified as being undetectable may vary across different countries depending on the tests available. But so long as your viral load is under 200 copies per millilitre, youre considered virally suppressed and unable to pass HIV on.
The frequency with which you are offered viral load testing may vary depending on where you are and the services available to you. The World Health Organization recommends that when first starting ART, you should have your viral load measured after the first 6 months of treatment and again at 12 months. After becoming undetectable you should still receive viral load testing at least every 12 months. Depending on the resources available and your particular health status, your health worker may recommend that your viral load is monitored more often than this.
Cdc And Who Guidelines For Prep Use
The 2014 guidelines from the US Centers for Disease Control and Prevention on the use of PrEP in the US recommend that daily oral Truvada be considered for HIV-negative people who are at substantial risk for HIV. This includes people who:
- are in a sexual relationship with a partner living with HIV
- do not regularly use condoms and who do not know the HIV status of their sexual partner
- have a high number of sexual partners
- are engaged in commercial sex work
- have had a recent bacterial sexually transmitted disease
- use injections drugs and share drug equipment, or were recently in a drug treatment program
There are also some reasons that PrEP is NOT recommended. These include having:
- unknown HIV status it is important that only people who test negative for HIV take PrEP
- signs or symptoms of acute HIV infection
- unknown hepatitis B status and/or vaccination status
The guidelines also suggest that providers consider PrEP for people who live in areas or have personal networks where HIV is more common . The guidelines provide tools to help providers identify these areas. The CDC also published a clinical providers’ supplement, which includes a patient/provider checklist, counseling about using PrEP while trying to become pregnant and during pregnancy, counseling about adherence and HIV risk reduction, and information sheets for patients in English and Spanish.
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Does Prep Have Any Side Effects
In some people PrEP can cause minor side effects like nausea, vomiting, fatigue and dizziness, but these usually disappear over time.
In rare cases PrEP can also affect kidney functions.
If youre taking PrEP and experience any side effects that are severe or dont go away, tell your healthcare professional.
> > what If I Miss A Dose
Youre still somewhat protected, as long as you continue to take PrEP consistently.
According to the makers of Truvada, the drug is most effective when taken every day. If you miss a dose, just take your next dose as soon as you remember, or call your doctor if youre unsure of what to do. Weve also seen in studies that PrEP offers some, though reduced, protection against HIV even when doses are missed. What we know for sure is that the more consistently you take it, the more thoroughly you are protected. If you consistently have trouble remembering to take PrEP every day, you will not be fully protected against contracting HIV and should reconsider whether PrEP is right for you.
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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.
How Does Prep Work To Reduce Hiv Infections
Pre-exposure prophylaxis medication is a recently developed strategy for the prevention of HIV infection. HIV-negative individuals are prescribed PrEP therapy to lower the risk of becoming HIV-positive when exposed to the virus. PrEP is a proven prevention treatment that was approved by the U.S. Food and Drug Administration in 2012.
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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.
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.
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Do I Still Need To Use Condoms If Im Undetectable
Some couples decide that they want to stop using condoms once they or their partner are undetectable. Its important to remember that although theres no HIV risk, being undetectable doesnt prevent you from getting or passing on other sexually transmitted infections or stop unwanted pregnancies, so you will have to use other measures to avoid these.
If you do stop using condoms, its important that both you and your partner are comfortable with the decision. It can help to talk it through with a healthcare worker first. Its recommended that you have a least two viral load tests confirming that youre undetectable before relying on this for HIV prevention. If your partner is HIV-negative they may consider using PrEP as an extra precaution.
In couples where both partners are living with HIV, its important that you are both undetectable before deciding not to use condoms. This is because if one partner has a different strain of HIV or has developed drug resistance this can be passed on if they have a detectable viral load.
Prep Failure Or Test Failure
There is no reason to suspect PrEP failure in this case. The patient disclosed high-risk sex up to the time he started PrEP, including in the week between his first and second negative HIV tests. The most likely scenario is that he was infected a few days before starting PrEP or even the day or two afterwards, at the time PrEP drug levels were reaching maximum.
However, while this does not point to PrEP failure, it certainly points to test failure or at least a poor ability to detect HIV infection in a context where someone has just started PrEP. Our current tests may not be sufficiently sensitive or discriminating to detect HIV infection when the levels of HIV antigens and RNA may be suppressed by PrEP, and the resultant antibody response to them is very weak.
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Repeat Testing Based On Risk
While the CDC recommends that all people between the ages of 13 and 64 get tested for HIV at least once, they also recommend yearly HIV testing for the following people:
- those having vaginal or anal sex without a condom or barrier method, especially men who have sex with men
- sexual partners of individuals living with HIV
- those who share needles
There are many steps that can be taken to prevent contracting HIV. These include:
- Using a condom.Using a condom during sex can help prevent transmission of the virus.
- Not sharing needles. Its important not to share needles or other injection drug equipment.
- Taking pre-exposure prophylaxis .PrEP is a daily oral medication. It can help to prevent contracting HIV during sex or when using injection drugs.
- Getting tested. Being aware of HIV status is a valuable tool in prevention. Testing for other STIs is also important because some STIs can increase the risk of HIV transmission. Encourage sexual partners to be tested as well.
- Asking about post-exposure prophylaxis .PEP is an emergency medication that can help prevent HIV after potential exposure. To be effective, it must be started within 72 hours after a possible exposure.
Has Prep Been Shown To Be Effective
Several recent clinical trials have shown that taking Truvada as oral PrEP can help prevent acquisition of HIV. These studies were conducted among men who have sex with men and transgender women in the US and Latin America, and among heterosexual women and men in several African countries. In three studies, Truvada provided between 44 and 73 percent additional protection against getting HIV. However, two other studies in southern Africa did not find either oral or topical PrEP to be effective in preventing HIV transmission to women.
Using PrEP as a “bridge” until the partner living with HIV in a serodifferent heterosexual couple has an undetectable viral load proved highly effective in another African study. As of February 2015, this strategy had reduced the risk of acquiring HIV by 96%. Recent research has shown that people living with HIV whose viral load is undetectable do not transmit the virus to their sexual partners.
Current clinical trials of PrEP among women are focusing on topical PrEP in the form of vaginal rings or a gel.
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After I Begin Hiv Treatment How Long Does It Take For The Risk Of Sexually Transmitting Hiv To Become Effectively Zero
There is effectively no risk of sexual transmission of HIV when the partner living with HIV has achieved an undetectable viral load and then maintained it for at least six months. Most people living with HIV who start taking antiretroviral therapy daily as prescribed achieve an undetectable viral load within one to six months after beginning treatment.
A persons viral load is considered durably undetectable when all viral load test results are undetectable for at least six months after their first undetectable test result. This means that most people will need to be on treatment for 7 to 12 months to have a durably undetectable viral load. It is essential to take every pill every day to maintain durably undetectable status.
What Are The Other Possible Side Effects Of Truvada For Prep
Serious side effects of TRUVADA may also include:
- Kidneyproblems, including kidney failure. Your healthcare provider should do blood and urine tests to check your kidneys before and during treatment with TRUVADA. If you develop kidney problems, your healthcare provider may tell you to stop taking TRUVADA.
- Too much lactic acid in your blood , which is a serious but rare medical emergency that can lead to death. Tell your healthcare provider right away if you get these symptoms: weakness or being more tired than usual, unusual muscle pain, being short of breath or fast breathing, stomach pain with nausea and vomiting, cold or blue hands and feet, feel dizzy or lightheaded, or a fast or abnormal heartbeat.
- Severe liver problems, which in rare cases can lead to death. Tell your healthcare provider right away if you get these symptoms: skin or the white part of your eyes turns yellow, dark “tea-colored” urine, light-colored stools, loss of appetite for several days or longer, nausea, or stomach-area pain.
- Bone problems, including bone pain, softening, or thinning, which may lead to fractures. Your healthcare provider may do tests to check your bones.
Common side effects in people taking TRUVADA for PrEP are headache, stomach-area pain, and decreased weight. Tell your healthcare provider if you have any side effects that bother you or do not go away.
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I Have Had Anal Sex Without Using A Condom But Did Not Take My Two Prep
If you forgot to take your PrEP before sex and you have had unprotected anal sex with someone of whom you do not know the HIV status or who is HIV positive and not on treatment, it is advisable to have checked whether you need PEP . PEP stands for Post-Exposure Prophylaxis. PEP consists of three different HIV medications you have to take for four weeks. During office hours you can visit the GGD STI outpatient clinic for PEP, outside office hours you can visit a hospitals emergency department. By taking PrEP tablets only after anal sex without using a condom, you are not sufficiently protected against an HIV infection.
How Do I Get Truvada For Free
Gilead Sciences, the manufacturer of Truvada, offers two programs to reduce the cost of medications: Gilead Advancing Access and the Medication Assistance Program. Gilead Advancing Access: Patients covered by commercial insurance can apply for a coupon card. The card, if approved, covers a maximum of $7,200 in
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