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.
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
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.
Who Can Use Prep
PrEP isnt right for everybody. PrEP is for people who dont have HIV, and are at higher risk for getting HIV. You may want to talk with a doctor or nurse about PrEP if you:
Dont regularly use condoms.
Have a sexual partner who has HIV .
Have a sexual partner who is at high risk for getting HIV .
Have anal or vaginal sex with many partners, especially if you dont use condoms regularly.
Recently had another STD .
Do sex work that includes vaginal or anal sex.
Have injected drugs, shared needles, or been in treatment for drug use in the past 6 months.
If youre at high risk for HIV and youre pregnant, trying to get pregnant, or breastfeeding, PrEP may also help you and your baby avoid getting HIV.
Your doctor or nurse will talk with you about your situation to figure out if PrEP is right for you. Its important to be honest so you can get the best health care for you doctors and nurses are there to help, not judge. The more accurate information they have, the better they can help you.
PrEP isnt the same thing as PEP . PEP is a short-term treatment for people whove already been exposed to HIV within the past 72 hours. PrEP is an ongoing daily pill for people who may be exposed to HIV in the future.
What Is The Most Important Information I Should Know About Truvada For Prep
Before and while taking TRUVADA for PrEP:
- You must be HIV negative before you start and while taking TRUVADA for PrEP. Do not take TRUVADA to reduce the risk of getting HIV-1 unless you are confirmed to be HIV negative.
- Get tested for HIV-1 immediately before and at least every 3 months while taking TRUVADA.
- If you think you were exposed to HIV-1, tell your healthcare provider right away. They may do more tests to confirm that you are still HIV negative.
TRUVADA can cause serious side effects:
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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.
What Will Being Undetectable Mean For Me
Having an undetectable viral load means that your ART is effectively controlling your HIV. This will protect your immune system and help you to stay in good health.
Being undetectable also means that you dont have to worry about passing HIV onto your sexual partners. For many people this is just as important to them, giving them relief from the anxiety of passing HIV on. Some people find that knowing theyre undetectable makes it easier to with others, as it can be reassuring for others to know that your health is protected and you cant pass it on too.
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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.
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.
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Why Are Some Research Findings Unclear
For any drug or other HIV prevention tool to work, it must be used and used correctly and consistently. This is true for condoms and is proving true for PrEP as well. In the studies mentioned above, the key to PrEP’s success was adherence, which means taking the drug when and how it is prescribed. In all studies, people who took the drug daily as prescribed were significantly less likely to acquire HIV when exposed to the virus during sex or injection drug use.
We do not yet fully understand the reasons why people especially women do not take oral PrEP consistently as prescribed. This makes more research into issues that might affect women’s interest in or ability to take a drug for HIV prevention very important. To answer these questions, women need to take part in future studies about PrEP. For more information about understanding, finding, and participating in research studies, see our fact sheet on clinical trials.
Am I Protected Against Hiv If I Take Prep Tablets Directly After Having Anal Sex Without Using A Condom
If you only take PrEP tablets after sex, you are not sufficiently protected against HIV. When using PrEP, it is necessary to take two tablets before having unprotected sex, followed by one tablet daily until 48 hours after the last time episode of unprotected sex . If you have not taken 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.
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Availability And Pricing In The United States
Within the United States, Truvada and Descovy are brand name products of Gilead Sciences that cost around $2200/month at wholesale price. In other countries around the world, generic Truvada is available for a much lower price. Expected fall of 2020, Teva Pharmaceuticals will begin producing a generic version of Truvada within the United States however, it has been reported that the details surrounding the rights to the patent are unclear, which makes it difficult to predict if this will increase access to the medications. In the meantime, there are several assistance programs at the local, state, and national level for gaining access to PrEP at reduced costs. Gilead has an “advancing access” co-pay coupon program that can be accessed by individuals and providers alike to help cover some of the monthly costs of these medications. It is recommended to discuss other available options with a community pharmacist or physician.
In December 2019, the U.S. announced the Ready, Set, PrEP program to provide free PrEP to the uninsured through major drugstore chains. The Ready, Set, PrEP program is led by the U.S. Department of Health and Human Services and allows qualifying individuals to fill their prescription for PrEP medication free of cost at their choice of participating pharmacies or through the mail.
Whilst You Are On Prep
Whilst you are taking PrEP you should have regular HIV, STI and urine tests every three months. Once a year at least, you should have a blood test to check your kidney function.
If you get ill with fevers and /or if you have missed some pills and had sex, you will need to come in sooner and have an HIV test in case you have seroconverted . It is important to identify this early so we can get you on the right medication and test any contacts you could have caught the infection from.
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Who’s Suitable For Prep
HIV negative men who have sex with men / trans who have had condomless anal sex in the last three months and are likely to continue to do so.
HIV negative people who are having sex with a partner who is HIV positive and whose virus is not undetectable .
Other people with risks may be individually suitable but this needs to be decided by a doctor specialised in the use of these medicines and who is able to determine the risks of the activities undertaken by that person.
How Will My Patients Pay For Prep Medication Clinical Visits And Lab Tests
Most insurance plans and state Medicaid programs cover PrEP. Prior authorization may be required.
Patient assistance program: There are medication assistance programs that provide free PrEP medications to people with no insurance to cover PrEP care. To learn more, call 855-447-8410 or visit www.getyourprep.comexternal icon
Co-pay assistance program: Income is not a factor in eligibility. More information is available at: Some states have their own PrEP assistance programs. Some cover medication, some cover clinical visit and lab costs, some cover both. To learn more visit:
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Can I Take Pep Every Time I Have Unprotected Sex
PEP is only for emergency situations. It is not the right choice for people who may be exposed to HIV frequently – for example, if you often have sex without a condom with a partner who is HIV-positive. In that case, you should talk to your health care provider about whether PrEP would be right for you.
Where To Get Prep
PrEP is now available free on the NHS in England from sexual health clinics.
Initially, PrEP was made available to 10,000 people in England as part of the IMPACT trial, which ended in July 2020.
In Scotland, PrEP is available through sexual health clinics. Visit the PrEPScot website to find out more information about how to access it.
In Wales, PrEP is available through sexual health clinics. For more information, see the Public Health Wales website.
All GUM clinics in Northern Ireland will be offering initial consultation and assessment appointments for a pilot trial, based at a centralised service in Belfast. This project will run for 2 years. There is currently no cap on numbers.
Taking PrEP has enabled me to trust again, have relationships and build bridges.
In clinical trials PrEP has been used in two different ways:
- taken regularly .
- only taken when needed .
This second method is often called on-demand or event based dosing.
Both methods have been shown to be very effective, although on-demand dosing has only been studied in gay and bisexual men.
Daily dosing is recommended for women who need to take PrEP every day for seven days to be protected against HIV.
Daily PrEP is recommended for all trans people using hormone treatment as there isnt sufficient data to support other dosing options.
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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 Much Does Prep Cost
Most health insurance plans, including Medicaid, cover PrEP. Check with your insurance company to see if PrEP is covered on your plan. You might also be able to get help with other expenses, like copays, coinsurance, and deductibles, though Gilead or patient advocacy groups like the Patient Advocate Foundation.
If you dont have health insurance, you can still get help paying for PrEP. Gilead has a medication assistance program that could make PrEP free for you, depending on your income. Your doctor or nurse will need to submit an application for you to find out if you qualify.
The staff at your local Planned Parenthood health center can also help you apply for health insurance or assistance programs that can make PrEP affordable for you.
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