I wanted to write a blog about PrEP because I am doing extensive information gathering on all things HIV so I can put together a slide show and do a 30 minute presentation for (forgive me momma, I forgot the official name haha) Board of American Medical Transcriptionists, of which my mother is Treasurer, because she’s awesome like that.
So now the pressure is on to learn more than I already know so I can talk for half an hour, which is kind of a lot! However, I am determined to get enough information for it and then I’d like to contact local high schools and ask to present to their health classes.
Now on to the topic for this blog 🙂
PrEP had been a pretty controversial issue among the gay community especially. Of course, it’s not only meant for gay men, it’s meant for ANYONE who is at risk for contracting HIV. So let’s start out with some FACTS then I’ll get to my 2 cents 😉
PrEP stands for Pre-Exposure Prophylaxis. The drug they use as PrEP is called Truvada which contains two medicines: tenofovir and emtricitabine. Try to say those five times fast.
PrEP is supposed to be taken one time a day, every day. If taken as prescribed (daily), the medicine in your bloodstream can OFTEN (not 100% of the time) stop HIV from taking hold and spreading. If it is not taken daily, there may not be enough medicine in the bloodstream to block the virus.
Although it does not prevent HIV 100% of the time, it lowers risk of contraction by 92%.
A person who uses PrEP must be able to take the pill every single day and get a check up every 3 months for HIV testing, refills, and a general follow up with their physician.
Common side effects of Truvada reported by patients were mild nausea, loss of appetite, and some with a mild headache. Generally, these went away after the first month. Of course, if your side effects are severe, let your doctor know and go from there.
Who is PrEP for? The CDC recommends PrEP to people who are HIV-negative and at substantial risk of HIV infection. This includes:
Having an ongoing relationship with an HIV-positive person.
Not mutually monogamous with an HIV-negative partner.
If you are gay or bisexual and not mutually monogamous with an HIV-negative partner and have had unprotected anal sex or been diagnosed with an STD in the past 6 months.
If you are a heterosexual man or woman who does not regularly use condoms during sex with partners of unknown HIV status who are at risk of HIV infection (people who inject drugs or have bisexual male partners).
If you have injected illicit drugs in the past 6 months and who have shared equipment or been in drug treatment for injection drug use in the past 6 months.
For heterosexual couples who are serodiscordant (one HIV-positive and one negative), PrEP is one of several options to protect the negative partner during conception and pregnancy.
Phew that’s a long list of people. Not many people realize how many different kinds of people would benefit from taking PrEP. A couple more things before I start my rant. How to start PrEP!
This can be tricky for some people. If you have a good relationship with your doctor, speak with them first. Even if you don’t have that great of a relationship, try it out. Chances are they will hear you out and evaluate you for risk. If they don’t want to help you out for whatever reason, find the closest HIV clinic. There will be a doctor there who will help you.
Once they agree that you would benefit from PrEP, you’re going to have to go through some poking and prodding. A general physical, STD and HIV testing for sure, and liver and kidney function testing.
Now not many people are aware but HIV drugs, including PrEP, are pretty rough on the kidneys and liver. The doctor is going to want to make sure you’ve got healthy insides before they start you on treatment.
Insurance can be an issue for some people, but they do have medication assistance programs that may be able to help you cover the cost of the meds. Just ask for help. Look for your local AIDS foundation and speak with someone there, they’ll be able to point you in the right direction.
Now let’s talk efficacy. Truvada is not going to be at its 100% protection level after your first pill. These things take time to get into your system and build up. Unfortunately, there aren’t any exact numbers, but there are a few studies that suggest that rectal tissue is protected after 7 days, vaginal after 20 days, and maximum protection is also 20 days.
That’s assuming you take the pill daily like a good patient. Intermittent treatment is NOT recommended nor is it nearly as effective. If you’re going to do this mode of protection, you’ve got to be responsible and take it as directed. Of course we’re all human, I myself have missed 2 whole doses over the last 2 years. Just do your very best not to.
Alright the first part of this is going to be what the CDC says and then I’m going to sprinkle my thoughts in there…
PrEP and condoms. The big question. According to the CDC you should always use condoms along with PrEP. PrEP offers a lot of protection from HIV, but not 100%. Condoms offer protection from HIV and other STDs, but again, not 100%. Although PrEP may offer increased protection from HIV, it does not protect against gonorrhea, chlamydia, and hepatitis. Only condoms offer a level of protection against those.
Alright opinion time. How many people are taking PrEP so they feel like they don’t have to use condoms? Probably A LOT. Let’s be real, I don’t think there is a single person on the planet who prefers condoms to condomless sex. That being said, it’s time we put those lovely brains we were given to use. It’s easy to use poor judgment in the heat of the moment, but do your best people. If you’re having sex with your partner, especially if you are monogamous, you can probably ditch the condom. If you’re going home with someone you met at the club, you’re going to be much happier the next morning when you remember you used a condom instead of finding out in a few days that you have a sticky, painful, sore-ridden genital area.
PrEP, in my opinion, is a really great addition to ways we can protect ourselves and other from the spread of HIV. No matter what your circumstances are, no matter what sexuality or gender you identify with, if you think you’re at risk for contracting HIV please, please, PLEASE speak with someone about PrEP. Trust me, speaking to someone about how to protect yourself is a much easier conversation than speaking to a doctor about treatment options for HIV.
Parents, talk to your kids. Sex should never be an issue your children can’t speak with you about. Knowledge is power, give your children the power to make smart decisions. Don’t wait until they are 18, or even 16. Statistically speaking, young people from ages 13-24 make up 26% of new infections every year; 72% of them being gay males. The younger they are when you speak with them about sex, the more comfortable they will be with speaking about “taboo” subjects like sex with their friends and with you as they get older. I would rather have a child who educates his or her peers than one who is being misinformed from their peers.
I hope this was helpful to one person who needed to learn about it 🙂
If you have any questions or comments, please leave one! Also, if you have any other questions regarding HIV ask me! I’d like to make sure I put it in my presentation 🙂
Sending love and compassion,
Vegan Dan 🙂
HIVegan 