PrEP An important tool in HIV prevention
Posted April 11, 2018 by Dr. Amy Hite - Infectious Diseases
In the United States, about one million people are living with HIV infection, but it’s estimated that 1 in 7 of those infected is not aware that that he or she is HIV positive.
These facts can lead to the spread of more infections with up to 40,000 new cases per year. Men who have sex with men and people of color are most affected. Safe sex with condoms is always recommended, but there are other methods of HIV prevention available to high-risk individuals. Pre-Exposure Prophylaxis, or PrEP, is where HIV-negative people take a medication to reduce their risk of getting HIV. Currently the only FDA-approved medication for PrEP is Truvada, which is taken once daily for prevention. Following are some key points about PrEP.
- PrEP is very effective. Many studies have been done on PrEP in different countries on men, women, gay, straight, transgender and bisexual persons. When taken correctly, which is very important, Truvada reduced HIV risk by at least 90 percent and in some cases up to 99percent. PrEP was also shown to reduce risk significantly in injection drug users who may be at risk for HIV. In addition, studies show PrEP to be safe with very few side effects and no major adverse events. PrEP needs to be taken for about 1-3 weeks before becoming fully effective.
- PrEP is indicated for those who want to reduce HIV risk. Those most at risk where PrEP may be used include those who have an HIV-positive sex partner, men who have sex with men, heterosexual women of color, those who do not regularly use condoms, injection drug users or people who have other sexually transmitted diseases. PrEP can also be used in pregnancy counseling of HIV discordant couples.
- Testing is needed when on PrEP. When on Truvada, close monitoring needs done. This is to monitor for HIV infection, other STDs and tests for kidney function. Testing must be done every three months. Ongoing condom use is encouraged and important as Truvada does NOT prevent other STDs. It is extremely important to know if one becomes HIV-positive while taking PrEP, although this is unlikely to happen. If someone becomes HIV-positive while on PrEP, they need to stop PrEP and enter HIV care as soon as possible. This is to avoid HIV drug resistance occurring while on PrEP, although this occurrence is very rare. Doctor visits on PrEP usually occur every 3-6 months.
- PrEP is easy to access. While some doctors have limited information about PrEP, there are providers who have knowledge about PrEP and prescribe Truvada. Some PrEP providers are HIV or Infectious Disease Specialists, but many primary care providers are comfortable prescribing PrEP. While PrEP can be expensive, most insurance plans cover Truvada for PrEP, including Medicaid plans. There are also co-pay assistance and patient assistance programs for those in need. A listing of PrEP providers in Ohio may be found at www.ohioprep.org. This site also has information on payment assistance.
If you feel you may be at risk for HIV infection, please discuss this with your healthcare provider. Some patients may feel uncomfortable talking about their sexual health, but open and honest communication is extremely important. Asking questions about your risk and how to reduce it should be a normal part of your healthcare visits. Remember YOU are your most important health advocate!
The CARE Center is located at the Summa Health System – Akron Campus, 75 Arch Street, Suite 104, and has many PrEP providers. Physicians are available for appointments to discuss HIV prevention including PrEP.
For those interested in more information or scheduling an appointment for PrEP, call the CARE Center at 330.375.4851. Please visit www.ohioprep.org for additional information.