What is PrEP?
PrEP (Pre-Exposure Prophylaxis) is a combination of two HIV drugs (tenofovir and emtricitabine) sold under the brand name Truvada. PrEP is a daily pill for high-risk, HIV-negative individuals that reduces their chances for getting HIV infection.
- Pre-Exposure = before or prior to coming into contact with HIV
- Prophylaxis = treatment that prevents HIV infection from happening.
Wait…isn’t PrEP for gay men?
Most PrEP ads are geared toward gay and bisexual men. However, multiple studies have shown that PrEP helps to reduce HIV risk in gay, bisexual, and other men who have sex with men, transgender women, heterosexual men and women, and people who inject drugs.
How does PrEP work?
Typically, when HIV invades the body, the virus hijacks the immune system’s CD4 T-cells and injects the cells with its genetic material. Once inside the cells, the virus’ genetic material combines with the cell’s DNA and reprograms the cell to make more copies of HIV. The infected cells rapidly make thousands of copies of the virus. These new copies of HIV burst out of the cell, enter the bloodstream, and infect other CD4 T-cells. This process continues until the immune system is completely destroyed.
PrEP, on the other hand, works by preventing HIV from multiplying within CD4 T-cells; thus, giving the body an opportunity to rid itself of the infected cells.
How effective is PrEP?
When taken daily, PrEP has been shown to reduce the risk of sexually transmitted HIV by more than 90%. The pill reduces the risk of HIV infection among people who inject drugs by more than 70%. When combined with condoms, the risk of getting HIV from sex is even lower. Remember, PrEP is only effective if it is taken consistently and correctly.
Should everyone take PrEP?
No, PrEP is NOT for everyone. The Centers for Disease Control and Prevention recommends PrEP for:
- Anyone in a sexual relationship with a known HIV-positive partner;
- Gay and bisexual men who (1) have condomless anal sex or (2) have been recently diagnosed with a sexually transmitted infection (STI);
- Anyone who (1) injects drugs and share needles or other injection equipment or (2) has been in a treatment program for injection drug use.
Condoms will suffice for everyone else.
So how much does PrEP cost?
Many private insurance plans cover most of the costs associated with PrEP treatment, with the expectation that patients pay the required co-pays and deductibles outlined in their policy. Medicaid should also provide coverage for PrEP, but, some states may require your doctor to get pre-approval for the drug before filling your prescription. Be sure to check with your insurer to learn what drugs and services are covered under your plan.
For those without prescription drug coverage, PrEP can be expensive. A year of PrEP treatment can exceed $13,000. BUT, all is not lost. Gilead, the manufacturer of Truvada, offers a Medication Assistance Program for PrEP and a Co-Payment Assistance Program for eligible individuals. The Patient Advocate Foundation also provides relief to qualified individuals needing help with PrEP related costs.
Ok, I’m convinced! Where can I get PrEP?
A prescription is required to get PrEP. Any healthcare provider licensed to prescribe medication may prescribe PrEP. If you don’t have have a primary care doctor or your healthcare provider doesn’t feel comfortable prescribing PrEP, there may be organizations in your area that assist people with getting PrEP. Click here to find a PrEP-friendly provider near you!
Once I start PrEP, can I ditch condoms?
It is recommended to use condoms every time you have sex even if you are taking PrEP. Condoms further decrease your risk for getting HIV and protect you from other STIs, such as chlamydia, gonorrhea, and syphilis. They also prevent unintended pregnancies.
In reality, not everyone chooses to use condoms. The decision to use condoms is at the sole discretion of you and your partner(s). In some instances, condom use is not a viable choice due to situations such as sex trafficking or domestic violence. In these situations, PrEP provides a self-controlled form of HIV prevention for those who can not negotiate condom use.
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