What once used to be a death sentence, is no longer. According to the 2020 Global HIV & AIDS fact sheet by UNAIDS, new HIV infections have reduced by 40% since the peak in 1998. Since the mid 1990s, advancements in treatment for people living with HIV have resulted in huge strides in the sexual health of key populations. Although antiretroviral medications (ART) can't cure HIV, when taken daily and safely on-demand, these medications help people with HIV live longer, healthier lives.
In combination with ART, the more recent introduction of PrEP (pre-exposure prophylaxis) is a type of medication taking a highly effective preventative approach to HIV. This innovation gives HIV-negative folks a method to reduce the risk of acquiring HIV if they are exposed to the virus. However, PrEP being a relatively new drug on the market since 2012, along with the stigma of HIV and vulnerable communities, there is still a lot of misinformation circulating. To slice through the uncertainty, I'm sharing some facts and common misconceptions about PrEP.
What is PrEP?
PrEP (pre-exposure prophylaxis) is a preventative pill taken once a day that protects an HIV-negative person from acquiring the HIV infection. There are currently two approved drugs for HIV prevention on the market, Truvada and Descovy.
How does PrEP work?
Since HIV normally takes a few days after exposure to establish itself in the human body, PrEP medication halts the virus from spreading. According to clinical studies by iPrEx, when PrEP is taken daily, it is up to 99% effective in people who are at risk of getting HIV.
PrEP can also be taken on-demand*, which is particularly helpful for those seeking an intermittent regimen rather than daily. On-demand PrEP is also known as event-based PrEP or PrEP 2-1-1. It involves taking two tablets 2 to 24 hours before engaging in sex, taking a single tablet 24 hours after the first two, and another tablet 24 hours after that. A 2015 study by French IPERGAY found that On-demand PrEP using daily Truvada was shown to be highly effective for gay and bisexual men.
*This method has been endorsed by the WHO, the British HIV Association, the European AIDS Clinical Society and the International AIDS Society-USA but has not been approved by the FDA or recommended by the US Centers for Disease Prevention and Control.
Should I take PrEP?
Normally, PrEP is recommended for HIV-negative folks that are considered to be part of a key population who are particularly vulnerable to HIV.
This includes an HIV-negative person who:
Is sexually active with an HIV-positive partner
Has anal or vaginal sex with partners who have been diagnosed with an STI (sexually transmitted infection) within the past six months
Does not use protective barriers such as condoms and have one or more sexual partners whose HIV status is unknown
Shares needles and syringes to inject drugs
Even if you aren’t considered part of the key population at higher risk for HIV, considering PrEP as a preventative measure is a personal choice. Always discuss with a trusted healthcare provider the options available to you to best look out for your sexual health.
Is PrEP Safe?
PrEP has not only been found to be highly effective, but safe. Many new users of PrEP report little to no side effects, but symptoms such as headache, abdominal pain, and weight loss can occur. These mild side effects typically aren’t long lasting and often are only experienced the first month of taking PrEP.
Is PrEP Safe for Transgender folks?
A study in the journal of Clinical Infectious Diseases found that transgender men and transgender women taking gender-affirming hormones can take PrEP with confidence and without fear of interference in hormone therapy. PrEP was found to be just as effective for those on hormone therapy than those who are not.