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There’s an HIV prevention medication with a success rate of over 90 percent. Still, very few people actually know about pre-exposure prophylaxis, or PrEP. We’ll talk with experts about what exactly this pill does, who uses it, and what’s in store for it’s future.
- Dr. Anthony Fauci Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health
- Matthew Rose Policy Associate, National Minority AIDS Council.
- Ben Ryan Reporter, POZ Magazine.
- Evan J. Peterson Author, "The PrEP Diaries: A Safe(r) Sex Memoir."
More Answers On PrEP
We invited Matthew Rose, one our guests, to answer some of the most frequently asked questions we received, as well as some of the ones we weren’t able to get to during the live show. Matthew is a policy associate for the National Minority AIDS Council, an organization dedicated to ending the high rates of HIV infection among people of color. Here, he answers questions you submitted via Facebook, email, Twitter, and the comments section of this site.
Who should take PrEP?
Individuals who believe they are in need of an additional prevention option, individuals that are not consistent in their condom use, those who feel like their lives might have greater exposure to HIV, individuals for whom HIV is one of their only worries about sex, anyone who feels like it could be a proactive step for them in taking control of their health.
Is Truvada the only brand of medication that can be used for PrEP?
Truvada is the only licensed drug in the US currently for PrEP, however this could change as new products are currently being explored and evaluated. This could change in the future but for now this is only one.
Can women use PrEP? Does it interfere with birth control?
Women can use PrEP, though the current recommendation is to be on the regimen 21 days before engaging in vaginal sex. For anal intercourse, one only needs only to wait 7 days to reach peak protective levels. There are not any known negative interactions between PrEP and hormonal birth control.
Can this regimen keep women from spreading HIV to their babies?
Yes. HIV positive people can have babies; there are just a couple considerations to take into account. If the mother is HIV positive, we would want her on a triple drug therapy – Truvada is only two, which wouldn’t be enough. The triple drug therapy would prevent the transmission of HIV to her child, and she would also need to refrain from breastfeeding. If the couple is of different HIV statuses, PrEP can help the individuals have a child without risk of transmission. Here is more detailed information on pregnancy and HIV.
Are there any serious side effects to the regimen?
There are no serious side effects to the taking PrEP. We have over a decade of data on individuals taking this medication for treatment, and about six years of data on people taking the medication for prevention. One of the reasons this medication was selected for PrEP is because of the low leave of side effects. Usually what we see from those taking the medication are short-term side effects, including nausea, abdominal cramping, vomiting, dizziness, headache, and fatigue. These usually dissipate in a matter of weeks for most people. There are also be some kidney issues in a small percentage of those who take it, which is why people taking the medication have their kidneys checked regularly. Finally, there can be a small bit of bone loss which hasn’t led to any major bone issues.
What does Truvada cost? With insurance? Without insurance?
So this is a challenging question, mainly because the price for the drug is around $13,000 before insurance. Thus far we’ve seen that most insurance providers cover at least part of the drug’s cost, since it is generally cheaper to pay for prevention than the possibility of paying for treatment. The cost for the co-pay can vary based on one’s insurance plan. Gilead offers payment assistance for those who don’t have insurance, or who have unaffordable co-pay. However, there are other expenses to consider such as provider office visits and lab work.
I’m HIV negative and not on PrEP; my partner is HIV negative and on PrEP. If he has sex with someone HIV positive, can I contract it from him?
If one’s partner is constant in their PrEP use you would be fine and protected. Since the person on PrEP would not be able get the virus there would be nothing to transmit to you. Furthermore, if the positive partner is virally suppressed, their chances of transferring the virus are almost impossible.
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