Quick Facts About PrEP

- PrEP is a single pill called Truvada taken once daily to prevent HIV infection in people who are at high risk for it.

- PrEP is used along with other prevention methods, such as condoms.

- PrEP must be prescribed by a health care provider.

- Since PrEP was recently approved by the FDA, some providers may not know about it or may not be knowledgeable.

-Some physicians may not want to prescribe PrEP.  You have the right to find a physician that will meet your needs.  

- Taking PrEP includes getting routine blood tests.

- You may have side effects from taking PrEP.

- When taken as prescribed and with other prevention options, PrEP is highly effective at blocking HIV infection.

-PrEP is available in Birmingham and most insurance plans help cover the cost.  Some may also qualify for prescription copay cards from Gilead.

 

Where can I get PrEP in Birmingham?

This new option for HIV prevention is available at the Magic City Wellnes Center.  Contact MCWC at 205.877.8677 or by email at info@mcwc-bao.org.

 

What is PrEP?

PrEP means Pre-Exposure Prophylasix, and it's the use of anti-HIV medication that keeps HIV negative people from becoming infected.  PrEP is approved by the FDA and shown to be safe and effective as a single pill taken once daily.  It is highly effective against HIV when taken every day.  The medication interferes with HIV's ability to copy itself in your body after you've been exposed.  This prevents it from establishing an infection and making you sick.

 

Even though PrEP has been around in the U.S. for over a year, few health care providers know about it.  And, even fewer people feel like they know enough about it to make an informed decision about whether or not to use it.  For those who do use it, the information they have might be more focused on practical issues, like where to get it, rather than on what PrEP does in the body to prevent HIV infection.

 

By using animation, in the video above, to show PrEP in the body and why "once a day" is recommended, people can see what PrEP does and people who currently use PrEP can create an image of what happens when they take a PrEP pill every day.

 

Three clinical studies show that HIV negative people who take Truvada for PrEP everyday, and who combine it with condoms (and other HIV prevention methods) - may see their risk for HIV cut by up to 92%.  This is true in both women and men and for both vaginal and anal sex.  Based on these studies, the US Food and Drug Administration (FDA) approved Truvada for PrEP in July 2012 for adults at high risk for sexual transmission of HIV.  PrEP is not just about taking a pill every day.  If you decide to take PrEP, you'll need to see your provider at least every three months for routine care and testing.  You'll need to talk about your current sexual activity, your level of risk, sexually transmitted diseases (STD's), your routine test results and any side effects.  This means more doctor visits, refills, co-pays, and extra attention to your HIV prevention plan.

 

Is PrEP right for me?

If you're HIV negative and are trying to stay that way, then PrEP may be right for you.  Here are some questions to consider.  If you answer "yes" to any of them, then PrEP might be a good thing to discuss with your provider.

 

- Is your main sexual partner HIV - positive?  In other words, are you part of a mixed-status couple?

- Has a man, especially an HIV positive man or a man whose status you're not sure about, penetrated you during anal sex ("topped" you)    

  without a condom recently?

- Have you been treated recently for an STD in your butt, such as rectal gonorrhea?

- Do you use alcohol and/or drugs heavily; or does your sex partner(s)?

- Do you exchange sex for money, housing, drugs, alcohol, or other needs; or, does your sex partner(s)?

- Has your partner ever threatened or forced you to have sex against your will?

 

What is Truvada and how does it work?

Truvada is a pill made up of two HIV meds - Viread and Emtriva.  It is commonly used together with other pills to treat HIV infection in HIV positive people.  Viread is also used to treat hepatitis B.  Truvada prevents HIV from reproducing in the body.  If you are exposed to the semen, pre-cum, vaginal fluids, or blood from an HIV - positive person, then Truvada can help to keep the virus from causing an infection.

 

What are Truvada's side effects?

Most people who take Truvada don't experience side effects.  In fact, some people have remarked that they wonder if the pill is working at all because they haven't felt side effects.  You can trust the drugs are there doing their job even if you don't feel them.

 

With that said, the short-term side effects noted in PrEP studies included headaches, weight loss and stomach problems like nausea, diarrhea and stomach ache.  These occurred in about 1 out of 10 people, and most subsided after the first few weeks of taking Truvada.

 

A few people have had minior problems with kidney health, which got better when Truvada was stopped.  Minor bone loss also occurred.  As for its long-term side effects, we don't yet know about them since these PrEP studies only followed HIV - negative people for less than two years.  However, in HIV - positive people, over time Truvada can cause bone loss and can damage the kidneys in a very small number of people who take it.  Because HIV by itself can also cause this, it's difficult to know whether Truvada on its own causes kidney and bone disease.  However, people with current kidney disease should not use PrEP.  Those who use PrEP should have their kidney health checked regularly.  One "side effect" that's often not mentioned is that some people end up feeling less anxious about HIV.  They have more time to organize their thoughts, which can eventually lead them to making better sexual choices.  You may find the PrEP gives you the mental and emotional space to becoming more proactive around your sexual health.

 

How much will it cost?

Since the prescription is approved by the FDA, it can be covered by health insurance if you have it.  It should also be available through government insurance programs like Medicaid.  Because PrEP is an entirely new HIV prevention strategy, not all insurers have yet decided to cover it.  Some may choose not to pay for it.

 

For people whose insurance covers PrEP, the major cost should only be the drug co-pay charged at the pharmacy and co-pays for medical visits and lab tests.  It's worth asking your health provider to contact Gilead Sciences, who makes Truvada, as they offer co-pay cards which help cover all or some of the drug's co-pay costs.  To access that program, visit Truvada online.

 

What Not to do while taking Truvada as PrEP:

- Do Not occasionally take your PrEP pill.  No study has shown that taking Truvada every now and then works at preventing HIV.  Doing so    

  could cause the drug level in your bloodstream to be too low to prevent infection.  It could actually increase your risk of having resistant HIV. 

  One study is looking at how effective less than daily dosing of Truvada might be, but results aren't expected until 2015.  In the meantime, it's

  important to use PrEP daily.

- Although other HIV drugs are currently being studied, no other HIV pill besides Truvada and Viread has been shown to prevent HIV infection. 

  Therefore, you should not use any other HIV pill in place of Truvada.

- Taking PrEP can be a major change in your life and can affect your sexual and other close relationship(s).  Consider talking about PrEP (and

  other prevention methods) to your partner(s) to continue to promote open dialogue about the choices you make