What is HIV pre-exposure prophylaxis (PrEP)?
HIV Pre-exposure prophylaxis, or PrEP, is a new way for HIV- people to prevent acquiring HIV infection by taking a pill every day. At present, the only medication with an FDA-approved indication for PrEP is oral tenofovir-emtricitabine (TDF-FTC) which is available as a fixed-dose combination in a tablet called Truvada®.
How does PrEP work?
When someone is exposed to HIV through sex or injection drug use, PrEP works by keeping the virus from establishing a permanent infection. If taken as prescribed, PrEP is an effective prevention strategy for reducing sexual HIV acquisition risk by 90-99%. Among people who inject drugs, it reduces the risk by more than 70%. PrEP is much less effective if it is not taken consistently.
PrEP will not prevent the spread of sexually transmitted infections (STIs), such as Chlamydia, Gonorrhea and Syphilis. Therefore, PrEP is best utilized as part of a comprehensive prevention plan that includes PrEP adherence counseling, condom use, HIV & STI risk behavior counseling, and HIV & STI prevention education.
Who might benefit from PrEP?
PrEP is recommended for men who have sex with men (MSM), people who inject drugs (PWIDs), transgender men and women, and heterosexual adults who are at high risk for HIV infection. Everyone’s risk is different and the scenarios that might lead to being on PrEP may vary. Currently, PrEP is most commonly prescribed to persons with ongoing risk for HIV such as partners of persons who are living with HIV.
Is PrEP safe?
PrEP can cause side effects like nausea in some people, but these generally subside over time. No serious side effects have been observed, and these side effects aren’t life threatening. If you are taking PrEP, tell your health care provider about any side effects that are severe or do not go away. In people who are HIV-negative and have taken PrEP for up to 5 years, no significant health effects have been seen.
How do I start PrEP?
PrEP can only be prescribed by a health care provider, so talk to yours to find out if PrEP is the right HIV prevention strategy for you. You must take PrEP daily for it to work. Also, you must take an HIV test before beginning PrEP to be sure you don’t already have HIV. In addition, you can expect your provider to perform an HIV test every three months and will also screen you for other STIs every six months. Your provider will also check to make sure your kidneys are working every year while taking PrEP.
How long do I have to take PrEP before it becomes effective?
When taken every day, PrEP is safe and highly effective in preventing HIV infection. PrEP reaches maximum protection from HIV for receptive anal sex at about 7 days of daily use. For all other activities, including insertive anal sex, vaginal sex, and injection drug use, PrEP reaches maximum protection at about 20 days of daily use.
How do I pay for PrEP?
The cost of PrEP is covered by many health insurance plans, and a commercial medication assistance program from the manufacturer provides free PrEP to people with limited income and no insurance. Colorado also has special programs to assist individuals at risk for HIV to obtain PrEP medication. Some programs will also pay for the related medical services and costs.
Where Do I Find Out More or Get Help?
If you don’t have a medical provider or health insurance, need help talking to your provider about PrEP, or need assistance paying for medication or medical services, contact the Colorado Department of Public Health & Environment at the:
Colorado HIV & STD Information Line: (303) 692-2739 or visit them on the web at www.stdhivco.org.