PrEP 101

 

What is PrEP?

PrEP stands for pre-exposure prophylaxis. It is a preventive medication for HIV (human immunodeficiency virus). The drug is taken by those at high risk of HIV exposure but have not yet contracted the virus. Currently, the only FDA approved PrEP drug is Truvada.

 

How does it work?

Truvada is an oral pill that is taken daily. Much like a birth control pill, it’s important that it’s taken around the same time every day. By having the drug constantly in your bloodstream, it prevents the virus from entering and manifesting in your body’s cells. When taken properly, Truvada is shown to be 92-99% effective in preventing HIV. PrEP is meant to work in tandem with other preventive measures, such as using condoms. It’s important to remember that Truvada only protects you against HIV and not against other STIs.

 

Who is it for?

Truvada is for people at high risk for contracting HIV. The Center for Disease Control considers the following groups at high risk for contraction:

  • Men who have sex with men who do not regularly use condoms*
  • People who inject drugs (such as heroin, meth, or other drugs administered in through an IV method)
  • Any individual with an ongoing sexual relationship with a partner who is known to be HIV positive
  • Any individual who regularly has unprotected sex with people of unknown HIV status that may fall into one of the above high risk groups

 

*A large portion of HIV research does not account for the advances in how we understand and refer to identity; thereby, in the eyes of the CDC, transgender women are included in this group

 

Why do we need PrEP?

HIV is still a major problem in the U.S. and around the world. Although the medical community has now developed effective HIV treatment methods, preventive measures are key in ending the global HIV/AIDS epidemic. While other preventive measures — such as using condoms — are effective in some situations, it’s important to continue to increase preventive options in order to maximize effectiveness and create accessible options that can protect everyone.

 

Won’t PrEP encourage people to stop using condoms?

PrEP is a single tool used to prevent HIV, and the medication is meant to be added to a combination of preventative measures, such as condoms. You should still wear a condom while on PrEP, as the medication does not protect against any other STIs. 

 

Where can I find Truvada?

You need a prescription to obtain Truvada. You can talk to your primary healthcare provider if you think that you would benefit from taking PrEP. If you don’t have a primary healthcare provider or are not sure where to go, you can check https://www.pleaseprepme.org, which is a database that can help you find the nearest provider.

 

How do I begin taking Truvada?

You will need to be tested for HIV immediately prior to beginning Truvada, as you must have a negative status to start the medication. You will also be required to come back to your PrEP provider every 3 months for routine HIV and STI testing to ensure that you remain HIV negative while taking Truvada. This is an important part of preventative care, as continuing to take Truvada while unknowingly HIV positive can increase your likelihood of developing drug resistance and other complications.

 

What is the cost of Truvada?

Without insurance or help with payment, Truvada is about $1,300 per month out of pocket. Most major insurance plans cover a large part of the cost, including Medicaid and Medicare. If the remaining cost is too high or you don’t have health insurance, there are alternative ways to make PrEP affordable.

The Gilead Advancing Access program, created by the pharmaceutical company Gilead Sciences that developed Truvada, offers resources for financial help to lower the costs of Truvada. You can check their website to see how this may be helpful for you at https://www.gileadadvancingaccess.com.

 

Who currently uses Truvada?

According to an analysis done by Gilead sciences, about 50,000 Americans have filled a prescription for Truvada. Of a survey completed by 21,463 people using Truvada (roughly half of the prescribed population), 74% of the users were white, 12% Latino, and 10% black. Additionally, only 6.7% were under the age of 25.

This is seemingly backwards, as young Black and Latino men who have sex with men and transgender women of color are among the most at risk communities for contracting HIV.

 

Does everyone have access to Truvada?

Instead of reflecting realistic medical needs, the above numbers expose a large gap in access to vital care. Although Truvada is technically available to everyone, there are significant barriers standing in the way of certain groups. Such as…

  • The cost of the drug
  • Financial access to doctor’s appointments, lab results, etc.
  • Geographic access to a provider
  • Citizenship status affecting access to healthcare
  • Social stigma surrounding HIV, which may prevent individuals from identifying themselves as someone intentionally at high risk of contraction

Additionally, there is a large lack of knowledge about PrEP within certain healthcare settings. Doctors who know little about PrEP may be reluctant to discuss or prescribe Truvada. And to this day, there is great stigma tied to all things HIV-related that manifests in even more barriers.

It’s important that we work towards destroying these stigmas and barriers so that everyone can benefit from this lifesaving drug.

 

For more information on PrEP, talk to a healthcare professional and/or research the preventive drug here.Â