HIV Prevention - Ochsner Doctor's Note with Dodd Denton, MD
What is HIV PrEP?
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What is HIV PrEP?
PrEP stands for “pre-exposure prophylaxis.” It’s a once-a-day pill that prevents infection from the human immunodeficiency virus (HIV) that is transmitted in semen, vaginal fluids, blood, and breast milk.
Truvada is a pill that is used for HIV PrEP. It can block HIV from infecting a person who has been exposed. In clinical studies, when taken daily, Truvada reduced the risk of HIV by 92% or more in people at high risk for infection. This was seen for all genders. It provided protection for risky anal or vaginal sex and for injection drug use. It is so effective that the US Food and Drug Administration (FDA) approved Truvada in 2012 for the prevention of HIV.
For PrEP to work effectively, it must be taken every day, not just once before a risky situation. This is because to be protected, there needs to be a certain amount of the medicine in your body to stop HIV from causing a lifelong infection. PrEP will NOT protect against other sexually transmitted infections (STIs) including chlamydia, gonorrhea, syphilis and herpes. For this reason, condoms are still recommended.
What is HIV?
How do I get on PrEP?
Ochsner offers confidential and professional PrEP services at many of our clinics. The first step is to call our HIV PrEP Appointment Scheduling Hotline at 1-855-241-9347.
HIV can lead to the disease known as AIDS (Acquired Immunodeficiency Syndrome). AIDS only happens when a person living with HIV (PLWH) does not take medicines to control the infection. In most cases, PLWH must take 3 medicines to fully control HIV. Truvada only contains 2 medicines. It is strong enough to prevent HIV infection in most cases, but NOT strong enough to control the virus if infection does occur. This is why your PrEP provider will ask you to follow up with HIV testing several times per year.
Who should use PrEP?
- Anyone over the age of 18 at significant risk for HIV. Teens age 12 to 17 may also benefit from PrEP but the process to prescribe is longer because of health care laws for minors. The most important first step is to ask your health care provider about PrEP. They can then help you overcome barriers to getting on PrEP.
- Been the receiving partner during anal or vaginal sex with no condom AND 1) If the partner was HIV + and you did not know if their virus status was “undetectable” or 2) you are not sure about their HIV status.
- You received treatment for anal or vaginal STI in past 6 months.
- Often have sex when judgment is substantially impaired by alcohol.
- Use recreational substances prior to or during sex (“Chem-Sex”), or use stimulants such as meth, cocaine, or crack.
- You exchange benefits like money, housing, drugs, or other things you value for sex or your partner does.
- Your partner is or may be sleeping with other people and refuses to use a condom.
- Your primary partner is HIV + and he/she has difficulty keeping up with HIV treatment or your anxiety about sex with him/her is getting in the way of intimacy.
Who should not use PrEP?
- If you don’t know your HIV status and don’t want to get tested.
- You are HIV + (Truvada is not strong enough to treat HIV by itself).
- Don’t have time or interest in regular medical visits every 3-6 months.
- Don’t think you can keep up with taking a pill once daily.
- Think you’ll use PrEP for a single night or weekend and then never again.
- Have chronic kidney disease and are unable to get close medical care for this condition.
Are there side effects on PrEP?
Most people taking once daily Truvada have no side effects. If side effects occur, most patients reported mild headaches, upset stomach and weight loss that most often resolved after a few weeks. Rare but serious complications involving the kidneys and liver are possible, which is why PrEP should not be shared or sold to individuals not receiving medical support. Even if a rare side effect occurs, when Truvada is stopped, most patients do not experience permanent harm to their health.
How much does PrEP cost?
This depends on your individual insurance plan; so an exact dollar amount cannot be determined until you talk to a health care provider.
Having health insurance can make getting PrEP much easier. If you have trouble affording PrEP, Ochsner can also help you navigate resources available to most patients to make PrEP services more affordable. In addition, PrEPLocator.org can help you find a community health center that offers special support for people who cannot afford insurance.
SOURCE: Content adapted from Project Inform