HIV PrEP: Pre-Exposure Prophylaxis for HIV
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In recent years, the fight against HIV infection has been bolstered by significant advancements in preventive medicine. One such groundbreaking development is Pre-Exposure Prophylaxis (PrEP), antiretroviral medication that dramatically reduces the risk of HIV infection through sex or injection drug use. Approved by the US-FDA and recommended by the CDC, HIV PrEP has become a cornerstone in HIV prevention strategies.
H.U.M. Clinic is at the forefront of providing accessible PrEP options, including the latest medications and personalized care plans, ensuring that individuals at risk of HIV have effective preventive measures within reach. For more information about PrEP service at H.U.M. Clinic, please visit the service page How to Get HIV PrEP.
What Is HIV PrEP?
Pre-Exposure Prophylaxis, or PrEP, is a medical breakthrough in the fight against HIV. It’s an antiretroviral medication that, when taken as prescribed, significantly reduces the risk of HIV infection from sex or injection drug use. The US Food and Drug Administration (FDA) first approved HIV PrEP medication, TRUVADA (F/TDF), for daily use in 2021. This was followed by the approval of DESCOVY (F/TAF) in 2019. Most recently, in 2021, the CDC recommended Apretude (Cabotegravir) as an injectable form of PrEP, providing an alternative to daily pills. While Apretude offers a new, more convenient option for HIV prevention, it’s not yet available in Thailand, highlighting the ongoing evolution and accessibility of PrEP options globally.
Remark: If you are a person who had a recent unprotected sexual encounters within 72 hours, what you need is HIV PEP (Post-Exposure Prophylaxis), not PrEP.
What Are The Benefits of HIV PrEP?
HIV PrEP (Pre-Exposure Prophylaxis) offers significant benefits for individuals at risk of HIV infection. One of the primary advantages is its high efficacy; when taken consistently, PrEP reduces the risk of contracting HIV through sexual activity by up to 99% and through injection drug use by at least 74%. This level of protection provides peace of mind and allows individuals to engage in intimate relationships with reduced fear of HIV transmission.
Additionally, PrEP is a proactive measure that empowers individuals to take control of their sexual health. It complements other preventive strategies, such as condom use and regular HIV testing, enhancing overall protection. Moreover, PrEP is well-tolerated with manageable side effects for most people, making it a practical long-term solution.
How Effective Is HIV PrEP?
Pre-exposure prophylaxis (PrEP) stands as a cornerstone in the fight against HIV, offering exceptional protection when adhered to correctly. Here’s how PrEP shields against HIV:
- Consistent Daily Use: Studies highlight that daily PrEP intake slashes the risk of HIV transmission through sexual encounters by approximately 99%. Consistency is key to unlocking its full protective potential.
- On-demand Strategy for MSM: For men who have sex with men (MSM), an event-based approach, known as the 2-1-1 schedule, lowers the risk by about 86%+. Adherence plays a crucial role in optimizing the efficacy of PrEP.
Who Should Consider Taking HIV PrEP?
HIV PrEP (Pre-Exposure Prophylaxis) is recommended for individuals who are at high risk of HIV infection. This includes:
- Multiple sexual partners, engage in unprotected sex, or have a partner with an unknown HIV status.
- Men who have sex with men (MSM), transgender women, receptive anal sex.
- People who inject drugs are also considered high-risk groups.
- Serodiscordant couples, where one partner is HIV-positive (unsure status of undetectable) and the other is HIV-negative.
- Individuals with a history of sexually transmitted infections (STIs).
- Those who frequently use post-exposure prophylaxis (PEP) are strong candidates for PrEP.
What Are Options of HIV PrEP ?
We prioritize accessible HIV prevention by offering a comprehensive selection of PrEP medications tailored to individual needs and preferences. Here are the options of HIV PrEP:
- Oral PrEP:
- [F/TDF or TDF/FTC] stands for Emtricitabine/Tenofovir disoproxil fumarate. TRUVADA (Original) has been discontinued from the product line. The Cost-effective solution for those seeking affordable access to PrEP is TENO-EM (Thai generic) and TENOF-EM (Indian generic).
- [F/TAF or TAF/FTC] stands for Emtricitabine/Tenofovir alafenamide, as commonly known as the original DESCOVY. The Indian generic version is also available, TAFICITA.
- Injectable PrEP: (Currently not available)
- [CAB LA] stands for Cabotegravir Long Acting Injection, as commonly known as Apretude.
How Do You Take HIV PrEP?
PrEP can be taken in two main ways, providing flexibility and personalization to suit different lifestyles, risk profiles, and individual preferences. These are 2 methods of taking Oral PrEP:
- Daily Regimen: The US FDA recommends taking one pill daily for ongoing protection. This regimen should start 7 days before potential HIV exposure and continue 7 days after the last exposure. The prototype drug is TRUVADA (TDF/FTC regimen), according to PROUD study. However, DESCOVY (TAF/FTC regimen), can also be taken daily, according to DISCOVER study.
- On-Demand (Event-Driven) PrEP Regimen: An off-label option involves taking 2 pills 2-24 hours before anticipated sexual activity, followed by one pill at 24 and 48 hours after the first dose. If sexual activity continues, the regimen is extended by one pill every 24 hours until 48 hours after the last encounter. This process is resumed for new sexual activities after the 48-hour period.
Credit: World Health Organization. (2022). Differentiated and simplified pre-exposure prophylaxis for HIV prevention
What Are the Side Effects of HIV PrEP?
HIV PrEP (Pre-Exposure Prophylaxis) is generally well-tolerated, but like any medication, it can cause side effects. Understanding these potential side effects can help users make informed decisions about their health. Monitoring and communication with a healthcare provider can help manage these side effects effectively. Regular check-ups are crucial to ensure PrEP is safe and effective for long-term use
Common Side Effects:
- Nausea: Some people may feel nauseous when they start taking PrEP, but this usually subsides after a few days.
- Headache: Headaches are a common initial side effect.
- Diarrhea: Digestive issues such as diarrhea can occur.
- Fatigue: Some individuals report feeling unusually tired.
Serious/Rare Side Effects:
- Kidney Problems: PrEP can affect kidney function, so regular monitoring is essential.
- Bone Density Loss: Long-term use may result in a decrease in bone mineral density.
- Allergic Reactions: Severe allergic reactions are uncommon but possible.
FAQ about HIV PrEP
How effective is HIV PrEP?
PrEP is highly effective for preventing HIV about 99% through sex and 74% from injection drug use when taken as prescribed correctly.
Can I have sex without a condom when I am on PrEP?
People who are taking PrEP and having sex without condom still at risk of many STD and STD is increased risk of getting HIV. Condom is recommended when you are on PrEP.
Is On demand PrEP effective?
Yes, it is. The recent study for On-demand PrEP shown highly effective on people who not have frequent sex
What is side effect of PrEP?
Most common mild side effects include dizziness, bloating, and diarrhea. Rare side effects include abnormal kidney function, loss of bone density.
Can I take PrEP if I have kidney problems?
Yes, F/TAF or Descovy is approved for patients who have impaired kidney function (eGFR 30-60)
Does PrEP affect my liver?
No, PrEP has no effect on the liver and CDC guidelines do not indicate liver function test as routine laboratory testing for PrEP. But a person who is hepatitis B carrier will need to monitor liver function and hepatitis B status.
When can I stop PrEP?
If you are taking on demand PrEP, take 1 pill every 24 hours until 48 hours after your last intercourse. If you are taking PrEP daily, take PrEP 7 more days after your last intercourse.
