PREP & PEP

What is PrEP?

“PrEP” stands for Pre-Exposure Prophylaxis. PrEP is a way for people who don’t have HIV but who are at very high risk of getting it to prevent HIV infection by taking a pill every day. The pill contains two medicines that are also used to treat HIV. If you take PrEP and are exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from taking hold in your body.

PrEP is a powerful HIV prevention tool and can be combined with condoms and other prevention methods to provide even greater protection than when used alone. But people who use PrEP must commit to taking the drug every day and seeing their health care provider for follow-up every 3 months.

Does it work?

When taken every day, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by more than 90%. PrEP is much less effective if it is not taken consistently. PrEP can be even more effective if it is combined with other ways to prevent new HIV infections like condom use, drug abuse treatment, and treatment for people living with HIV to reduce the chance of passing the virus to others.

PrEP was tested in several large studies with men who have sex with men, men who have sex with women, women who have sex with men, and people who inject drugs. Information on the details of these studies can be found at www.cdc.gov/hiv/prep.

Is PrEP safe?

Some people in clinical studies of PrEP had early side effects such as an upset stomach or loss of appetite, but these were mild and usually went away within the first month. Some people also had a mild headache. No serious side effects were observed. If you are on PrEP, you should tell your healthcare provider if these or other symptoms become severe or do not go away.

Should I consider taking PrEP?

PrEP is for people without HIV who are at very high risk for getting it from sex or injection drug use. The federal guidelines recommend that PrEP be considered for people who are HIV-negative and in an ongoing sexual relationship with an HIV-positive partner.

This recommendation also includes anyone who

PrEP is also recommended for people who have injected drugs in the past 6 months and have shared needles or works or been in drug treatment in the past 6 months.

If you have a partner who is HIV-positive and are considering getting pregnant, talk to your doctor about PrEP if you’re not already taking it. PrEP may be an option to help protect you and your baby from getting HIV infection while you try to get pregnant, during pregnancy, or while breastfeeding.

Because PrEP involves daily medication and regular visits to a health care provider, it may not be right for everyone. And PrEP may cause side effects like nausea in some people, but these generally subside over time. These side effects aren’t life threatening. See Is PrEP safe?

* Mutually monogamous means that you and your partner only have sex with each other and do not have sex outside the relationship.

What is the cost?

The cost of PrEP is covered by many health insurance plans, and a commercial medication assistance program provides free PrEP to people with limited income and no insurance to cover PrEP care.

How can I start PrEP?

PrEP can be prescribed only 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 and every 3 months while you’re taking it, so you’ll have to visit your health care provider for regular follow-ups.

Visit http://www.pleaseprepme.org for list of providers in your area.

The cost of PrEP is covered by many health insurance plans, and a commercial medication assistance program provides free PrEP to people with limited income and no insurance to cover PrEP care.

For more info and a flow chart to prepare for PrEP visit: https://www.projectinform.org/prep-chart/

If I start PrEP, can I stop using a condom?

No, you should not stop using condoms because you are taking PrEP. PrEP doesn’t give you any protection against other STDs, like gonorrhea and chlamydia. Also, while PrEP can significantly reduce your risk of HIV infection if taken daily, you can combine additional strategies like condom use with PrEP to reduce your risk even further.

If used the right way every time you have sex, condoms are highly effective in preventing HIV and some STDs you can get through body fluids, like gonorrhea and chlamydia. However, they provide less protection against STDs spread through skin-to-skin contact, like human papillomavirus or HPV (genital warts), genital herpes, and syphilis. See How well do condoms prevent HIV? Learn the right way to use a male condom.

 

 How long do I need to take PrEP?

You must take PrEP daily for it to work. But there are several reasons people stop taking PrEP. For example,

  • If your risk of getting HIV infection becomes low because of changes in your life, you may want to stop taking PrEP.
  • If you find you don’t want to take a pill every day or often forget to take your pills, other ways of protecting yourself from HIV infection may work better for you.
  • If you have side effects from the medicine that are interfering with your life, or if blood tests show that your body is reacting to PrEP in unsafe ways, your provider may stop prescribing PrEP for you.

You should discuss this question with your health care provider.

How long do I have to take PrEP before it is 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.

Source: http://www.aids.gov

WHAT IS PEP?

PEP stands for post-exposure prophylaxis. It means taking antiretroviral medicines (ART) after being potentially exposed to HIV to prevent becoming infected.

PEP must be started within 72 hours after a recent possible exposure to HIV, but the sooner you start PEP, the better. Every hour counts. If you’re prescribed PEP, you’ll need to take it once or twice daily for 28 days. PEP is effective in preventing HIV when administered correctly, but not 100%.

Is PEP right for me?

If you’re HIV-negative or don’t know your HIV status, and in the last 72 hours you

  1. think you may have been exposed to HIV during sex (for example, if the condom broke),
  2. shared needles and works to prepare drugs (for example, cotton, cookers, water), or
  3. were sexually assaulted,

talk to your health care provider or an emergency room doctor about PEP right away.

PEP should be used only in emergency situations and must be started within 72 hours after a recent possible exposure to HIV. It is not a substitute for regular use of other proven HIV prevention methods, such as pre-exposure prophylaxis(PrEP), which means taking HIV medicines daily to lower your chance of getting infected; using condoms the right way every time you have sex; and using only your own new, sterile needles and works every time you inject.

PEP is effective, but not 100%, so you should continue to use condoms with sex partners and safe injection practices while taking PEP. These strategies can protect you from being exposed to HIV again and reduce the chances of transmitting HIV to others if you do become infected while you’re on PEP.

When should I take PEP?

PEP must be started within 72 hours after a possible exposure. The sooner you start PEP, the better; every hour counts.

Starting PEP as soon as possible after a potential HIV exposure is important. Research has shown that PEP has little or no effect in preventing HIV infection if it is started later than 72 hours after HIV exposure.

If you’re prescribed PEP, you’ll need to take it once or twice daily for 28 days.

Does PEP have any side effects ?

PEP is safe but may cause side effects like nausea in some people. These side effects can be treated and aren’t life-threatening.

Where can I get PEP?

Your health care provider or an emergency room doctor can prescribe PEP. Talk to them right away if you think you’ve recently been exposed to HIV.

How can I pay for PEP?

If you’re prescribed PEP after a sexual assault, you may qualify for partial or total reimbursement for medicines and clinical care costs through the Office for Victims of Crime, funded by the US Department of Justice (see the contact information for each state).

If you’re prescribed PEP for another reason and you cannot get insurance coverage (Medicaid, Medicare, private, or employer-based), your health care provider can apply for free PEP medicines through the medication assistance programs run by the manufacturers. Online applications can be faxed to the company, or some companies have special phone lines. These can be handled urgently in many cases to avoid a delay in getting medicine.

Can I take a round of PEP every time I have unprotected sex? 

PEP should be used only in emergency situations.

PEP is not the right choice for people who may be exposed to HIV frequently—for example, if you often have sex without a condom with a partner who is HIV-positive. Because PEP is given after a potential exposure to HIV, more drugs and higher doses are needed to block infection than with PrEP, or pre-exposure prophylaxis. PrEP is when people at high risk for HIV take HIV medicines (sold under the brand name Truvada) daily to lower their chances of getting HIV. If you are at ongoing risk for HIV, speak to your doctor about PrEP. Also, read our Q&As on PrEP.

Learn more about how to protect yourself and get information tailored to meet your needs from CDC’s HIV Risk Reduction Tool (BETA).

source: http://www.aids.gov