If you need to brush up on your HIV basics which is a great idea before reading the rest of this article! Finally, some people are HIV-positive themselves and want to protect their sexual partners or want to start a family and have biological children who are HIV-negative.
A daily medication that is taken regularly before and after exposure to prevent HIV. It is meant to prevent HIV exposures that occur on an occasional to frequent basis. People who take PrEP might decide to take it for months or years.
A medication that is taken to prevent HIV after an exposure happens. It is taken within 72 hours of an exposure and continued for 28 days. PEP is not used for routine HIV prevention but in unexpected situations like sexual assault, blood exposures, or broken condoms.
TasP treatment as prevention is providing treatment to HIV-positive people not only to keep them healthy but to prevent HIV from being transmitted to other people. HIV-positive people who are on medication that successfully reduces the amount of virus in their body cannot pass HIV to others during sex.
There are a couple of caveats here — different HIV medications work well for different people and they do not work immediately. For treatment to work as HIV prevention, the person with HIV needs to be on medications that work well for their body and needs to be taking them consistently and correctly what this means is different for each medication but usually means once a day.
In most people, the amount of virus in their body will be too low to transmit after two to three months of treatment. However, none of these medications do anything to prevent any other kind of STI and none of them do anything to prevent pregnancy. In other words, these are useful tools for protecting your sexual health but are not a complete safer sex strategy on their own. That being said, other STIs are nothing to sniff at especially with infections like gonorrhea that are becoming increasingly resistant to antibiotics.
Another major disclaimer — this article mostly discusses sexual transmission of HIV, not blood-to-blood transmission. It is unknown whether PrEP protects people from getting HIV through injection drug use or whether treatment as prevention prevents people from transmitting HIV through injection drug use. If you are using injection drugs, there are still a lot of ways you can protect yourself from HIV. PrEP is used to prevent HIV exposures that occur on a regular basis like in someone who is sexually active with people who are or might be HIV-positive and is taken as a daily medication.
The medication that is currently used as PrEP is a pill that contains two different medications tenofovir and emtricitabine. In the United States, this pill is usually sold under the brand name Truvada, but outside the U. How does it work? When a person on PrEP is exposed to HIV, the drugs stop the virus from making copies of itself, preventing the infection from becoming established. For PrEP to do its job at preventing HIV, it needs to first build up inside of the body until it reaches a high enough level to work.
The drugs in PrEP need to be present in the parts of the body where HIV transmission happens — the lining of the rectum and the lining of the genitals the walls of the vagina and the inside of the urethra in a penis.
PrEP builds up faster in the lining of the rectum than it does in the genitals. This means that while PrEP can be really effective, it is not a great HIV prevention method for someone who would have trouble taking daily medication.
Who is PrEP for? PrEP is for teens and adults of all genders and sexualities who might be at risk of getting HIV through sex. This means people who are gay , straight, bi, and queer , people who are cis, trans, and nonbinary, and people who are young and old. People who take PrEP can be: Having sex with any number of people who are HIV-positive or of unknown status. A person on PrEP might have casual sex with multiple people, be in a committed non- monogamous relationship , be in a relationship with one or more HIV-positive people, doing sex work, not doing sex work, and so on.
Having any kind of sex that can transmit HIV. Using or not using drugs. PrEP provides protection from sexual transmission of HIV regardless of whether someone injects drugs. Using or not using hormones. PrEP works in transgender and nonbinary people regardless of whether or not they take hormones.
This is especially true of young people. Unfortunately, the majority of awareness campaigns around PrEP have focused on gay and bisexual cis men, and a large amount of attention has been concentrated in wealthier, white communities. Women are often left out of educational campaigns around PrEP and until the past few years, PrEP research studies excluded transgender people.
People who have heard of PrEP often believe that PrEP is only for gay men who have a lot of condomless anal sex with anonymous partners. The CDC estimates that the number of cis women who are at high risk for acquiring HIV is about equal to the number of gay and bi cis men at risk in fact, 1 in 5 new HIV diagnoses are in women.
Why might someone use PrEP? The most common reason a person might decide to use PrEP is that they are at high risk for getting HIV and want to reduce that risk.
Some things that increase your chance of being exposed to HIV are: Having partners who are HIV-positive. Using injection drugs or having sex with folks who use injection drugs. Most people who take PrEP will fit into at least one of the above categories. Especially for people who have internalized the idea that certain kinds of sex are inherently dangerous or deadly, using PrEP can be very liberating.
Why might someone stop taking or never take PrEP? Taking PrEP is not a lifetime commitment. They might be dating someone who is HIV-positive, or experimenting with their sexuality or just going through a more sexually active period. So, there are people who take PrEP when they feel like they need it and stop taking it when it no longer feels necessary.
They might realize that their HIV risk is not really that high, or that they are comfortable with other HIV prevention methods like condoms alone. Those are totally valid reasons to stop taking PrEP. Some other also totally valid reasons why people might want to stop PrEP or just not start in the first place are: Privacy issues, like worrying that a partner or family member will find the bottle of PrEP and ask about it.
Not being able to pay for the medication or get it refilled on time. Concerns about side effects. Not wanting to take a pill every day. How do you take PrEP?
This might be the person who you see for regular medical care, or it could be someone at a sexual health clinic resources for finding a provider are at the end of this article. Most people are also offered a full STI screening during their intake. How do you find a PrEP provider? For many people, taking PrEP is no big deal. Especially if someone already has a regular doctor and has taken medication before, getting regular labs and taking a pill every day can feel pretty straightforward.
However, not everyone has the same access to healthcare. So to start off: PrEP is not available over-the-counter: You might already have someone who you see for regular health care who fits this bill.
All you need to do is make an appointment with them. And although this should never happen, there are providers who have homophobic attitudes or who behave judgmentally towards people who ask to be on PrEP. Luckily, you have a lot of options. Sexual and reproductive health clinics like Planned Parenthood are one example. There are several online databases of PrEP providers that you can use to find resources in your area.
In some regions — especially rural areas — none of the above options may seem realistic. Telemedicine involves meeting with a provider over a computer, having your bloodwork done at a local lab, and getting the medication filled at a local pharmacy. This option is increasingly available in the United States. Being your own advocate: Educating your provider is one way to help advocate for your health needs and get more involved in the care you receive.
There are some handy resources out there designed to help health providers learn more about PrEP. However, there are programs out there to help people afford the cost of PrEP and in reality, most people pay very little if anything to be on PrEP.
Most sexual and reproductive health clinics that provide PrEP will help you figure out how to pay for it. That might look like helping you get signed up for insurance or government benefits or it might involve helping you apply for private programs that help provide medication for free. The bottom line is there are a bunch of resources and social workers out there that make it possible for anyone who wants PrEP to be able to afford it.
Taking a pill every day For some folks, taking PrEP is the first time they have ever taken a daily medication. You can also get tiny pill boxes that fit in a pocket or on a keychain, which are useful if you usually keep your medication at home but sometimes sleep elsewhere.
They can help you with more complex troubleshooting. Although PrEP is becoming more normalized in some queer and trans communities, people of all genders and sexualities worry about being judged for taking PrEP. A common concern folks have when taking PrEP is whether to tell family, friends, or partners that they take it.
No one else has to know that you take PrEP and you can make your own decisions about who you decide to tell. If you take PrEP or are thinking about taking PrEP and have concerns about disclosure and stigma, you most definitely are not alone. Worried that PrEP makes people stop wearing condoms?
A really common myth — even among sexual health providers and educators — is that people use PrEP as an excuse to stop using condoms, or that PrEP will lead to a rise in STIs. Rates of STIs like chlamydia, gonorrhea, and syphilis have been on the rise in the United States, especially among young women, and some folks have been quick to blame PrEP for leading to lower rates of condom use and higher rates of STIs.
The truth, however, is that some research suggests that taking PrEP does not cause people to stop using condoms and that, at least among gay cis men, condom use was already on the decline before PrEP came out.
In general, people who get tested for STIs more frequently get diagnosed more frequently — because you have to get tested to get diagnosed!