PrEP: Protection against HIV in a pill?

HIV (the human immunodeficiency virus) weakens the human immune system and destroys the vital cells that combat illness and an infection. An individual can get HIV when bodily fluids — together with blood, semen, pre-seminal fluid, rectal fluids, or vaginal fluids of an individual with the virus — are available in contact with a mucous membrane or broken tissue. HIV will be transmitted by way of breast milk, or when a contaminated needle or syringe comes into direct contact with the bloodstream.

There isn’t a treatment for HIV, however with correct medical care the virus and its results will be managed. HIV transmission will be lowered by constant use of condoms and clear needles. Nevertheless, one other strategy to shield towards getting HIV is pre-exposure prophylaxis, or PrEP.

PrEP is a tablet that may assist stop HIV

PrEP is a mix of two antiretroviral medicines, tenofovir and emtricitabine, that, if taken every single day, can now stop HIV. The tablet (Truvada) is FDA authorised. Truvada works by blocking an enzyme in order that HIV can not reproduce and set up an infection within the physique.

The tablet is taken by mouth with or with out meals. It’s best if taken on the similar time every single day, as this helps set up a routine. Skipping days isn’t advisable. For those who neglect a dose, take it as quickly as you bear in mind. Whether it is nearly time to take the subsequent dose, skip the missed dose and proceed the common dosing schedule. Truvada takes full impact seven to twenty days after beginning the medicine. It may be discontinued each time the safety it presents isn’t vital (for instance, in case your threat for HIV or preferences change). Do speak to your physician when stopping or beginning any medicine.

Who ought to think about PrEP?

The next circumstances imply that PrEP could also be a good selection and value a dialog along with your physician:

  • if in case you have had anal or vaginal intercourse with a couple of accomplice and like to make use of condoms solely generally or under no circumstances
  • if you’re a sexually energetic grownup male who prefers male companions, whose HIV standing might not be identified
  • if you’re in a relationship with an HIV-positive accomplice
  • if in case you have not too long ago had a sexually transmitted an infection in your anus or vagina
  • if in case you have had intercourse with individuals who inject medication, or when you inject medication your self
  • if you’re making an attempt to conceive with a identified HIV-positive accomplice
  • if in case you have used stimulants, poppers, cocaine, meth, ecstasy, or velocity within the final six months.

What about condoms?

Condoms do present safety towards HIV. In contrast to PrEP, in addition they shield towards different sexually transmitted infections, and stop being pregnant when used appropriately and persistently.

Does PrEP have uncomfortable side effects?

General PrEP could be very properly tolerated. As with beginning any medicine, some individuals will expertise uncomfortable side effects reminiscent of nausea, gasoline, or headache. Normally, these uncomfortable side effects are delicate and have a tendency to enhance with time if the medicine is stopped. Kidney issues can happen occasionally, and so your physician will monitor your kidney operate with common blood checks. Some individuals could expertise a light discount in bone mineral density. The importance of this isn’t identified, however it tends to stabilize or return to regular over time.

PrEP doesn’t intervene with most medicines together with suboxone, methadone, or oral contraceptives, and doesn’t have an effect on sexual efficiency. Whereas this medicine has been used extensively in pregnant and breastfeeding ladies who’ve HIV an infection, the danger/advantage of utilizing it for HIV prevention throughout being pregnant or breastfeeding must be individualized. Discuss to your physician if you’re taking NSAIDs like ibuprofen or naproxen, or antivirals like valacyclovir or acyclovir.

What are the subsequent steps when you suppose PrEP is best for you?

Make an appointment along with your physician and speak about why you suppose you want to take this medicine. Your physician will run checks to test for HIV and different sexually transmitted infections in addition to hepatitis A, B, and C, and test your kidney operate earlier than beginning PrEP. Often your supplier might want to get prior authorization for the medicine. Most insurances cowl the associated fee. In case your supplier is uncomfortable prescribing this medicine, ask to be referred to an HIV specialist in your space.

You’ll need to see your physician initially after one month after which each three months, when HIV and sexually transmitted an infection testing will likely be repeated. Your kidney well being will likely be monitored through a blood take a look at as soon as inside six months, and PrEP should be stopped if the kidneys are adversely affected.

References

Facilities for Illness Management and Prevention, HIV Fundamentals: About HIV.

Facilities for Illness Management and Prevention, HIV Fundamentals: PrEP.

World Well being Group, Steering on oral pre-exposure prophylaxis (PrEP) for serodiscordant {couples}, males and transgender ladies who’ve intercourse with males at excessive threat of HIV.

US Public Well being Service, Preexposure Prophylaxis for the Prevention of HIV An infection in the US — 2014: A Scientific Observe Guideline (PDF).

Acknowledgements: Dr. Linda Shipton, MD, an internist and infectious illness specialist at Cambridge Well being Alliance, for help throughout the preparation of this publish.

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