We live in a world where access to information is at the touch of a few buttons. Where word of mouth is still an effective form of communication and where social media educates on days trolls aren’t spewing hate.
So why then do so many people not know what PrEP is? Across the world stereotypes and stigmas are something members of the LGBTQIA community face almost every day. Couple that with the stigma around HIV and Aids, despite the medical advances made through the years, and you have just one of the answers.
With the help of the Centers for Disease Control and Prevention here is the 411 on PrEP, who should take it, why, how and where you can access it.
What is PrEP?
Pre-exposure prophylaxis (PrEP) is an HIV prevention strategy where HIV-negative individuals take anti-HIV medications before coming into contact with HIV to reduce their risk of becoming infected. The medications work to prevent HIV from establishing infection inside the body.
PrEP has been shown to reduce the risk of HIV infection through sex for gay and bisexual men, transgender women, and heterosexual men and women, as well as among people who inject drugs.
The Bangkok Tenofovir Study demonstrated that PrEP works for people who inject drugs.
It does not protect against other sexually transmitted infections (STI) or pregnancy. It is not a cure for HIV.
Is PrEP a vaccine?
No. PrEP does not work the same way as a vaccine. A vaccine teaches your body to fight off infection for several years. For PrEP, you take a pill every day by mouth. If you take PrEP daily, the presence of the medicine in your bloodstream can often stop HIV from taking hold and spreading in your body. If you do not take PrEP every day, there may not be enough medicine in your bloodstream to block the virus.
I’m transgender, will PrEP interfere with my hormone therapy?
According to the Centers for Disease Control and Prevention, more studies are needed on this topic. However, there are no known drug conflicts or interactions between the medicines used in PrEP and hormone therapy. There is no known scientific reason why the drugs cannot be taken at the same time.
If you are worried that PrEP will affect your hormone therapy, ask your health care provider to check your hormone levels. People who use PrEP should see their health care provider every 3 months for follow up, HIV tests, and to have their prescriptions refilled. This visit could be combined with your hormone therapy appointments.
If I take PrEP, can I stop using condoms when I have sex?
No, you should not stop using condoms because you are taking PrEP. PrEP doesn’t give you any protection against other STDs, like gonorrhoea and chlamydia.
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 gonorrhoea 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.
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. PrEP reaches maximum protection from HIV for receptive anal sex at about seven days of daily use. For receptive vaginal sex and injection drug use, PrEP reaches maximum protection at about 21 days of daily use. No data are yet available about how long it takes to reach maximum protection for insertive anal or insertive vaginal sex.
How effective is PrEP
Truvada for PrEP provides 92 to 99 percent reduction in HIV risk for HIV-negative individuals who take the pills every day as directed. If a daily dose is missed, the level of HIV protection may decrease. It only works if you take it. People who use PrEP correctly and consistently have higher levels of protection against HIV.
According to data analysis from the iPrEx study that found PrEP to be effective:
- For people who take 7 PrEP pills per week, their estimated level of protection is 99%.
- For people who take 4 PrEP pills per week, their estimated level of protection is 96%.
- For people who take 2 PrEP pills per week, their estimated level of protection is 76%.
Is PrEP safe?
PrEP can cause side effects like nausea in some people, but these generally subside over time. No serious side effects have been observed, and these side effects aren’t life threatening. If you are taking PrEP, tell your health care provider about any side effects that are severe or do not go away.
How long do I need to take PrEP?
You must take PrEP daily for it to work. However, 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 always discuss this question with your health care provider.
Can you start PrEP after you have been exposed to HIV?
PrEP is only for people who are at risk of getting HIV. But PEP (post-exposure prophylaxis) is an option for someone who thinks they’ve recently been exposed to HIV during sex or through injection drug use.
PEP means taking antiretroviral medicines after a potential exposure to HIV to prevent getting the virus. PEP must be started within 72 hours of possible exposure to HIV. If you’re prescribed PEP, you’ll need to take it once or twice daily for 28 days.
Access to PrEP
Use the following link to find a PrEP provider in your city or province - https://www.myprep.co.za/locations
Read more in IOL Lifestyle’s Queer+ digital magazine