Prevent HIV with PrEP man in blue shirt
Oct 31, 2022

How to Prevent HIV with PrEP

With proper medication and treatment, most people with human immunodeficiency virus (HIV) or AIDS can now live longer, healthier lives. HIV treatment, known as antiretroviral therapy (ART), uses regular doses of medicine to reduce the amount of HIV in the body. This doesn’t cure the disease, but the virus remains in the body at lower levels, allowing ART to keep it under control.

Fortunately, doctors now have a successful HIV treatment protocol for reducing the risk of acquiring HIV among individuals who are susceptible to exposure to the virus. It’s called Pre-Exposure Prophylaxis (PrEP), and it consists of an antiretroviral medication that prevents HIV from overriding the human immune system.

What is PrEP for HIV

The Center for Disease Control (CDC) defines PrEP as a medicine that reduces the chances of HIV-negative individuals from getting HIV from sexual activity or needles injected intravenously. Approved by the FDA in 2012, PrEP is highly effective for HIV prevention when taken as prescribed.

HIV medications are available in two types of pills and as an injection. Truvada® is a PrEP pill prescribed for people at risk of contracting HIV. Descovy® is a pill for people at risk through unprotected sex. People at risk through sexual activity can opt for Apretude, the only shot approved for PrEP use, as long as they weigh at least 77 lbs.

How PrEP Works

When HIV enters the body it attacks the immune system, using the body’s CD4 T cells to create more copies of the virus and spread the infection. PrEP prevents HIV from spreading by protecting the CD4 T cells. This prevents the HIV from creating more copies of itself and the individual remains HIV negative.

HIV PrEP uses a combination of two antiretroviral drugs (tenofovir and emtricitabine) to prevent the virus from taking control. These drugs are typically taken every day and are often used in combination with other HIV medications.

PrEP is highly effective for preventing HIV. When taken as prescribed, it reduces the risk of getting HIV from sexual activity by about 99%. The effectiveness of HIV PrEP pills with people who take drugs intravenously has not yet been clearly established. However, it is estimated to reduce the risk of getting HIV by at least 74%. Currently, PrEP shots are not recommended for people who inject drugs. Whether in pill or injection form, PrEP effectiveness declines when not taken as prescribed.

Who Should Take PrEP

PrEP is only for people who don’t have HIV and want protection against contracting it. Doctors recommend PrEP for HIV-negative people with lifestyles that include one or more of these behaviors:

  • Intercourse with an HIV-positive partner
  • Intercourse without condoms
  • Multiple sexual partners
  • Have been diagnosed with a sexually transmitted disease in the past six months
  • Share needles, syringes, or other equipment to inject drugs

Doctors may also prescribe PrEP HIV treatment for people who have an injection partner with HIV; share needles, syringes, or other drug injection equipment (i.e. cookers); or have been prescribed post-exposure prophylaxis, PEP, yet continue to engage in behaviors known to be source of transmission or have used multiple PEP courses.

Is It Safe to Use PrEP

PrEP is safe to use, but some people experience side effects. These can range from headache and fatigue to nausea, stomach pain and diarrhea. These side effects usually go away in a few days. Tell your health care provider about any side affects you experience, especially if they don’t go away after a short time.


Learn more about side effects from the drugs in the PrEP medications Truvada®, Descovy®, and Apretude.


Frequency of PrEP Medications

There are two FDA-approved ways to take PrEP for HIV. Work with your care provider to determine the best method for you.

  1. Daily PrEP. This method is for people of any gender identity who have possible exposure to HIV on a frequent or unpredictable basis. Taking one pill a day allows them to feel protected from HIV.
  2. Long-Acting Injectable PrEP. Anyone eligible for HIV PrEP who weighs at least 77 pounds can take long-acting PrEP. However, they must be able to attend regular in-office medical appointments to receive the injections. This method provides an option for people who don’t want to take pills or have a hard time consistently taking oral medication as prescribed.

Getting Started with PrEP

Make an appointment with your health care provider to determine whether PrEP is right for you. If you decide to take the medication, you will be tested to ensure you are HIV-negative. Once you start the HIV treatment, it is recommended to meet regularly with your provider for follow-up visits, HIV tests, and prescription refills or shots. Depending on the provider, these may be available via mail-in HIV tests and/or telehealth follow-up visits.

If you don’t have a health care provider, the HIV prevention services locator can help find one near you.


Did you know TrueCare offers HIV and AIDS Case Management in Oceanside and San Marcos?


Fight Back Against HIV with TrueCare

TrueCare’s HIV/AIDS community resources provide ongoing support ranging from HIV education and prevention to ADAP and OA-HIPP enrollment and more. We also offer free HIV Testing, PrEP access, and condoms. For more information, please contact our PrEP Health Navigator at prep@truecare.org, or call (442) 372-7763.

HIV/AIDS Case Management is offered at our Oceanside and San Marcos locations, integrated into their primary care departments. Schedule an appointment today!

PrEP FAQs:

Can PrEP users switch from pills to shots?

Talk to your healthcare provider about switching from PrEP pills to shots. PrEP shots may be right for you if you don’t have HIV and have no known allergy to the medicines in the shot. If you decide to switch from PrEP pills to shots, you will need to visit your health care provider regularly to receive the shots. You will also need to be tested for HIV prior to each shot.

When is it safe to stop taking PrEP?

People stop taking PrEP for several reasons:

  • Life changes reduce your risk of getting HIV
  • You don’t want to take the pills as prescribed
  • You often forget to take your pills
  • You struggle to visit your healthcare provider to get the shots when needed
  • Side effects from the medicine are not tolerable
  • Blood tests indicate your body is reacting to PrEP in unsafe ways

Talk to your health care provider before discontinuing your PrEP medication. Ask about other HIV prevention methods that may work better for you.

Is PrEP covered by my insurance?

The Affordable Care Act requires PrEP to be free under most private health insurance plans. This includes insurance provided by your employer and self-purchased plans, as well as those purchased through HealthCare.gov or state-based Marketplaces and state Medicaid expansion coverage plans.

If your insurance covers PrEP you don’t pay any out-of-pocket costs, including clinic visits, PrEP medications, and lab tests to maintain your prescription. In some states, basic Medicaid covers PrEP at no cost. However, this does not automatically apply to Medicare. Medicare Part D prescription drug plans cover PrEP medications, but you pay part of the cost.

How do I know if my health plan covers the cost of PrEP medications?

If you have private health insurance (self-purchased or through your employer) contact your provider to inquire about coverage for PrEP medications. Or, browse their online list of prescription drugs to find information about coverage for drugs approved for PrEP. If your health plan is provided by HealthCare.gov or a state-based marketplace, visit the National Alliance of State and Territorial AIDS Directors (NASTAD) for more information. If you use Medicaid, speak with your benefits counsellor. If you use Medicare, find which plans cover your drugs.

What if I don’t have health insurance or Medicaid coverage?

Resources are available to help pay for PrEP treatment costs. The U.S. Department of Health and Human Services’ Ready, Set, PrEP program pays medication costs for people who qualify for the program. Lab tests and clinic visit costs may vary based on your income and clinic/health care provider. Gilead’s Medication Assistance Program for PrEP (Gilead makes two of the FDA-approved drugs for PrEP) offers assistance to U.S. residents who don’t have insurance and whose household income is below 500% of the federal poverty level.

If your health insurance requires a co-pay and you can’t afford it, you may receive co-pay assistance from drug manufacturers, state assistance programs, or the Patient Advocacy Foundation.


Resources:

>> HIV.gov
>> Centers for Disease Control and Prevention
>> California Department of Public Health
>> San Diego County Health & Human Services


TrueCare provides a number of health services for all ages and stages of life, from newborn to toddler, adolescent, young adult to adult and senior care, including wellness checks. Our providers are committed to quality comprehensive care with heart. Contact your local TrueCare health center today to set up your appointment. We accept anyone, regardless of their ability to pay.

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The information, including but not limited to text, graphics, images, and other material contained on this website, are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen. Never disregard professional medical advice or delay in seeking it because of something you read on this website.

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Jessica L. Randalls, PA
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