You may have seen the odd acronym “PrEP” among the alphabet soup of medical terms so prevalent today. It stands for “pre-exposure prophylaxis” against HIV infection and is a very simple therapy: a daily dose of Truvada, the highly effective antiviral medication used since 2004 to treat patients who are already HIV-positive. Actually, Truvada is the brand name of a combination of two drugs in one pill: tenofovir and emtricitabine. It has few side effects, is covered by most insurance plans and has been approved by the FDA for prophylactic or preventative use since 2012.
Various studies on Truvada are encouraging. One showed that daily intake of Truvada could potentially achieve 99 percent of risk reduction of contracting HIV in high-risk individuals. Another study showed an overall PrEP effectiveness of 50 percent, rising to 100 percent when participants took the drug four or more times per week. Clearly the most important aspect of this prevention therapy is strict adherence: taking the medication daily and regularly.
So should you consider PrEP? Well, if you are currently HIV-negative, plan to stay that way and are sexually active at all (regardless of sexual orientation) you ought to at least educate yourself about PrEP. The groups at highest risk for HIV infection include gay and bisexual men and their negative partners (again, regardless of gender or orientation), younger men (who may be very under-informed about HIV in general), members of minority groups (who may lack information, access to healthcare and fear cultural stigma) and substance users (all those needles). And in our community with its higher than average populations of both older people and gay men, seniors may be at risk as well. So if you fall into or near any of those categories, knowing about PrEP might save you some worry later.
HIV prevention still includes safer sex practices, condoms, serosorting (having sexual partners only of the same HIV status) and of course, abstinence. But we all know those don’t always work in the heat of a moment. Today, there is the additional pro-active option of PrEP therapy. Your doctor or health care provider can further advise you on it and if they won’t discuss it, find another doctor. I’ve found that one must never be shy about full disclosure on sexual matters with a primary care physician.
It’s also wise to do your research before beginning that conversation. There is a wealth of information online about PrEP: research data, Truvada guidelines, how to adhere to a meds regimen and of course, the latest updates on HIV/AIDS treatments and potential cures. Here are a couple of good places to start: the Centers for Disease Control website at cdc.gov/hiv/risk/ and a comprehensive PrEP primer at projectinform.org/pdf/prep_msm.pdf.
To understate the obvious, one’s sex life can have profound effects on one’s long-term health. So you can never know too much about these vital health care issues—however complicated or intimidating–which ultimately determine the quality of our lives.