How effective is PrEP in preventing HIV? Game-changing, says expert

LGBTQ Health
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PrEP (pre-exposure prophylaxis) is a highly effective once-daily medicine for people who don't have HIV but who may be at risk of getting HIV through sex or injection drug use. PrEP reduces the risk of getting HIV from sex by about 99%, and the risk of getting HIV from injection drug use by at least 74%.

"PrEP has been a game-changer, significantly reducing the risk of contracting HIV through sexual activity and protecting people from HIV, the virus that causes AIDS," says Dane Menkin, CRNP, director of LGBTQ services at Main Line Health. "For PrEP to be effective, however, it has to be taken as prescribed by your health care provider."

LGBTQ Inclusive Care

In our culture of diversity, respect, equity and inclusion, Main Line Health provides a safe environment where LGBTQ patients, families and visitors can expect inclusive care from a welcoming health system at our locations throughout the Philadelphia region.

Who should take PrEP?

The Centers for Disease Control and Prevention (CDC) recommends PrEP for people who are HIV-negative who have had anal or vaginal sex in the past six months and:

  • Have a sexual partner with HIV (especially if the partner has an unknown or detectable viral load), or
  • Have not consistently used a condom, or
  • Have been diagnosed with a sexually transmitted disease (STD) in the past six months

PrEP reduces the risk of getting HIV from sex by about 99%, and the risk of getting HIV from injection drug use by at least 74%.

PrEP is also recommended for people HIV-negative who inject drugs and:

  • Have an injection partner with HIV, or
  • Share needles, syringes or other equipment to inject drugs

Is PrEP safe?

There are two medications approved for use as PrEP:

  • Truveda® is for all people at risk through sex or injection drug use.
  • Descovy® is for people at risk through sex, except for people assigned female at birth who are at risk of getting HIV from vaginal sex.

PrEP is safe. Some people may experience mild side effects like nausea, but they usually go away over time. Since PrEP only protects against HIV, condom use is still important for protection against other sexually transmitted infections. Condom use is also important to help prevent HIV if PrEP is not taken as prescribed.

Is PrEP expensive?

Under the Affordable Care Act, PrEP must be free under almost all health insurance plans. Patients won't be charged for their PrEP medication or the clinic visits and lab tests they need to maintain their prescription. There are no out-of-pocket costs. Patients should check with their specific insurance plan. Resources also exist to help people who do not have insurance or Medicaid coverage.

Another HIV treatment option in emergency situations: PEP

PEP (post-exposure prophylaxis) is a medicine to prevent HIV after a possible exposure. PEP should be used only in emergency situations and must be started within 72 hours after a possible exposure to HIV.

Exposure can happen:

  • During sex (for example, if a condom breaks)
  • Through sharing needles, syringes or other equipment to inject drugs
  • If you've been sexually assaulted

"The sooner you start PEP, the better. Every hour counts," Menkin says. "If you can't talk with your health care provider, go to an emergency room or urgent care center."

Menkin adds that PEP is not a substitute for other HIV prevention tools like PrEP, especially for people who may be exposed to HIV frequently.

"Prevention and treatment of HIV has evolved significantly since it was first identified 40 years ago," Menkin says. "While there is still no cure, people living with HIV who get effective HIV treatment can live long, healthy lives and protect their partners. And now we have ways to prevent it as well."

Next steps:

Learn more about the LGBTQ Inclusive Care program
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Why LGBTQ+ health and inclusive care matter

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