PrEP and PEP

Written By ProjectSTAY Admin

What is PrEP?

PrEP stands for “Pre-Exposure Prophylaxis,” and refers to medication taken to prevent getting HIV (human immunodeficiency virus). HIV is typically transmitted through sex or drug use, both of which often involve exchanging bodily fluids. The fluids that can transmit HIV are: blood, semen (cum), pre-seminal fluids (pre-cum), rectal fluids (different from feces), vaginal fluids, and breast milk. Taking PrEP as prescribed reduces HIV transmission from sex by 99% and from drug use by at least 74%.

Four things to know about PrEP

  • PrEP is for everyone: PrEP is approved for all adults regardless of sex and gender, and is approved for adolescents weighing over 77 pounds.

  • PrEP is safe: short-term side effects of PrEP may include diarrhea, fatigue, and nausea, but these generally go away over time.

  • PrEP is effective: consistent daily use of PrEP has been shown to reduce the risk of sex-based HIV transmission by 99%.

  • PrEP is affordable: Most insurance plans and state Medicaid (including New York) cover PrEP, and there are a number of PrEP coverage programs such as “Ready, Set, PrEP” and “ViiVConnect.”

Types of PrEP

  • PrEP Pills

    PrEP can be taken orally as a daily pill. Truvada ® (and its generic equivalent tenofovir disoproxil fumarate + emtricitabine) is approved for all people, while Descovy ® (and its generic equivalent) has not been approved for people assigned female at birth. PrEP pills require a visit to your provider every three months.

  • PrEP Shots

    PrEP can also be taken as a shot, taken once every two months. Apretude ® has been approved for all people.

  • “Vacation” PrEP

    PrEP can also be taken on-demand, which is also called “vacation PrEP.” On-demand PrEP has only been approved for cisgender gay and bisexual men engaging in anal sex. It has not been approved yet for transgender people and people engaging in vaginal sex.

 

What is PEP?

PEP stands for Post-Exposure Prophylaxis, and refers to a 28-day program of antiretroviral medication given to prevent HIV after a high-risk exposure, such as unprotected sex with a partner whose HIV or PrEP status is unclear. HIV is known to infect the host rapidly, often within 24 to 36 hours after exposure, so it is recommended that patients take PEP as soon as possible. At the latest, PEP must be taken within 72 hours after exposure. When taken correctly and in time, PEP has an estimated efficacy of over 90%.

To see if PEP is the right option for you, you can consult the following flowchart provided by the CDC, which also defines high-risk scenarios.

If the following fluids —blood, semen, vaginal fluids, rectal fluids, breast milk, or any liquid contaminated with these fluids— come into contact with the following body parts —vagina, rectum, eye, mouth, or other mucous membrane (such as nose or urethra)— then that could constitute a high-risk exposure, given that the HIV status of the source is known to be positive.

The most common PEP regimen is:

1) tenofovir disoproxil fumarate (TDF)(300 mg) + emtricitabine (F)(200 mg) once daily

+

2) raltegravir (RAL)(400 mg) twice daily or dolutegravir (DTG)(50 mg) once daily

This regimen is equivalent to taking one Truvada pill with one extra pill a day for 28 days.

Source: The Center for Disease Control

ProjectSTAY Admin
Next

Hormone Replacement Therapy