Since the early 1990s, a lot has changed regarding protection methods and treatment therapies for HIV/AIDS. Today, people can live longer, fuller lives.
One preventive medication, pre-exposure prophylaxis (PrEP), also known by its brand name Truvada, is helping in the fight against the disease. According to the Centers for Disease Control and Prevention, studies have shown that PrEP used along with safe sex practices can reduce the risk of contracting HIV from sex by about 99%. For those who inject drugs, it reduces the risk by 74%.
But the pill isn’t a perfect solution. There are financial limitations and a lack of education and awareness for communities at the greatest risk. Randy S. Gelow, MD, a family medicine physician at Banner Health Center who specializes in HIV specialty care, explains the use of PrEP.
What is PrEP?
The combination drug emtricitabine-tenofovir (Truvada) is a once-a-day pill taken to prevent HIV for those who are at very high risk of becoming infected. Having PrEP in your bloodstream can stop HIV from taking hold and spreading.
“Even though this drug has been around since 2004, a lot of people are still learning about it,” Dr. Gelow said. “There is no denying the effectiveness of the drug preventing an HIV infection. We just need to get the word out to more communities who are at higher risk.”
Who Is at the Greatest Risk?
“Although Latino and African American MSM (men who have sex with men) and trans females are at greatest risk, PrEP is for people who don’t have HIV, and are at higher risk for getting HIV, not just MSM,” Dr. Gelow said. This includes anyone who:
- Has recently had a sexually transmitted disease
- Doesn’t regularly use condoms
- Has an HIV-positive partner
- Has anal or vaginal sex with many partners, especially if you don’t use protection
- Has injected drugs, shared needles or been in treatment for drug use
Dr. Gelow added, “It’s so important the pills are taken every day. And, it doesn’t prevent other sexually transmitted infections, so you want to make sure you’re still using condoms and getting tested often.”
Why Do People Choose Not to Take It?
There are some stigmas and fears surrounding the use of PrEP. According to a 2017 study, MSM and transgender women felt taking the drug meant they’d admit to being irresponsible or promiscuous, but that stigma differed according to race. Another stigma was that people who take PrEP are actually HIV-positive and lying about their status. Dr. Gelow says the CDC and other advocacy groups are working hard to change perceptions of the drug and increase awareness and adherence to using PrEP.
How Can I Start PrEP?
It’s important to speak with your primary care provider (PCP), so they can answer any questions you may have about PrEP and work to find the right HIV prevention strategy for you. You must take the pill every day to ensure it works, and regularly follow up with your doctor. You’ll also get tested for HIV, Hepatitis B as well as other STIs, like gonorrhea, chlamydia and syphilis, depending on your risk.
If you’re having challenges getting access to the medication, you still have options, Dr. Gelow says. “Some nurses and doctors don’t know about PrEP, or they don’t prescribe it because they don’t know the facts. You can always go to your local Planned Parenthood,” he said. Another option is to visit www.preplocator.org to locate one in your area.
Is It Covered by Insurance?
Most private plans cover PrEP. You may be able to receive co-pay assistance through Patient Advocacy Foundation or through Gilead, the manufacturer of the drug.
If you are on Medicare, Dr. Gelow says to check with your benefits counselor. If you are without insurance, consider enrolling in an insurance marketplace, your state’s Medicaid plan or through a patient assistance program, such as the Southwest Center in Phoenix. There are many ways to get access to this important medicine. Set an appointment with a Banner physician to discuss your options and make a plan.