{"id":3677,"date":"2019-07-11T10:45:58","date_gmt":"2019-07-11T14:45:58","guid":{"rendered":"https:\/\/www.med.unc.edu\/nchivtraining\/?page_id=3677"},"modified":"2019-08-25T10:57:40","modified_gmt":"2019-08-25T14:57:40","slug":"prep","status":"publish","type":"page","link":"https:\/\/www.med.unc.edu\/nchivtraining\/prep\/","title":{"rendered":"PrEP"},"content":{"rendered":"

PrEP Frequently Asked Questions (FAQs)<\/strong><\/p>\n

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Why do we need new HIV prevention tools, like PrEP? <\/a><\/div>\n
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Behavior change is very difficult, even when the stakes are high. Despite all that we know about the dangers of tobacco, millions continue to smoke. We also know that we should exercise and eat well, yet obesity is on the rise. We\u2019ve got the same struggles when it comes to HIV prevention and sexual health.<\/p>\n

Until now, adopting safer behaviors\u2014including condom use\u2014has been the only option available for people who wished to protect themselves from becoming infected. Lots of people were able to successfully change their behavior in the late 1980s and early 1990s, so much so that the rate of new infections dropped by an amazing degree. Since then, however, helping people maintain safer behaviors or getting younger people to adopt them has gotten a lot harder. In fact, more than 50,000 people are estimated to have become infected each year since the mid- to late-1990s. That\u2019s about 800,000 new infections since then. Among gay and bisexual men, new cases are actually on the rise, especially for young black and Latino men.<\/p>\n

And it\u2019s not just individual behaviors that put people at risk for HIV. There are many external factors that contribute, too. These include poverty, homophobia, racism, homelessness\u2014all of these things can significantly increase HIV risk while also contributing to significant health disparities across various racial and socio-economic groups.<\/p>\n

We desperately need new tools in order to turn things around. PrEP is a new HIV prevention strategy that puts the power of prevention in the hands of HIV-negative people. Now that PrEP has been shown to be effective in clinical trials, the next step is to determine whether and how PrEP can be used to reduce HIV infections in communities.<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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Is PrEP right for me? Who is PrEP meant for? <\/a><\/div>\n
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PrEP is not the right fit for everyone but may be useful for men, women, and transwomen who are at risk for HIV infection through sex and injecting drug use and okay with the idea of taking a daily pill to prevent HIV.<\/p>\n

If you can answer yes to any of the questions below, then PrEP may be one HIV prevention strategy to consider.<\/p>\n

\u2022 Do you use condoms sometimes or not at all?
\n\u2022 Do you often get STIs in your butt?
\n\u2022 Do you often get STIs in your vagina?
\n\u2022 Have you taken post-exposure prophylaxis (PEP)<\/a> more than once in the past year?
\n\u2022 Are you in a serodiscordant relationship, where your sexual partner is HIV positive and you are HIV negative?
\n\u2022 Are you in an open relationship or having anal and\/or vaginal sex with multiple partners?
\n\u2022 Are you having sex with someone whose HIV status you don\u2019t know?
\n\u2022 Are you having sex with someone in a city or region<\/a> where the HIV prevalence is high\u2014that is, where there are large numbers of people living with HIV?<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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I think I\u2019ve been accidently exposed to HIV; is PrEP a good option for me? <\/a><\/div>\n
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No. If you have been exposed to HIV, PrEP is not the best option for you because it is meant to reduce your risk before exposure. If you are reading this within 72 hours after exposure, consider starting PEP (short for post-exposure prophylaxis)<\/a>, a month-long course of drugs that can reduce the likelihood of infection. To access PEP, immediately contact your doctor and\/or go to the nearest emergency room. PEP must be started within 72 hours<\/strong> after exposure<\/div>\n<\/div>\n<\/div>\n
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Does PrEP protect against other sexually transmitted infections (STIs) besides HIV?<\/a><\/div>\n
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No, PrEP does not protect against other STIs. PrEP only reduces your risk of getting HIV.<\/div>\n<\/div>\n<\/div>\n
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What does taking PrEP entail? <\/a><\/div>\n
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It\u2019s not just simply taking a pill. It\u2019s taking a pill every single day, getting regularly tested for HIV and STIs, and going into your doctor\u2019s office every 2\u20133 months to get your labs checked.<\/div>\n<\/div>\n<\/div>\n
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How effective is PrEP at preventing HIV? <\/a><\/div>\n
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If taken correctly and consistently, PrEP is 92%\u201399% effective in reducing your risk for HIV.<\/div>\n<\/div>\n<\/div>\n
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What drugs are being used for PrEP? <\/a><\/div>\n
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Currently, Truvada is the only FDA-approved drug for PrEP. There are studies underway to explore other drug options.<\/div>\n<\/div>\n<\/div>\n
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How soon does PrEP become effective after you start it? How long does it take for PrEP to become protective? <\/a><\/div>\n
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It\u2019s estimated that it takes at least 7 days for PrEP to reach high levels of protection in the body. When used correctly, Truvada for PrEP provides 92%\u201399% reduction in HIV risk for HIV-negative individuals who take the pills every day as directed.<\/div>\n<\/div>\n<\/div>\n
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How often should I get tested for HIV when I start PrEP? <\/a><\/div>\n
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Before you start using PrEP, it is essential to make sure you are HIV negative; you run a small risk of developing HIV drug resistance if you are already infected with HIV when you start PrEP. That\u2019s because Truvada is not enough on its own for treating HIV; if you are already infected, the virus in your body could become resistant to the two drugs in the Truvada pill. HIV drug resistance means certain medications will no longer keep the virus in check if you are HIV-positive. For this reason, it is really important that before you start using PrEP, you get tested for HIV using an RNA test<\/a>, which looks for the actual presence of virus in your blood. During early HIV infection, it\u2019s a more reliable test than the standard antibody test, which looks for the presence of antibodies to HIV, not the virus itself.<\/p>\n

When you are using PrEP, you should get tested for HIV every three months to make sure this HIV prevention strategy is working for you.<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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How often do I have to go to the doctor when taking PrEP?<\/a><\/div>\n
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You should expect to see your doctor every 2\u20133 months for follow-up. If you are getting PrEP through a clinical trial or demonstration project, then you may see your doctor more often.<\/div>\n<\/div>\n<\/div>\n
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What happens if I contract HIV while taking PrEP? <\/a><\/div>\n
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Remember, HIV today is a manageable disease. Work with your doctor to get linked in to HIV care and start getting the treatment you need to maintain your health. Also remember that it\u2019s important to find a support system and have people you can lean on with the emotional and physical challenges ahead.<\/div>\n<\/div>\n<\/div>\n
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What happens if access to PrEP is interrupted? What if I stop taking PrEP and then start taking it again later? <\/a><\/div>\n
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If a daily dose is missed, PrEP is still effective but the level of HIV protection may decrease. It only works if you take it correctly and consistently.<\/p>\n

According to an important PrEP study among gay and bisexual men and transwomen<\/a>:<\/p>\n

\u2022 For people who take 7 PrEP pills per week, their estimated level of protection is 99%.
\n\u2022 For people who take 4 PrEP pills per week, their estimated level of protection is 96%.
\n\u2022 For people who take 2 PrEP pills per week, their estimated level of protection is 76%.<\/p>\n

There are not enough data available to provide specific timing guidance on non-daily use, so the FDA recommends PrEP be used daily to achieve the highest level of protection.<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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What about side effects from taking Truvada for PrEP? How will my body be affected? <\/a><\/div>\n
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For the first few weeks of starting Truvada for PrEP, some people complain about nausea, vomiting, fatigue, and dizziness, with these minor symptoms eventually resolving themselves over time.<\/p>\n

Some people in clinical trials had elevations in blood tests that looked at kidney function. With this particular side effect, there were no physical symptoms, so it is important to remember that if you take PrEP, you need to get routinely checked by your doctor to make sure your kidneys are working properly.<\/p>\n

Some people in studies had a decrease in bone mineral density within the first month. However, but these changes were small, did not progress over time, and did not increase risk for fracture. Once Truvada was stopped, the bone mineral density returned to normal.<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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What about the chance of HIV developing drug resistance to Truvada for PrEP? <\/a><\/div>\n
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Before you start using PrEP, it is very important to make sure that you are HIV-negative because you run the small risk of developing HIV drug resistance if you are already infected with HIV when starting PrEP. That\u2019s because Truvada is not sufficient on its own for treating HIV; so if you are already infected, the virus in your body could become resistant to that drug. To develop HIV drug resistance means certain medications will no longer keep the virus in check if you are HIV-positive.<\/div>\n<\/div>\n<\/div>\n
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I have private health insurance. Will my health insurance coverage cover PrEP? <\/a><\/div>\n
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To date, we have not heard any reports of health insurance companies denying requests to fill prescriptions for PrEP in the United States. Some health insurance companies have pre-authorization requirements to determine if you are eligible to have it covered under insurance. This doesn\u2019t necessarily mean that your particular plan will cover it\u2014we can\u2019t guarantee that! However, reports indicate that most people have no trouble getting their private healthcare insurance to cover PrEP.<\/p>\n

My PrEP Experience<\/a> has a wonderful resource monitoring insurance and Medicaid coverage of Truvada for PrEP. If you have trouble getting a prescription for Truvada as PrEP, or getting a PrEP prescription covered by insurance or Medicaid, please send an email to myprepexperience@gmail.com<\/a>.<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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I have private health insurance. My insurance coverage charges me a high co-pay for Truvada. Is there any way I can get assistance to help cover my co-pay? <\/a><\/div>\n
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Yes! Gilead\u2019s co-pay assistance program<\/a> is specifically set-up for this purpose and can help those eligible cover the cost of co-pays. Contact Gilead for more information and to find out if you are eligible.<\/p>\n

My PrEP Experience<\/a> has a wonderful resource monitoring insurance and Medicaid coverage of Truvada for PrEP. If you have trouble getting a prescription for Truvada as PrEP, or getting a PrEP prescription covered by insurance or Medicaid or Gilead, please send an email to myprepexperience@gmail.com<\/a>.<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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I have private health insurance but is there a way that I can get PrEP for free? <\/a><\/div>\n
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There are many clinical studies and demonstration projects happening across the country where you can get PrEP for free. The non-profit organization AVAC has a compiled an up-to-date, searchable list of all ongoing PrEP studies here<\/a>.<\/div>\n
<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

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