Is PrEP Right for You?
PrEP is not for everyone. However, if you’re HIV-negative and at risk of getting HIV, then PrEP might be right for you. Here are some questions to consider:
Is your main sex partner HIV-positive?
Have you had sex without a condom (bareback sex) recently?
Have you had an STD recently, such as gonorrhea, chlamydia or syphilis?
Are you having sex with people whose HIV status you don’t know?
Are you having sex with multiple partners?
Have you used post-exposure prophylaxis (PEP) in the past year?
Do you or your sex partner(s) use alcohol and/or drugs when having sex?
Do you or your sex partner(s) exchange sex for money, housing, drugs, alcohol or other needs?
Has anyone ever threatened or forced you to have sex against your will?
If you answered “yes” to any of these, then you are likely a good candidate for PrEP.
What Is PrEP?
PrEP is a way for people who don’t have HIV to help prevent HIV infection by taking a pill every day. PrEP stands for “pre-exposure prophylaxis,” which means the pill protects you before you get exposed to HIV and keeps the virus from finding a home in your body. Truvada is the medication that is currently used for PrEP, and it has been used, together with other medications, to treat people living with HIV for many years. PrEP is not a cure for HIV and it does not keep you from getting other sexually transmitted diseases (STDs) such as gonorrhea, chlamydia, herpes, warts, and syphilis. Condoms are still the best way to avoid catching other STDs.
There is another treatment you can take after a potential exposure to HIV—such as sex without a condom—called PEP. PEP stands for “post-exposure prophylaxis.” If you think you have been exposed to HIV and you are not on PrEP, call us or come to the health center immediately and ask us about PEP. PEP works best if you take it as soon as possible after the exposure, but definitely within 72 hours of when you think you were exposed and it must be taken for 28 days. We can tell you how to get PrEP or PEP at 323-536-1083.
Does PrEP Work?
PrEP can be 99% effective at preventing HIV infection if it is taken every day, seven days a week. When you start taking Truvada, you need to take it for at least five days in a row before you are protected for rectal exposures. (Protection for vaginal exposures may take up to 21 days.) After you start taking Truvada, you should take the pill every day. If you don’t take the pill every day, you will be less protected. We do not recommend only taking Truvada when you plan to have sex.
Does PrEP Have Side Effects?
Most people who are on PrEP don’t have any side effects. Some people have minor side effects, such as nausea, headaches, or weight loss, but they usually go away after a few weeks. A few people have more serious side effects affecting their bones and kidneys. A provider will do tests while you are on PrEP to find out if you are experiencing these problems.
How Do I Get PrEP?
If you think PrEP might be right for you, make an appointment with us. We will be able to answer your questions and help you make a decision about whether or not you should start PrEP. Be honest with your medical provider about your current sexual activity and level of HIV risk. Never take Truvada without first talking to a medical provider. If you talk to a doctor in another health center or clinic about PrEP and they won’t prescribe it to you, ask for a referral to an HIV specialist or another doctor who might be able to help you. If you are having problems and need to talk to someone about a referral, call us at 323-536-1083.
What Should I Expect If I Start Taking PrEP?
Before a provider gives you PrEP, you will be required to take an HIV test to make sure you’re HIV-negative. You will also be required to take tests for hepatitis B, kidney function, and other STDs. After you start taking PrEP, you should take the pill every day.
In the BTAN LA network, you will see a provider every month for the first three months for routine testing. These tests will make sure you continue to be HIV-negative and check for any side effects or STDs. Our providers will also want to continue talking with you about your sexual activity and level of HIV risk. We will not refill your next prescription until your HIV testing is done and it comes back negative, so don’t wait until the last minute to get your blood work done.
PrEP may only make sense for you at different points in your life—for example, when you are in a relationship with a partner who is HIV-positive or when you are having sex without condoms with partners whose HIV status you don’t know. You can stop taking PrEP if your level of risk changes. It’s important to talk with a doctor when stopping or starting PrEP.
Can I Still Get HIV If Take PrEP?
When taken as prescribed, seven days per week, PrEP is extremely effective at preventing HIV. When you miss a dose, the protection from PrEP is lower. People have contracted HIV when being inconsistent with PrEP or after stopping PrEP. No HIV prevention method is perfect and regular HIV testing and using more than one prevention method (such as condoms and PrEP) is always the safest method of protection.
Regular HIV testing is a critical part of taking PrEP. Therefore, it is particularly important to make sure you don’t start or continue to take PrEP if you think you’re already having symptoms that could be your body acquiring HIV such as fatigue, fever, rash, sores in the mouth or genitals, and enlarged lymph glands. Truvada is not enough to treat HIV once it’s in the body, and can lead to virus resistant to the medications in Truvada, making that HIV harder to treat. If you have any questions or concerns, you should speak with our medical providers immediately.
How Much Does PrEP Cost?
Most people can access PrEP at little or no cost. PrEP is covered by all health insurance companies in California, including Medi-Cal. Although you be required to pay a certain amount (known as a co-pay), you can get help paying for PrEP through a patient assistance program. If you do not have health insurance, call 323-536-1083 for assistance enrolling in a plan.