Be PrEP-ared: The HIV Prevention Option You Need to Know About
It's Pride Month, which means the hot days of summer are upon us! And now that "outside" is a thing again, beach vacations, Mimosa's on the patio, and carefree summer love may even be on your radar. As you ease your way back into the dating pool, steamy days and sultry summer nights provide the perfect backdrop to find your Mr. or Ms. Right or hell, Mr. or Ms. Right now! But, while summer flings can be exciting and passionate, nothing kills the mood more than not having a foolproof plan, like getting started on PrEP- an HIV pre-exposure prophylaxis. So, before you jump into an uncomplicated, no-strings-attached "hook up," here is everything you need to know about PrEP.
What is PrEP?
You may be a PrEp expert (yay!), or this information could be totally new so let's start with the basics. PrEP can reduce your risk of getting HIV through sexual contact by about 99 percent when taken as prescribed. These wonder drugs provide maximum protection against HIV in about seven days if you engage in receptive anal (bottoming) sex and about 21 days if you participate in receptive vaginal sex or injection drug use. Researchers still don't know how well PrEP protects against HIV during insertive anal sex (topping) or insertive vaginal sex, so do what you can (i.e., use condoms) to protect your health.
Are There Different Types of PrEP?
Yes! The good news is that you have a few options to get started on PrEP. Truvada is a once-a-day prescription tablet available for anyone at higher risk of contracting HIV through sex or injection drug use.
Descovy is another pill that protects against HIV. But it shouldn't be used by people assigned females at birth who participate in vaginal sex since researchers have not yet studied its effectiveness in this population.
If pills aren't your thing, there's still an option for you. The Food and Drug Administration recently approved the first injectable form of PrEP (Apretude), first given two shots one month apart. After your first two doses, you can expect to receive your shots every two months.
Who Should Use PrEP?
PrEP is available to anyone who is not living with HIV. And the number of PrEP users over the age of 16 has steadily increased in recent years. But it's still underused in populations who could most benefit from this drug regimen.
For example, transgender women (assigned male gender at birth and identifying as female) represented 84 percent of transgender people infected with HIV between 2009 and 2014. But only 32 percent of transgender women used PrEP, citing barriers like medical mistrust and concerns about drug interactions between gender-affirming hormones and PrEP as described in the 2019-2020 National HIV Behavioral Surveillance, 7 U.S. Cities report.
These reservations are understandable, but a 2021 study published in Clinical Infectious Disease found that PrEP use didn't impact gender-affirming hormones. Researchers also found that gender-affirming hormones didn't impact PrEP concentration as participants exhibited levels high enough to achieve protection against HIV.
Despite the known benefits of PrEP, evidence indicates PrEP use among black men who have sex with men is low. A 2021 study of HIV-negative men who have sex with men in Atlanta, Detroit, and New York City found that 61.2 percent of participants had never used PrEP. Participants expressed concerns about product safety, cost, and availability.
Undoubtedly, more work must be done to reduce the structural barriers that impede consistent PrEP use among communities that HIV greatly impacts.
How Does PrEP Work?
Before starting PrEP, you'll be tested for HIV to ensure you're eligible for the regimen since HIV-negative people can only take PrEP.
Your healthcare provider will give you Truvada or Descovy pills to take by mouth once a day. Taking your medicine daily ensures maximum effectiveness and that you have the right amount of the drug in your body to protect you from HIV. Don't stop taking your medicine without talking to your doctor. Also, contact your provider when your medication starts to run low so you can get a refill.
If you miss a dose, take it as soon as you remember but don't take a double dose of your medicine to make up for a missed one.
Initially, when you start injectable PrEP, your health care provider may have you take the pill version of the medicine once a day for a month to measure your tolerance of the medicine before switching you over to the shots. Then, you'll receive one shot of Apretude (injectable PrEP) for two consecutive months. You can expect to get your follow-up injections every two months.
Being on PrEP provides excellent protection against HIV. But, it doesn't protect you from other sexually transmitted infections like chlamydia, gonorrhea, or syphilis, so consider using a condom and getting tested for STIs regularly.
So How Do I Get PrEP?
If you think PrEP is right for you and want to get started, talk to your health care provider about a prescription. If you're opting for injectable PrEP, schedule an appointment to see your doctor since the shots can only be given during office appointments. You can expect to visit your provider every two to three months while on PrEP for follow-up visits, HIV testing, prescription refills, and your injection (if you opt for the shot).
If you don't have a regular healthcare provider or are between doctors, visit your local HIV/AIDS organizations or health departments to access PrEP services.
Are There Any Side Effects of PrEP?
Like any other medications, when starting oral PrEP, you may experience side effects like:
● Stomach trouble
● Headaches
● Vomiting
● Loss of appetite
These side effects usually lessen during the first month of use. Tell your doctor if any of these symptoms are severe or do not go away.
You may also experience side effects from injectable PrEP, like:
● Reaction at the injection site
● Headache
● Fever
● Fatigue
● Back pain
● Muscle aches
● Rash
Call your doctor immediately if you have any unusual problems while taking your medicine.
Is PrEP Affordable?
The good news is that most private insurance plans and state Medicaid programs cover the fees associated with PrEP. And other programs provide PrEP for free or at a reduced cost. These include:
Ready, Set, PrEP This program covers the cost of the medicine if you don't have insurance. The cost of clinic visits and lab tests will vary depending on your income.
Co-pay assistance programs The makers of Truvada- Gilead Sciences assist in lowering the costs associated with PrEP medications.
State PrEP assistance programs Some states have programs to cover the cost of the medicine, some cover the cost of clinical visits and lab costs, and others cover all associated costs.
Be PrEP-ared
Pride month starts a season of outdoor concerts, street festivals, and finding your possible love match. And making sure your dating plans include PrEP can give you that boost of confidence you need to keep sparks flying all summer long.
June is Pride Month, and a significant part of Lala's Bedtime Tales mission is to provide a safe space and judgment-free zone to educate yourself on sexual health & wellness. The Sexual Health & Wellness corner will have monthly articles dedicated to continuous education on living a positive and sexually healthy lifestyle. Subscribe to Lala's Bedtime Tales Newsletter and follow @LalasBedtimeTales on social media to never miss any sexual education to help you live the healthiest life possible. Also, check out the Lala's Bedtime Tales Podcast and Lala's Oh So Exclusive Patreon account for even more content!
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