There are approved pills and shots that have been developed to prevent transmission of HIV to people who do not carry the virus.
While condoms are a generally reliable method of protection, these medicines may add to (or in some cases replace) the use of condoms.
HIV PrEP is for use prior to exposure to HIV.
HIV PEP is for use after an event with possible exposure to HIV.
What about HIV PrEP (pre-exposure prophylaxis or prevention) - available medications
- Pre-exposure prophylaxis (or PrEP) is taking a medicine before a sexual exposure to prevent getting HIV. There are some methods of PrEP that have been shown to be highly effective for preventing HIV.
- HIV PrEP pills Reduce the risk of getting HIV from sex by about 99%.
- Reduce the risk of getting HIV from injection drug use by 74%.
- Note: PrEP is less effective when not taken as directed. Approved PrEP for people with HIGH FREQUENCY EXPOSURE: Four medications have proven effectiveness in preventing HIV infection when taken regularly. 1 & 2 (pills) Truvada® (now also available as a generic equivalent- emtricitabine & tenofovir disoproxil fumarate )
- a very similar medicine- Descovy® (emtricitabine & tenofovir alafenamide (only available as the brand name version).
- These pills are taken daily for protection for people with high frequency of exposure.
- Another plan for people with LOW FREQUENCY OF EXPOSURE:
- From the CDC- Taking PrEP pills only when you are at risk for getting HIV is known as “on-demand” PrEP. Other names for it include “intermittent,” “non-daily,” “event-driven,” and “off-label” PrEP use.
- The on-demand PrEP with the most data is referred to as 2-1-1 PrEP. There is growing evidence that this 2-1-1 schedule of medicine provides effective protection for gay and bisexual men who have anal sex without a condom. A Canadian/French study showed it was 86% protective.
- 2-1-1-uses the same two pills listed above (Truvada or Descovy) but with different doses.
- Dosing - take 2 tablets prior to sex (ie - when planning or likely to have an encounter). Then if you "get lucky" take another 1 tablet 24 hours after the first double dose and the final 1 tablet again 48 hours after the first double dose.
- *Doc Lee's Opinion
- Both of these preventive pills have been shown to be very effective (about 99%) when they are taken like birth control- that is every day (just in case) or still fairly effective (but not as protective) if they are used infrequently as 2-1-1. The studies have shown It is very important to be tested for Hepatitis B prior to trying these medicines because they may impact Hepatitis B infection.
- Differences-
- Truvada is an older and now generic medicine (ie cheaper). It is not quite as "clean" as the newer Descovy and has a greater association with side effects.
- Side effect studies:
- Studies that looked at the potential side effects-
- 5387 participants
- Bone Density Changes-
- after 96 weeks 4% taking Descovy versus 16% taking Truvada
- after
- Out of 5387 study participants, three people taking TAF/emtricitabine experienced a serious adverse event and five people taking TDF/emtricitabine did.
- After 96 weeks, 4% taking TAF/emtricitabine and 16% taking TDF/emtricitabine had a 5% or greater drop in spine bone mass density.
- Two people out of 2694 people taking TAF/emtricitabine stopped treatment because of kidney function while six people out of 2693 taking TDF/emtricitabine stopped.
- Cholesterol levels reduced in both groups, and slightly more so with TDF/emtricitabine.
- Those taking TAF/emtricitabine gained a median of 1.7kg of body weight while those taking TDF/emtricitabine gained a median of 0.5kg.
- 3:
- Apretude® (cabotegravir) shots are given every other month by a healthcare provider after 2 initiation injections 1 month apart The reported study in men showed that only 12 out of 2,278 people (less than 1%) became HIV infected during the three years of the study compared to 3 times that number of infections in the comparative study arm that was supposed to be using the daily pills. The shot is also effective in preventing HIV infections, particularly for people who may not take the pills regularly. (FYI the shots are fairly large)
Prevention of sexual Infections
If you believe you may have been exposed to HIV, or other infections, please call right away. The Doc Shop (913-362-0220) offers same-day or next-day treatment.
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More Effective than Chill Pills...
If you are worried you may have been exposed to a sexually transmitted infection because you found your partner has symptoms or an infection after the f(Act) :
Gonorrhea or Chlamydia (drip, drip - discharge, burning)
or
Syphilis - rash or painless open sore (chancre) on genitals, mouth or face.
You may want to use an after-exposure (Post-Exposure-Prophylaxis) treatment-
A study reported in August 2022 showed taking a common antibiotic for a short time as soon as possible after sexual exposure to bacterial infections (STI's) appears to be effective in reducing the likelihood of transmission of gonorrhea, chlamydia and syphilis.
*Doc Lee's Opinion on (post-exposure prophylaxis or PEP) The studies on this preventive treatment for bacterial infections are not definitive. This study showed the use of 200 mg of doxycycline within at most 72 hours after exposure reduced the overall incidence of STIs by half. This study included 554 Men who have sex with men. Infections occurred in 10.3% of doxy recipients and 29% of the placebo (no treatment) group. Initially it looks like the medicines reduce infections by about half. Protection appears to work best for gonorrhea, followed by chlamydia and syphilis.
*Doc Lee's Opinion on (post-exposure prophylaxis or PEP) The studies on this preventive treatment for bacterial infections are not definitive. This study showed the use of 200 mg of doxycycline within at most 72 hours after exposure reduced the overall incidence of STIs by half. This study included 554 Men who have sex with men. Infections occurred in 10.3% of doxy recipients and 29% of the placebo (no treatment) group. Initially it looks like the medicines reduce infections by about half. Protection appears to work best for gonorrhea, followed by chlamydia and syphilis.
Please call the Doc Shop right away if you believe you have been exposed to any sexually transmitted disease. We will help you sort your risks and determine the best options for prevention or treatment. Call 913-362-0220.