PrEP Can Decrease the Odds of Getting HIV Through Sex by 99%
Up until 2012, there was only one way to protect yourself from acquiring the Human Immunodeficiency Virus (HIV) from sex: wearing condoms. While condoms are still a great preventive tool, there’s actually another incredibly effective method you can use to significantly decrease your chances of getting HIV. It’s called pre-exposure prophylaxis, or PrEP.
What is PrEP, exactly?
PrEP is a daily HIV-prevention pill that decreases the likelihood of acquiring HIV from sex by 99% and by 74% among people who inject drugs, according to the Centers for Disease Control and Prevention (CDC). Currently, there are two forms of FDA-approved PrEP available in the United States: Truvada and Descovy, both of which were developed by the pharmaceutical company Gilead.
Truvada is a once-a-day oral pill that’s been FDA-approved as a form of PrEP since 2012. It combines two medications: Emtriva (also called emtricitabine or FTC) and Viread (also called tenofovir disoproxil fumarate or TDF), according to the FDA. Together, these medications stop the HIV virus from taking hold and spreading throughout the body. It also blocks an enzyme called HIV reverse transcriptase. When the enzyme is blocked, HIV can’t copy and reproduce its cells in the body.
The drugs found in Descovy are similar to what’s in Truvada, and the two Gilead medications work in the same way. However, there are two significant differences between the products: the potential side effects (research indicates that Descovy may have fewer) and who can take each drug. While the FDA’s approval allows for people of all genders to take Truvada, the agency has only approved Descovy for cisgender men and transgender women. More research is needed to ensure Descovy is equally effective in preventing HIV among people who have vaginas.
Who should consider taking PrEP?
The CDC notes that PrEP is for HIV-negative people who are at a high risk of getting HIV from sex or injection drug use, including people who:
Have an ongoing sexual relationship with an HIV-positive partner
Are gay or bisexual and have had anal sex without using a condom in the past six months
Have been diagnosed with an STI in the past six months
Have injected drugs in the past six months
Are heterosexual and do not regularly use condoms with partners of unknown HIV status
Do not regularly use condoms with partners who are at substantial risk for HIV infection
What are the side effects of PrEP?
While few people experience adverse effects from taking PrEP, side effects vary between the two medications, and everyone responds differently.
Truvada
Nausea, headaches, weight loss, and potential damage to the kidneys are all possible side effects for folks who take Truvada. Additionally, bone density can be affected by the drug, which can increase the risk of osteoporosis, according to Mayo Clinic.
Per the recommendation of the CDC, providers are instructed to test Truvada patients’ renal function before they start taking the drug and at least every six months to make sure their kidneys aren’t being damaged. In the vast majority of patients who do experience kidney harm, the damage is reversible, according to a Journal of Acquired Immune Deficiency Syndrome study. In fact, 96% of participants who saw a decrease in renal function had a rebound of at least 75% eight weeks after discontinuing Truvada.
Descovy
As for Descovy, early studies indicate that the drug may have fewer side effects than Truvada. According to research, Descovy may have less of a negative impact on bone density and kidney function, for example. However, more studies must be conducted to know for certain.
Diarrhea, nausea, fatigue, and stomach pain are common side effects of Descovy. And people who take Descovy may be at a higher risk of obesity and cardiovascular issues than people taking Truvada, according to research.
Misconceptions about PrEP
There are misunderstandings, miscommunication, and misinformation about PrEP that discourage people who are at a high risk for contracting HIV from taking the drug, says Perry Halkitis, Ph.D., M.P.H., the dean of the Rutgers School of Public Health.
While conducting HIV-related research on 492 young gay and bisexual men, Halkitis and his team discovered that nearly every study participant knew about PrEP. But very few—only 14%—had actually taken it. “We learned that young gay and bisexual men don’t have a complete trust in the medication working effectively,” Halkitis says.
Another big misconception is that condoms are no longer needed if you’re taking PrEP, says Marguerita Lightfoot, Ph.D., the director of the Center for AIDS Prevention Studies (CAPS). The thing is, PrEP only protects against HIV. It doesn’t protect against any other sexually transmitted infections, including gonorrhea, chlamydia, syphilis, and genital herpes. Condoms are still the best method to avoid contracting those other infections and viruses.
The third major misconception Lightfoot points out is that PrEP is unaffordable if you don’t have insurance. It’s true that if your insurance doesn’t cover PrEP, or you don’t have insurance, PrEP can cost hundreds of dollars a month. But there are programs you can enroll in that can significantly reduce that price or even make it possible to obtain PrEP for free.
Gilead has a co-pay program for people in the United States, Lightfoot explains. Gilead’s Advancing Access program can help you get access to PrEP whether you are insured, uninsured, or underinsured. For example, Gilead’s co-pay coupon card covers up to $7,200 in co-pays per year, which could mean you’d pay as little as $0 for PrEP. For more information on the Advancing Access program, you can head to Gilead’s info page for it. And if you want to apply to the program (it only takes about 10 minutes), you can do so online here.
Lightfoot also notes that there may be other programs, depending on where you live, that can make PrEP more affordable and accessible. To find out what’s available in your area, check out Emory University’s PrEP Locator, which allows you to search for providers who prescribe PrEP in your area, as well as filter by “PrEP for uninsured.”
If you’re someone who’s at a high risk of contracting HIV or otherwise thinks you could benefit from being on PrEP, discuss it with a healthcare provider. And remember, there are a few different ways you can get PrEP even if you don’t have insurance.
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