Pre-Exposure Prophylaxis (PrEP)

Overview

What is PrEP?

PrEP is short for Pre-Exposure Prophylaxis. Prophylaxis means the prevention of a disease. If you are HIV-negative but are at risk of HIV exposure, PrEP reduces your risk for becoming infected. PrEP can help protect you from getting HIV when you use it in combination with risk-reduction practices, like wearing condoms. PrEP gives you an option to minimize your risk of getting HIV.

To participate in PrEP, you take a prescription pill called Truvada once a day. Truvada reduces your risk for infection by minimizing the virus’s ability to make copies of itself in your body. Taking Truvada every day as prescribed while practicing safer sex has been shown to reduce risk for infection by more than 90 percent.

About Truvada

Truvada is an antiviral medication that consists of two medications (tenofovir and emtricitabine) in one tablet that you take once per day. It was approved by the Food and Drug Administration (FDA) for PrEP in July 2012 and has been used for HIV treatment since 2004.

Truvada is the only FDA-approved option, in combination with safer sex practices, that has been shown to reduce the risk of HIV. Truvada is not intended to be taken throughout your life. You only need to take it during periods of your life when you are at risk of getting HIV. People who take Truvada may experience mild or temporary side effects, if they experience any side effects at all.

Cost of PrEP

Truvada can be expensive; however, Gilead, the manufacturer of Truvada, has a patient assistance program available if you need help paying for the medication. Most health insurance plans also cover Truvada. Additionally, IU Health LifeCare may be able to help you find financial assistance if you meet certain financial criteria.

What to Expect

PrEP may not be for everyone. PrEP only protects against those who are HIV- and not other STDs or pregnancy. Patients on PrEP must take Truvada every day as prescribed and participate in regular follow-up appointments.

• You must be committed to taking your medicine every single day.
• You must come to an appointment every three months.
• At appointments, you must get lab tests, an HIV test and a urine pregnancy test, if applicable.

If you do not satisfy these requirements, you will not be able to access medication refills.

If you are being evaluated for PrEP, you can expect the following:

Before Starting PrEP

Certain tests are needed to check for PrEP eligibility, including:

• HIV testing
• Pregnancy testing and check for breastfeeding, if applicable
• Assessing kidney function
• Screening for sexually transmitted infections and hepatitis
• Checking for acute or recent viral infection

Beginning PrEP

After an initial work-up is completed and you are eligible for PrEP, you receive:

• Up to a 90-day prescription for Truvada
• Medication counseling
• Risk-reduction counseling

While taking PrEP

You will have a follow-up appointment every two to three months. Clinic visits include:

• HIV testing
• Pregnancy testing, if applicable
• Assessing kidney function
• Screening for sexually transmitted infections and hepatitis
• Renewing prescriptions if you are HIV-negative
• Risk-reduction counseling

Potential Risks & Side Effects

While most patients who decide to take Truvada experience few to no side effects, you may have nausea in the first one to two weeks. Other, less common side effects include decreased bone density (weaker bones) and liver or kidney damage.

If you become infected with HIV while taking Truvada, it may not work as an effective HIV treatment. You may need to take other medications to treat HIV infection.

Pregnant women usually do not experience problems with Truvada, and there is no known increased chance of birth defects among women who become pregnant or breastfeed while taking this medication. However, you and your doctor can discuss whether you should continue taking Truvada if you become pregnant, plan to become pregnant or are breastfeeding.