If you are part of the LGBT (lesbian, bi, gay, trans) community and have any social media, you have surely seen posts about PrEP. If you are straight, there is a good chance that you’ve never heard of PrEP. However, that doesn’t mean you should stop reading. Being straight, you most likely haven’t heard of PrEP because in the United States HIV/AIDS is still largely viewed as a “gay problem.” Although the highest transmission rates of HIV in the U.S. does happen to be between men who have sex with men, that doesn’t mean that you are not at risk. The posts I see on my social media account are generally split between “everyone needs to go on this” and “no one should be on this.” So, here are some common questions and facts.
What is PrEP?
PrEP (Pre-Exposure Prophylaxis), brand name Truvada (a mix of emtricitabine and tenofovoir disproxil fumarate), is a blue pill taken once a day to protect against HIV infection.
Is PrEP the same as PEP?
No, PrEP is a pill that you take every day and PEP (Post-Exposure Prophylaxis) is a series of pills taken for 28 days (and within 72 hours of potential exposure).
Is PrEP safe?
Both the Centers for Disease Control and Prevention (CDC) and the United States Food and Drug Administration (USFDA) approved PrEP in 2012. Approval of PrEP was specified as in addition to safe sex practices (as in, don’t stop using condoms).
What are the side effects?
In clinical trials, the most common side effect was nausea, which dissipated after a few days to a few weeks. Do we know the possible long term effects; no- the drug simply hasn’t been around long enough. This is true for essentially any new prescription drug.
Does PrEP work?
Research has shown that PrEP maybe be as high as 99% effective in the prevention of HIV when taken daily. you’ve seen conflicting advertisements that say this isn’t the case? In clinical trials, there were trials in which the efficacy was much lower. However, continued analysis of these participants looked at biomarkers (hair or blood samples) which revealed that these participants had very low (if any) levels of the drug in their bodies. In short, it is concluded that those participants were not taking the drug regularly.
Does PrEP protect against anything else?
PrEP only protects against HIV. It does not protect against HPV, herpes, chlamydia, gonorrhea, etc.
Is it true that PrEP is causing a rise in STI rates?
It is true that in the last year we saw a rise in STI rates across the U.S. However, at MOST, there are currently 30,000 PrEP subscribers nationwide. In order for PrEP to have affected the rates, all of these subscribers would have had to contract multiple STI’s over and over and over again, and get them treated. Most likely, STI rates have risen because funding for programs like Planned Parenthood have been cut and people are losing resources for getting tested and treated, which increases the spread rate. Also, abstinence only education has shown to make STI rates rise- there is no way to stop people from having sex, they need to be taught how to protect themselves. Is it possible that PrEP may play a role in rising STI rates in the future? Only time will tell.
Isn’t everyone just using PrEP as an excuse to have condomless sex?
This is probably the mostly highly debated question around PrEP. Anecdotally, I have heard multiple people make comments about not needing condoms now because they are on PrEP. However, no research has yet been able to adequately support this claim. What research has shown us, this far, is that safer sex practices do not seem to change when someone goes on PrEP. In other words, if someone initially had inconsistent condom use, they continue to and likewise, if someone always used condoms, they continue to. May take on this is that if someone says, “we don’t need condoms, I’m on PrEP,” doesn’t mean that they stopped using condoms because they are on PrEP- it means they didn’t use them all the time to begin with. But, that is my own opinion- it’s possible they did use condoms before and stopped. Again, this is not the end of the story. There are currently multiple research studies ongoing which are examining this. Again, the drug has not been available long enough for us to really know what the long term impact will be.
Who is PrEP for?
Well, technically, PrEP can be prescribed to anyone. It is recommended for those who are at high risk of HIV acquisition. Who’s at high risk? Because of the high rate of transmission in the gay, bi, trans community, it has been argued that all of these people should be on PrEP. It is also argued that only those who are in serodiscordant relationships (one HIV-negative and one HIV-positive) should be on PrEP, sex workers, or/and those who have multiple sex partners. What does that really mean? It means that if you think it might be right for you, then you should talk to a medical professional that you trust and be honest with about your personal activities.
For more information and connections to resources, click the CDC link below.