"PrEP"-aring Against HIV Exposure
What is PrEP?
Pre-exposure prophylaxis (or PrEP) is when people at higher risk for HIV take HIV medicines daily to lower their chances of getting infected. A combination of two HIV medicines (tenofovir and emtricitabine), sold under the name Truvada® (pronounced tru vá duh), is approved for daily use as PrEP to help prevent an HIV-negative person from getting HIV from a sexual or injection-drug-using partner who is HIV-positive. Studies have shown that PrEP is highly effective for preventing HIV if it is used as prescribed. PrEP is much less effective when it is not taken consistently.
Daily PrEP reduces the risk of getting HIV from sex by more than 90%. Among people who inject drugs, it reduces the risk by more than 70%. The risk of getting HIV from sex can be even lower if PrEP is combined with condoms and other prevention methods.
If I take PrEP, can I stop using condoms when I have sex?
No, you should not stop using condoms because you are taking PrEP. PrEP doesn't give you any protection against other STDs, like gonorrhea and chlamydia. Also, while PrEP can significantly reduce your risk of HIV infection if taken daily, you can combine additional strategies like condom use with PrEP to reduce your risk even further.
If used the right way every time you have sex, condoms are highly effective in preventing HIV and some STDs you can get through body fluids, like gonorrhea and chlamydia. However, they provide less protection against STDs spread through skin-to-skin contact, like human papillomavirus or HPV (genital warts), genital herpes, and syphilis.
Who should take PrEP?
PrEP is for people without HIV who are at high risk of getting it from sex or injection drug use. The federal guidelines recommend that PrEP be considered for people who are HIV-negative and in an ongoing sexual relationship with an HIV-positive partner.
This recommendation also includes anyone who:
- isn't in a mutually monogamous* relationship with a partner who recently tested HIV-negative, and
- is a . . .
- gay or bisexual man who has had anal sex without using a condom or been diagnosed with an STD in the past 6 months, or
- heterosexual man or woman who does not regularly use condoms during sex with partners of unknown HIV status who are at substantial risk of HIV infection (for example, people who inject drugs or women who have bisexual male partners).
PrEP is also recommended for people who have injected drugs in the past 6 months and have shared needles or works or been in drug treatment in the past 6 months.
If you have a partner who is HIV-positive and are considering getting pregnant, talk to your doctor about PrEP, if you're not already taking it. PrEP may be an option to help protect you and your baby from getting HIV infection while you try to get pregnant, during pregnancy, or while breastfeeding.
Because PrEP involves daily medication and regular visits to a health care provider, it may not be right for everyone. PrEP may cause side effects like nausea in some people, but these generally subside over a few weeks. These side effects aren't life threatening.
* Mutually monogamous means that you and your partner are in a trusting relationship, only have sex with each other, and do not have sex outside the relationship.
How do I obtain PrEP?
PrEP can be prescribed only by a health care provider, so talk to yours to find out if PrEP is the right HIV prevention strategy for you. You must take PrEP daily for it to work. Also, you must take an HIV test before beginning PrEP to be sure you don't already have HIV and every 3 months while you're taking it, so you'll have to visit your health care provider for regular follow-ups.
What resources do UC students with UC SHIP have to obtain PrEP?
PrEP is available at Student Health Services.*
The process for initiating PrEP can take one month or more from the first visit. The process includes the following:
- Make an appointment for an initial visit with your Primary Care Provider (PCP) at Student Health Services
- Meet with a Health Educator from Health Promotion Services to discuss risk reduction
- Meet with UCSD Skaggs School of Pharmacy Pharmacist to discuss the medication itself
- Complete laboratory tests ordered by your PCP
- Make an appointment for a follow-up with your PCP
*If you do not have UC SHIP, contact your current PCP for information on PrEP
What resources do UC students with UC SHIP have to learn about PrEP?
If you are a student with UC SHIP Health Insurance, meet with your primary care provider to find out if PrEP is the right HIV prevention strategy for you. Your primary care provider may refer you for a PrEP Medication Education Session with a pharmacist from the UC San Diego Skaggs School of Pharmacy. These sessions generally last around 30-40 minutes and provide you the opportunity to ask any questions and discuss any issues you may have.
Each PrEP Medication Education Session covers:
- Purpose/Efficacy of PrEP
- Getting and Paying for Truvada®
- Side Effects of Truvada®
- Drug Interactions with Truvada®
- Drug Resistance
The PrEP Medication Education Session is available via Zoom, a secure and HIPAA-compliant televideo web service that allows you to virtually meet with the pharmacist from a convenient, yet private location of your choice. When the session is complete, the pharmacist will notify your primary care provider's office that you have completed your medication education session and are ready to take the next steps with your provider to obtain PrEP.
- Centers for Disease Control and Prevention. HIV/AIDS: PrEP. Available at https://www.cdc.gov/hiv/basics/prep.html
- Centers for Disease Control and Prevention. HIV/AIDS: PrEP 101 Consumer Info Sheet. Available at https://www.cdc.gov/hiv/pdf/library/factsheets/prep101-consumer-info.pdf
- Centers for Disease Control and Prevention. HIV/AIDS: PrEP Infographics. Available at https://www.cdc.gov/actagainstaids/pdf/campaigns/starttalking/stsh-prep-infographic-basics.pdf
- United States Public Health Service. Pre-Exposure Prophylaxis for the Prevention of HIV Infection in the United States – 2014: A Clinical Practice Guideline. Available at https://www.cdc.gov/hiv/pdf/PrEPguidelines2014.pdf