Pre-exposure prophylaxis (PrEP) treatment to prevent HIV

Pre-exposure prophylaxis (PrEP) treatment is designed to prevent the spread of HIV. HIV is the virus that causes AIDS, which can cause serious health problems and even death. HIV can be spread through direct contact with body fluids such as blood and semen.

 

PrEP treatment is designed to provide an extra layer of protection against HIV transmission

What is HIV?

HIV (also known as human immunodeficiency virus) weakens your body's immune system and reduces your ability to fight infection. It targets a specific type of white blood cell in your immune system called CD4+ T cells. CD4+ cells play an important role in recognizing harmful pathogens such as viruses and bacteria so that your body can start fighting them.

When you are infected with HIV, the virus attaches to the surface of a CD4+ cell, invades it and makes copies of itself, then kills the infected CD4+ cell and releases more copies of HIV into your blood to attack other CD4+ cells. . If left untreated, HIV can further damage your immune system, killing CD4+ cells over time until you develop AIDS (or acquired immunodeficiency syndrome).

Having HIV increases your risk of contracting opportunistic infections such as candidiasis, tuberculosis, pneumonia, etc. These are opportunistic infections because they often occur in people with weakened immune systems.

HIV Transmission

HIV is commonly found in blood, vaginal fluids, pre-ejaculatory fluids, semen, breast milk, and rectal fluids.

It can be transmitted through:

• Sexual contact – oral, vaginal, and anal sex and sharing sex toys
• Sharing needles
• Blood transfusions from infected people
• Birth
• Breastfeeding
• Biting someone or being bitten by someone who has the virus – when the skin is broken and the blood has drained
• Body modifications such as piercings and tattoos using unsterilized instruments

How can HIV be prevented?

There is currently no cure for HIV. Once you have the virus, it stays in your body for life. Fortunately, you can protect yourself from the virus by:

• Sexual abstinence
• Practicing safe sex without exchanging body fluids
• Using condoms correctly every time you have sex
• Avoid sharing needles or use sterile needles
• Talk to your doctor about taking HIV prevention medicines like PrEP

What is HIV PrEP?

PrEP is an HIV prevention medicine for people who haven't been exposed to the virus. If taken as directed, it reduces the risk of infection through sex by up to 99% and the risk of infection through injection by up to 74%. HIV PrEP can be given as a tablet or injection.

FDA-approved PrEP medicines include:

Truvada

Truvada for PrEP is a once-daily prescription medicine that contains two active ingredients - emtricitabine and tenofovir. It is taken once a day as long as there is a risk of contracting HIV. It is recommended for adolescents and adults who weigh at least 35 kg. Both men and women can use this medicine.

Descovy

Descovy is an HIV PrEP pill that is taken once a day when there is a risk. It contains two main active ingredients – emtricitabine and tenofovir. The drug should be used by adult males and male adolescents who weigh at least 35 kg.

However, Descovy is not approved for use in women who are at risk of contracting HIV through receptive vaginal intercourse. This is because we do not yet know if Descovy is effective in women.

Apretude

As of 2022, Apretude is the only FDA-approved PrEP injectable. It contains cabotegravir as an active ingredient. This HIV PrEP drug is given by a doctor in the form of an intramuscular injection. Six injections are required each year.

People who are at risk of contracting the virus through sexual intercourse and weigh at least 35 kg can use Apretude. However, it is not recommended for people who inject drugs because it may not be as effective.

Can PrEP prevent HIV? How does it work?

PrEP drugs such as Truvada and Descovy belong to a class of antiviral drugs called nucleoside reverse transcriptase inhibitors (NRTIs). This means they prevent HIV from multiplying. They do this by blocking the protein reverse transcriptase – a protein that is needed so that HIV can replicate.

When you take these drugs, they form a wall around your CD4+ cells, preventing HIV from entering your healthy cells and making copies of itself.

Unlike these pills, the Apretude injection is an integrase inhibitor. It prevents the HIV virus from entering your healthy cells and making copies of itself.

Before starting PrEP medication, ask your doctor for a test to confirm that you are HIV negative. If you are HIV positive and taking PrEP, you may develop HIV drug resistance. This means that despite taking antiretroviral drugs, the HIV in your body continues to make copies of itself. This is a problem because the virus learns to bypass how the drugs work, making them ineffective.

Note that while PrEP protects you from HIV infection, it does not protect you from other sexually transmitted infections (STIs).

How long does it take for PrEP to work?

The simple answer is that it depends on your HIV risk factors. Taking PrEP tablets daily during anal sex will achieve maximum protection against HIV after about 7 days. Daily use with vaginal sex and medication use will take about 21 days. Not taking medication as prescribed can increase your risk of contracting HIV.

Your doctor will give you monthly injections of HIV PrEP for the first 2 months. Then, you will receive injections of cabotegravir every 2 months. The injections are long-lasting and may remain in your body for 12 months or more after your last injection.

Who should use PrEP?

PrEP should be used by people who do not have HIV/AIDS but are at risk of contracting HIV. You may be a good candidate for PrEP if you:

• Have had vaginal, anal, or oral sex in the past 6 months with a sex partner who has HIV - detectable or unknown viral load
• Have had vaginal, anal, or oral sex in the past 6 months and have not always used a condom during intercourse
• Have had vaginal, anal, or oral sex in the past 6 months and have a sexually transmitted disease (STD) in the past 6 months
• Inject drugs and have an HIV-positive partner
• Inject drugs and share syringes, needles, or other equipment used to inject drugs
• Have used post-exposure prophylaxis (PEP) (a preventive medication started after exposure to the virus. PrEP, on the other hand, is started before exposure) and continue to report high-risk behaviors
• Have used PEP multiple times

If you are a woman whose partner is HIV-positive and you are thinking about having a baby, ask your doctor about PrEP HIV medication. It may be a way to protect you from contracting the virus while you try to get pregnant.

Is PrEP safe?

PrEP for HIV is safe. Some people who take the medication may experience side effects such as headaches, fatigue, nausea, stomach pain, and diarrhea. These side effects usually go away with time. If side effects are severe or persist, talk to your doctor as soon as possible.

Where do you get PrEP?

Are you at risk for HIV? PrEP may be right for you. See your doctor for testing to see if you are a good candidate for this HIV prevention medication. He or she will prescribe it for you and work with you to develop an HIV prevention plan.

If you test positive, you can still live a happy and fulfilling life. You should talk to your doctor about how to start taking the right HIV medication. If you already have HIV/AIDS, you are not a good candidate for PrEP.