What is pre-exposure prophylaxis (PrEP)?PrEP-_Infographic (3) PrEP is an HIV prevention method for people who are HIV-negative. It involves taking a daily anti-HIV medication to reduce the risk of becoming infected with HIV. Several studies have shown that, when taken as directed, PrEP dramatically reduces the risk of becoming infected when combined with other prevention services. The CDC currently recommends PrEP for all individuals who are at high risk for HIV infection. What is considered “high risk” for HIV infection? There are many factors that place an individual at high risk for HIV infection. These include the following:

  • Having a partner who is HIV-positive (sero-opposite couples);
  • Having had sex or needle-sharing partners of unknown HIV status during the past 12 months;
  • Having had sex under the influence of drugs or alcohol during the past 12 months; and/or
  • Having been diagnosed with an STD during the past 12 months.

How do I make an informed decision about my health? First, you can assess your risk and decide if PrEP might be right for you.

  • Review the information above including CDC recommendations.
  • Make a list of reasons you think that PrEP would be a good choice for you.
  • Decide if making a commitment to take a pill every day is something that you are able to do.
  • Seek support from your support network and/or a health educator at ncsdconnection@gmail.com or (760) 631-5000 extension 7000.

What’s in the pill? The brand name for the medication is Truvada, which contains two medications, tenofovir and emtricitibine. Truvada is commonly used to treat HIV positive individuals in combination with other anti-HIV medications. Truvada was approved by the Food and Drug Administration (FDA) in July 2012 for the prevention of HIV-infection in HIV-negative men and women. Is it safe? According to several studies, taking Truvada daily for PrEP is safe and well tolerated. About 1 in 10 people in the PrEP studies reported that they had headache, stomach pain, or weight loss when they first started taking Truvada. In most people, these side effects improved or went away after they had been taking the Truvada for a few weeks. A small number of people had a slight decrease in kidney function that normalized when they stopped the medication. Small losses of bone density (thickness) have been seen in people taking Truvada. These changes have not been associated with an increase in fractures in these studies. How do I know whether PrEP is right for me? The only way to determine whether PrEP is right for you is to talk to your doctor. How do you talk to your doctor about PrEP? If you believe PrEP is a good choice for you, the next step is to make an appointment with your healthcare provider to discuss the medication. Be prepared to have an open and honest discussion with your provider about your sexual health and the reasons you believe that you should be prescribed PrEP. You will find a link below for PrEP 101 (hyperlink) that will provide you with more information about how you can talk to your doctor about PrEP. Below is a list of considerations to discuss with your provider:

  • Make a health history list for your provider that includes any past illnesses or concerns you have, as well as a list of your current medications (including supplements, herbs, etc.).
  • Do not be shy. Give your provider all the details about your life that could be important to your health. Don’t worry about being judged. If your sexual health is a hard topic to talk about, say that to your provider when starting the conversation.
  • Ask questions, like what is required of me in order to be prescribed PrEP? How long will it take until I can be prescribed PrEP? What is expected of me after I have been prescribed PrEP?
  • Your provider may not know the answers to these questions. If not, you can refer the provider to https://start.truvada.com/hcp/truvadaprep-patient-resources-hcp#
  • Take notes during your visit so that you can remember what your provider said.

After the appointment:

  • Review your notes or any information provided by your provider.
  • Consider your options. Your doctor may give you a lot of information, now it is up to you to make the right decision for yourself.
  • Call your healthcare provider if you have more questions.
  • Schedule tests or follow-up appointments your medical provider requested.
  • Get your results if you had tests done at your appointment and ask your healthcare provider to review them with you. Seek support from your support network and/or a health educator at ncsdconnection@gmail.com or (760) 631-5000 Extension 7000.

What other resources are available to me besides PrEP? FREE prevention services include groups, one-on-one support, condoms and help to assess risk online. An online sexual health assessment is available for HIV negative and positive gay and bisexual men to anonymously self-assess their risk and get health information and referrals at www.myonlinesexualhealth.com. For a list of locations that provide free condoms go towww.sdhivprevention.com. How do I get PrEP? Truvada for PrEP is covered by many private insurance plans and by Medi-Cal. Talk to your doctor about whether Truvada may be right for you. If you do not have a doctor or health insurance, contact Covered California for information on signing up for insurance or Medi-Cal. See the Covered California website for more info: www.coveredca.com or call 2-1-1 for assistance. If you do not have insurance or need assistance with the costs, your healthcare provider can talk to you about medication assistance programs that help pay for PrEP medicine. Gilead also has co-pay assistance program and can also help cover the cost of the medication for those who qualify. To learn more about how you can start PrEP treatment, please call 760.631.5000 ext. 7000 to schedule your FREE consultation.     For More Information about PrEP: PrEP for HIV Prevention Fact Sheet: Center for Disease Control and Prevention www.cdc.gov/hiv/pdf/PrEP_fact_sheet_final.pdf PrEP 101:Centers for Disease Control and Prevention www.cdc.gov/hiv/basics/prep.html PREPFacts.org: San Francisco AIDS Foundation prepfacts.org/ For Medical Providers: Pre-exposure Prophylaxis For The Prevention Of HIV Infection In The United States – 2014 A Clinical Practice Guideline:Centers for Disease Control and Prevention www.cdc.gov/hiv/pdf/guidelines/PrEPguidelines2014.pdf Pre-exposure Prophylaxis For The Prevention Of HIV Infection In The United States – 2014 Clinical Providers’ Supplement: Centers for Disease Control and Prevention www.cdc.gov/hiv/pdf/guidelines/PrEPProviderSupplement2014.pdf