The first reported cases of HIV were diagnosed in 1981. This devastating epidemic disproportionately affected the LBGTQ+ community and places throughout the world that have limited access to sexual education and healthcare.
Since then it has continued to be a major public health concern throughout the world. Approximately 84.2 million people have been infected with HIV since the start of the epidemic.
As heartbreaking and devastating as this epidemic has been, cases have been decreasing globally, with more treatment options available for people who have been diagnosed with HIV, as well as preventative measures that can keep people from contracting it in the first place.
HIV and AIDS 101
Before diving into PrEP, it helps to have a basic understanding of how HIV transmission works and the difference between the virus and AIDS.
Human immunodeficiency virus, (HIV) is the virus that is the precursor to acquired immune deficiency syndrome (AIDS). The HIV virus destroys T-cells, weakening the immune system over time. This causes people with HIV to have a difficult time fighting off illnesses, even minor ones.
Some people infected with HIV may experience flu-like symptoms like:
Fever and chills
A rash or mouth sores
People with HIV may not always show symptoms, which is why it’s essential to be tested for it during STI screenings.
Over time, HIV can develop into AIDS, which is marked by having a very low count of a certain type of white blood cells and a severely damaged immune system. Without treatment, this trajectory can take about 10 years.
What Is PrEP?
Medical advances have allowed for many people infected with HIV to continue relatively healthy lives without advancing into AIDS. There is, however, a preventative medication available that can prevent HIV transmission in the first place – PrEP. Pre-exposure prophylaxis, PrEP is highly effective at reducing someone’s risk of contracting HIV.
How Does PrEP Work?
When taken correctly, PrEP reduces a person’s risk of contracting HIV from sex by about 99%. For people who take injectable drugs, the risk decreases by at least 74%. PrEP’s effectiveness, however, decreases the less consistent someone is about taking it.
PrEP helps the body to produce antibodies that help protect against foreign pathogens, like viruses. These medications block the enzyme that the HIV virus needs in order to replicate.
What Type of PrEP Medications are Available?
In the United States, there are two FDA approved daily oral medications available Truvada® and Descovy®.Truvada® is intended for people who are at risk through injection drug use or through sex, while Descovy® is intended for people who were assigned male at birth and are at risk of contracting HIV through sex.
There is also a long acting injectable medication available called Apretude® which is administered by a healthcare provider every two months in lieu of taking an oral medication.
Who Is a Good Candidate for PrEP?
In order to be prescribed PrEP, you need to first test negative for HIV. PrEP is intended for anyone who is at a higher risk of contracting HIV.
This includes people:
Who use injectable drugs.
That have an injection partner with HIV.
That share syringes, needles, or other injection equipment
Who have a partner who has HIV, especially if their viral load is unknown or undetectable.
Who have had anal or vaginal sex in the past 6 months and have consistently not used a condom and/or have been diagnosed with an STI in that time.
People also may be a good candidate for PrEP if they have been prescribed PEP (post exposure prophylaxis) and they continue risk behavior or have had to use PEP multiple times.
Another scenario where someone may want to consider taking PrEP is if they have a partner with HIV and they are considering getting pregnant. PrEP can help protect the gestational parent and the baby from contracting HIV.
Side Effects of PreP
People who have taken PrEP for at least five years have reported no significant health effects, especially when compared to the risk of contracting HIV.
Still, there are some potential side effects from taking this medication:
Nausea and diarrhea
Headache and fatigue
These side effects typically go away with time. It is also important to note that while PrEP can protect you from HIV, it does not protect against other STIs, so it’s still important to be diligent about using barrier methods and getting tested when appropriate.
How Do You Get PrEP?
PrEP is only available as a prescription medication, and the method of accessing it changes depending on where you live. In most places, any doctor is able to prescribe it. There are also many HIV services and reproductive health clinics around the globe where you can also get a prescription to PrEP.
PrEP is covered by insurance in many places. People who are on PrEP need to see their doctor every three months for a prescription refill, as well as to get an HIV test and check-in.
Despite how effective PrEP is at preventing HIV transmission, many people are still contracting HIV throughout the globe. One of the major roadblocks people face is accessibility.
The place that is the most disproportionately affected is in the African region, where 3.4% of adults are living with HIV. These cases are concentrated in sub-saharan African countries, which hold half of the world’s population that are living in extreme poverty.
Healthcare accessibility is obviously a major problem throughout the globe, but especially when it comes to getting medication that could protect people from a potentially life-threatening illness.
The Future of HIV Prevention and AIDS Treatment
Choosing to take PrEP can be potentially life-saving, but it is an individual decision that someone needs to come to with the help of their medical provider. PrEP has been an absolute game changer in preventing more people from contracting HIV.
Even people who have already contracted HIV are often able to live relatively normal lives thanks to medications that keep their viral load low, and prevents it from progressing into AIDS. Another advance is an HIV vaccine, which has been developed but not yet approved by the FDA in the U.S.
As devastating as HIV and AIDS have been, there is a bright glimmer of hope thanks to medications like PrEP. If you think you are a good candidate for PrEP, we urge you to talk with your healthcare provider or find a reproductive health clinic near you.