PrEP and nPEP
PrEP – It’s an acronym gaining prominence among the sexually active, whatever their orientation.
Equal amounts of praise and scorn have been attached to its significance. We at AIDS Help owe it to the community to acknowledge and discuss it factually as an inarguably-powerful prevention tool without politics or morality embedded in it.
PrEP stands for Pre-Exposure Prophylaxis. For further definition, the word ‘prophylaxis’ means “to prevent or control the spread of an infection or disease.”
For sexually active people, no prevention strategy is 100% effective, but PrEP is one way to prevent HIV infection by taking one pill every day. The pill (commonly referred to as Truvada, its brand name) contains two medicines (tenofovir and emtricitabine, used in combination with other medicines for HIV treatment).
When someone is exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from establishing permanent infection. So, by taking PrEP , the mission is to keep the virus from taking physical hold.
PrEP is covered by most insurance programs. Even without insurance, healthcare providers can explore medication assistance programs that help pay for PrEP.
Once choosing to take PrEP, commitment is critical. The drug must be taken every day with follow-up every 3 months by a healthcare provider. Consistent use has been shown to reduce the risk of HIV infection in people who are at high risk by up to 92%. It is considerably less effective if the protocol is not adhered to.
PrEP is recommended for use by:
◊ A person who IS in an ongoing relationship with an HIV-infected partner.
◊ A person IS NOT in a mutually monogamous relationship with a partner who recently tested HIV-negative.
◊A gay or bisexual man who has had sex without a condom or been diagnosed with a sexually
transmitted infection within the past six months.
◊A heterosexual man or woman who does not regularly use condoms when having sex with partners known to be at risk for HIV (e.g., injecting drug users or bisexual male partners of unknown HIV status)
◊A person who has, within the past 6 months, injected illicit drugs and shared equipment or been in a treatment program for injection drug use.
Individuals who use PrEP should use it in conjunction with other effective HIV prevention strategies.
◊ Using condoms consistently and correctly.
◊ Getting HIV testing with your partners.
◊ Abstinence and/or monogamy.
◊ Getting STD testing with your partners.
◊ Choosing less risky sexual behaviors, such as oral sex.
◊ If you inject drugs, participating in a drug treatment program.
nPEP is a separate, prescribed medical intervention designed to prevent disease after potential exposure to HIV. It is strongly urged for anyone who has had unprotected receptive vaginal or anal intercourse or who has shared an IV needle with an HIV-infected partner or with a partner whose HIV status is unknown. (nPEP is rarely recommended for the insertive partner or for oral sex.)
Don’t think of nPEP as a “morning after pill”…because it isn’t. It actually required taking medication within 72 hours, usually twice a day, for 28 days. nPEP patients should expect laboratory tests and follow-up visits at 2 weeks, 4-6 weeks, 12 weeks and 24 weeks post-exposure.
In other words, nPEP is not a substitute for safer sex. Use condoms until your follow-up visit at 6 months, post-exposure. nPEP is not guaranteed to work and you could have put your partner(s) at risk of contracting HIV and you may put yourself again at risk of HIV exposure.
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