Pre-exposure prophylaxis (PrEP) is on the minds of many gay men in New York City. It seems everyone knows someone on it or is taking it himself. The drug effectively blocks HIV infections 92-99% of the time for people who take it everyday, yet it remains controversial. Some have argued that it will encourage gay men to stop using condoms causing STI and STD infection rates to go up. Others have argued that this is a real solution for men looking to take away the inherent fear about becoming HIV positive: a fear many have been living with all their lives. Whatever side of the argument you may fall on PrEP is here to stay and rates of infection continue to go down as more prescriptions are filled.
Going on PrEP is an individual choice every man must make for himself based on lifestyle, relationship status and sex life. Below are five questions to ask yourself to understand if PrEP might be right for you.
1 Is PrEP something I should be on?
Frequency of sex is often brought up as the determining factor for whether someone should be on PrEP, but the more important question, is how often do you practice safe sex? If you are diligent about condom usage 100% of the time then PrEP may not be something you need. However, if you are not always safe, then PrEP may be right for you.
2. Will I have side effects?
Like a lot of prescription medications PrEP has side effects. For the first few weeks, some report nausea, vomiting, fatigue, and dizziness. These minor symptoms resolve themselves. But other side effects may include elevated kidney levels and decreased bone mineral density. Not all side effects are visible, so consult your physician.
3. What if I forget to take PrEP?
Consistency is key! PrEP can be very effective in preventing the spread of HIV even with partners who have the disease, but consistency by the user is critical. The more daily doses missed the less effective PrEP will be.
4. Will I always have to be on PrEP?
You can go off PrEP at any time. It’s your personal choice. If you decide to stop using PrEP, you should discuss the plan with your doctor as you will need to have your blood tested after.
There are rumors of drug resistance for people that have gone on and off of PrEP. This is true if you were already HIV positive and taking PrEP, then the virus may become resistant. However, the user would have to be resistant to both drugs in PrEP (tenofovir and emtricitabine) and have a detectable viral load all of which are possible but unlikely all at once. Before being prescribed PrEP your doctor will test to make sure you are HIV negative to eliminate the possibility of developing drug resistance.
5. How will I pay for PrEP?
If you have health insurance PrEP should be covered by your plan, so check first with your HMO. You will pay the co-pay like you would any other medication. Gilead, the makers of PrEP, is also giving away co-pay cards in large urban centers you can obtain from your doctor. These cards enroll you in a program that will pay your co-payment so the prescription is free. In order to take advantage of this you will have to call in the prescription from the manufacturer and have them send it to you directly instead of picking it up at your local pharmacy. For those that don’t have access to private health insurance, Medicaid will cover PrEP in certain states like New York and Florida. Whatever your situation, ask your doctor or insurance before starting on PrEP and understand the costs for you involved because without coverage PrEP could cost up to $13,000 a year.
Sources
http://www.cdc.gov/hiv/basics/prep.html
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1 comment
Wow, I didn’t know they had drugs that could effectively block HIV infections 92-99% of the time. That is a great statistic for people who are at risk of getting it. At least now HIV isn’t a sure sign of death.
https://www.cancommunityhealth.org/prep/