What is PrEP and how effective is it?

You are at the right place if you are sexually active and want to minimise your exposure to HIV. There are more medications now than ever to prevent HIV and reduce the harm associated with having an active sex life.

PrEP is a safer method of sex for people at risk of contracting HIV. Keep going through the article and discover how you may benefit from PrEP.                                                                  

What is PrEP?

Pre-exposure prophylaxis, or PrEP, is a medication that protects you from the human immunodeficiency virus (HIV). It is a drug you take before you think you might come into contact with the virus. It lessens the chances of getting HIV from sex or injection drug use. PrEP prevents HIV infection in HIV-negative people at higher risk for HIV. PrEP combines two drugs in one pill. PrEP in your bloodstream may stop HIV from taking hold and spreading, keeping you HIV-negative.

PrEP is designed for HIV-negative people at risk of HIV infection, like:

• Having an HIV-positive sexual partner who is not on treatment or you are at higher risk of getting HIV
• Men having sex with men without a condom
• You inconsistently use condoms and are sexually more active

PrEP is not necessarily for everyone and is a personal choice. Your circumstances and your risk of getting exposed to HIV will all play a role in deciding whether PrEP is right for you.

Types of PrEP

PrEP is available as pills or shots.

There are two pills approved as PrEP:

• Truvada is for people at risk via sex or injection drug use
• Descovy is for people at risk via sex. Descovy is not for people assigned females at birth and is at risk for HIV via receptive vaginal sex.

Apretude is the only shot FDA has approved for use as PrEP. Apretude is for those at risk through sex with a weight of at least 77 pounds (35 kg).

Essential things you must know about taking PrEP

Before initiating PrEP, the doctor will check your health and schedule some tests at your first appointment, like:

• A full STI test
• An HIV test
• Kidney and liver function tests
• You must consult your doctor every 3 months for repeat HIV and STI tests and a new PrEP prescription.
• PrEP may have side effects, so cooperate with the doctor to monitor your general health.
• PrEP does not give you protection against other STIs
• PrEP will not protect against other sexually transmitted infections, like
• Syphilis, gonorrhoea, or chlamydia

Condoms and lubricants may provide protection against and reduce the risk of spreading an STI. Even if you have no symptoms, it is essential to have a sexual health test every 3 months while on PrEP. You will also receive information about reducing your risk of acquiring HIV. Take PrEP wholly as your doctor prescribes for maximum adequate protection.

Side Effects of PrEP

PrEP is a safe drug if consumed at prescribed therapeutic parameters. It may cause specific side effects that may usually go away over time. The common side effects of PrEP are:

• Nausea
• Diarrhoea
• Constipation
• Bloating
• Headache
• Fatigue
• Tiredness
• Dizziness
• Stomach pain or discomfort
• Loss of appetite
• Weight fluctuations

A significant side effect of Truvada is its effect on kidney function and health. Truvada may decrease the filtering capacity of your kidneys. There are no other serious or life-threatening side effects. Consult your health care provider about any side effects that are severe or do not go away.

How effective is PrEP?

If you take the drug as your doctor prescribes, PrEP is highly effective for preventing HIV by 99 %. If you take it as your doctor recommends, usually a pill daily, PrEP is quite effective against future HIV contact. PrEP is super effective when combined with other protections, such as condoms. PrEP is highly effective for preventing HIV as it:

• PrEP lessens the risk of getting HIV from sex by about 99% if you take it as your doctor prescribes.
• Although there is little information about how effective PrEP medication is among people who inject drugs, PrEP pills reduce the risk of HIV by at least 74% if you take them as your doctor prescribes.
• Presently, PrEP shots are not recommended for people who inject drugs.
• PrEP is little or not practical when you do not take it as your doctor recommends.
• Insertive partners (those topping) have a lower chance of getting HIV, while those receiving (bottoming) have a higher chance.
• For daily PrEP users, it may reduce HIV risk by 84% from drug injection.
• PrEP on-demand has overall efficacy of 86% in preventing HIV (if you take it as your doctor prescribes) among MSM (men who have sex with men).
• For anal sex, PrEP is highly effective after taking it for 7 days consistently.
• For vaginal/frontal sex, PrEP takes about 21 days to reach desired concentrations for protection.
• Taking PrEP four times a week, it's 99% effective at preventing HIV infection through anal sex. If you take it twice a week, efficacy drops to 75%.
• PrEP is less effective when you do not take it as your doctor recommends.

The drug doesn't work as well if you miss doses. You must take it as directed to get the protection.

How Does PrEP Medication Work?

PrEP works by preventing HIV from replicating in the body. The drug works as a catalyst and aids the body in producing antibodies, which fight against disease-causing viruses and germs. After contacting the virus, the tenofovir and emtricitabine block the enzyme the virus needs to replicate. PrEP erases the risk of contracting the virus after exposure if used correctly.

PrEP ceases HIV from taking hold in your body and spreading. If PrEP works as desired, you will not become HIV-positive. Truvada is the primary medication that doctors prescribe as a PrEP medication. It combines two medicines, emtricitabine and tenofovir, to block an enzyme the virus needs to make copies of itself in your body.

Descovy is the other drug FDA has approved for PrEP use. However, doctors are unsure if it protects in the case of transmission through vaginal sex, so it might not work in those cases.

How long Does PrEP take to work?

• For receptive anal sex (bottoming), PrEP tablets reach maximum protection against HIV at about 7 days of consecutive use.
• In the case of vaginal sex and injection drug use, PrEP medications reach maximum protection at about 21 days of daily use.
• There is no data yet available regarding the efficacy of the PrEP pill for insertive anal sex (topping) or insertive vaginal sex are available.
• It is not evident how long it takes for PrEP shots to reach maximum protection during sex.

Is PrEP Right for Me?

PrEP may help protect if you don't have HIV and any of the following factors apply to you:

You had vaginal or anal or vaginal sex in the last 6 months, and you

• have a sexual partner with HIV (particularly if the partner has an unknown or detectable viral load)
• have not consistently used a condom
• are diagnosed with a sexually transmitted disease in the last 6 months

You are habitual of injecting drugs, and you

• have an injection partner who is HIV-positive
• share syringes, needles, or other drug-injection tools

The doctor prescribes you PEP (post-exposure prophylaxis), and you

• have continued risk behaviour
• have used multiple courses of PEP

You should consider taking PrEP if:

• You have sexual intercourse with multiple partners
• You inject drugs and/or use drugs during sex
• You had condom-less sex without knowing your partner's HIV status

You may opt to take PrEP, even if the behaviours listed above don't apply to you.

How long do I need to be on PrEP?

Discuss with your doctor your personal circumstances. There are several reasons because why people stop taking PrEP:

• The risk of getting HIV infections becomes low because of changes in your life.
• You don't want to take medication daily or often forget to take your medicine; other ways of protecting yourself against HIV might work out for you.
• The drug causes adverse effects that are bothering your life.
• Blood tests reveal your body is reacting to PrEP medication in unsafe ways. The doctor may decide there are other options for you.

Consult your doctor if you have difficulty remembering to take your medication or want to stop PrEP. It is essential to ensure that you continue taking PrEP for 28 days after your last potential exposure to HIV before ceasing it.

Can I take PrEP while pregnancy or breastfeeding?

If you have an HIV-positive partner and are planning to get pregnant, consult your health care provider about taking PrEP if you're not already on it. PrEP might be an option to protect you and the baby from acquiring HIV when you are trying to conceive, during pregnancy, or while breastfeeding. It helps block the virus during pregnancy or while breastfeeding. 

Conclusion

Pre-exposure prophylaxis (PrEP) is an oral medicine that prevents HIV in people at risk of infection with the virus. PrEP, if used correctly, is quite effective against HIV contact. It prevents HIV infection 99 % of the time. In addition, the medication prevents the virus from reproducing within the body. You may also prevent HIV transmission by using condoms during anal or vaginal sex, using sterile injecting equipment, not sharing injecting equipment or achieving and maintaining undetectable HIV viral loads if you are HIV-positive.