PrEP: So Many Options
As seen in GED Magazine
The HIV prevention world has changed dramatically in the more than 10 years since the U.S. Food and Drug Administration (FDA) approved Gilead Sciences’ Truvada as pre-exposure prophylaxis (PrEP) in July 2012.
Following the discovery that Truvada can pose renal and bone density problems in some individuals (which, thankfully, go away after the medication is discontinued), the FDA approved Gilead’s more kidney-and-bone-friendly Descovy as PrEP in October 2019. While Truvada is currently available as a generic equivalent, Descovy is still under patent.
More than a year ago — on December 20, 2021 — the FDA approved GSK’s Apretude, the first and only long-acting injectable form of PrEP, which requires a new dose every two months.
According to the Centers for Disease Control (CDC), when taken as prescribed, PrEP reduces the risk of HIV infection from sexual activity by more than 99%, and by at least 74% for those who use intravenous drugs. You should be on PrEP for HIV protection if you are 18 years or older, are sexually active (or soon planning to be), and are HIV negative.
“The great news with injectable PrEP is that it is a wonderful alternative for people who have issues with adherence and may forget to take their daily pill,” says DAP Health Clinical Supervisor of Sexual Wellness, Nurse Practitioner Trent Broadus. “It’s also very helpful for unhoused people who may have nowhere to store their meds, or who may be concerned that they’ll be stolen. Even more exciting, longer-lasting forms of injectable PrEP are currently being studied. Data are promising on one injection that would last a full six months.”
Before starting PrEP — whether orally or by injection — you’ll need to get tested for HIV, STIs, kidney function, and Hepatitis B and C.
Some people experience gas, nausea, or headache when beginning PrEP. These side effects typically go away within the first week. Note that it takes at least one week on PrEP before you’re protected for anal sex, and three weeks for vaginal sex.
Most insurance plans cover oral PrEP for HIV. Injectable PrEP is covered by Medi-Cal, but some Medicare and private insurance plans may require you to go through your primary care provider.
All forms of PrEP require regular follow-up HIV, STI, and kidney function testing. Every three months for oral PrEP; every two months for injectable PrEP.
You should talk to your doctor before stopping any medication. And if you stop taking PrEP, talk to a health care provider about using other HIV prevention strategies.
If you’re interested in PrEP, contact a DAP Health PrEP navigator at 760.656.8400. You can also talk to any nurse or nurse practitioner during your visit if you want to discuss which PrEP may be right for you.
If you don’t have health care insurance, or if you need financial assistance, a PrEP navigator can also explain your options, help you get access, and answer questions about finding a doctor or working with your pharmacy.
And remember: All PrEP visits and lab work done at DAP Health’s sexual wellness clinics in Palm Springs and Indio are always free of charge to all patients.