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PrEP FAQ

PrEP FAQ2022-04-04T17:07:00-05:00

QUESTIONS YOU MAY HAVE

Answers About PrEP

WHAT IS PREP?2020-08-20T13:48:13-05:00

Pre-Exposure Prophylaxis (PrEP) is a single daily dose pill for HIV-negative individuals. People exposed to HIV can prevent contracting it with the assistance of PrEP.

To date, there are two FDA-approved medications for PrEP, Truvada® the original PrEP approved in 2012, and now Descovy®, which was approved in 2019. Studies have shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily.

IS PREP SAFE? WHAT ARE THE SIDE EFFECTS?2020-04-02T16:57:24-05:00

PrEP is safe, and the regimen is generally well-tolerated. The original pill used for PrEP, Truvada, has been used to treat people living with HIV since 2004. PrEP can cause mild side effects, including upset stomach, headaches, and weight loss, especially at the beginning of the regimen.

A very small percentage of patients have issues with their kidneys or bones. That’s why we perform several tests on your first visit to see if you are at risk. We’ll also continue to monitor your health at regular intervals.

Descovy (TAF/FTC) was approved as PrEP in 2019 after a scientific study demonstrated that Descovy is not inferior to Truvada in terms of efficacy for cis men and trans women.

The main difference between Truvada and Descovy as PrEP for cis men and trans women is that for a very small percentage of prospective PrEP users, Truvada might be contraindicated due to bone mineral density or kidney function issues. Descovy can still be safely used in those cases because it has less of an effect on bone mineral density and kidney function than Truvada does. However, this does not mean that Descovy is an overall “safer” drug or that Truvada is “unsafe.”

WHAT IS THE DIFFERENCE BETWEEN TRUVADA FOR PREP AND DESCOVY FOR PREP?2020-07-13T15:00:57-05:00

Truvada (TDF/FTC) was the first medication approved for use as PrEP, back in 2012.

Descovy (TAF/FTC) was approved as PrEP in 2019 after a scientific study demonstrated that Descovy is non-inferior to Truvada in terms of efficacy for cis men and trans women. It is not FDA approved as PrEP for use by people who may be sexually exposed to HIV through vaginal sex because it has only been studied so far in trans women and cis men.

For a side-by-side comparison of Truvada and Descovy’s use as PrEP, please see this brief informational article from the San Francisco AIDS Foundation, which runs a PrEP clinic similar to ours:

https://www.sfaf.org/resource-library/side-by-side-comparison-truvada-and-descovy-for-prep/

The main difference between Truvada and Descovy as PrEP for cis men and trans women is that while that for a very small percentage of prospective PrEP users, Truvada might be contraindicated due to bone mineral density or kidney function issues, Descovy can still be safely used in those cases because it has less of an effect on bone mineral density and kidney function than Truvada does. However, this does not mean that Descovy is an overall “safer” drug or that Truvada is “unsafe.”

MCPC prescribes both forms of PrEP. Like all our services, they are both free for the patient, including the cost of the medication itself, the lab work and appointments to monitor them.

WHAT IS THE COST?2020-08-20T13:49:23-05:00

We provide all our services at no cost to our patients, regardless of their insurance status, income, or citizenship status.

These services include PrEP prescriptions and necessary monitoring tests, PEP prescriptions, STD testing, and some forms of STD treatment. We can help patients who have tested positive for HIV get connected with HIV treatment.

WHO CAN TAKE PREP?2020-07-13T15:12:58-05:00

Anyone who wants to stay HIV-negative and thinks there is a chance that they may be exposed to HIV sexually or through sharing injection equipment at some point in the future. For example, if you think there’s a chance you may end up choosing to have anal, vaginal, and/or oral sex without condoms, PrEP can benefit you by giving you confidence you’ll stay negative while doing so, regardless of your partner’s HIV status.

IS PREP EFFECTIVE?2020-07-13T15:13:34-05:00

Studies have shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily.

HOW DOES PREP WORK?2020-07-13T15:17:54-05:00

PrEP works to prevent HIV from establishing itself in someone’s body even if they’re exposed to HIV through sex or sharing injection equipment.

Being on PrEP involves taking a pill every day and having an appointment every three months with your PrEP provider to check in and get tested.

HOW OFTEN DO I HAVE TO TAKE PREP?2020-07-13T15:17:23-05:00

In the United States, the only PrEP dosing regimen approved by the FDA is daily dosing.

The pill does not have to be taken at the same time every day to be effective, but often, people are less likely to forget to take a daily pill when they take it at the same time every day and pair it with another daily ritual, like when brushing their teeth in the morning or at night.

HOW LONG UNTIL PREP BECOMES EFFECTIVE?2020-07-13T15:20:07-05:00

According to the CDC, PrEP reaches maximum protection from HIV for receptive anal sex at about 7 days of daily use. For receptive vaginal sex and injection drug use, PrEP reaches maximum protection at about 21 days of daily use.

DOES PREP PROTECT AGAINST OTHER SEXUALLY TRANSMITTED DISEASES?2020-04-02T17:33:17-05:00

PrEP does not protect against other STDs.

IF I AM USING HORMONES, CAN PREP INTERFERE?2020-07-13T15:20:52-05:00

PrEP has not been shown to alter hormone levels. When taken daily, PrEP is just as effective for people using hormones as it is for people who are not using hormones.

DO I HAVE TO TAKE PREP FOREVER?2020-07-13T16:14:06-05:00

No, it is not necessary to take PrEP forever. With medical direction, it is possible to safely stop and re-start taking PrEP at different times throughout one’s life. Be sure to follow the direction of a knowledgeable healthcare provider when starting or stopping PrEP to ensure you’re still HIV-negative while using PrEP and you’re informed about how many doses are necessary before and after sex to get full protection.

If you’re ever considering stopping PrEP because you have gotten into a monogamous relationship with someone you believe to be HIV-negative, please note that a significant portion of HIV transmissions occur in the context of relationships that were thought to be monogamous, and HIV is most transmissible in the few months after someone acquires it, at which point they usually haven’t yet been diagnosed. PrEP can help give you peace of mind even during monogamous relationships.

DO I NEED A PRESCRIPTION FOR PREP?2020-07-13T15:24:05-05:00

Yes, PrEP is a prescription medication and requires lab monitoring.

HOW FAST CAN I GET MY PREP?2020-07-13T15:25:24-05:00

In most cases, it is delivered to your address in less than one week of your PrEP appointment. We have challenges with some patients’ insurance plans which sometimes causes us to deliver outside of that time frame.

HOW DO I GET MY PREP PRESCRIPTION?2020-07-13T15:26:16-05:00

If you and your Music City PrEP provider determine that PrEP is right for you, they will send your prescription immediately to one of our partner pharmacies (Avita Pharmacy and CVS Specialty Pharmacy) or another pharmacy if you prefer. Once your insurance or your financial assistance is processed, you’ll receive a call from your pharmacy to confirm the address where your prescription should be mailed, and it will arrive within 2 to 3 days.

If you do not feel comfortable having prescriptions shipped to your home or workplace, you can have them shipped to us and pick them up from us, or if you fill with CVS Specialty, they can ship your prescription to one of their retail locations.

WHAT HAPPENS IF I MISS A DOSE?2020-08-20T13:52:27-05:00

Daily PrEP is somewhat forgiving with missed doses, which is an advantage it has over condoms, which provide no protection when they are not used. From the write-up of a study on PrEP’s protection:

In terms of stopping PrEP, after 30 days of daily dosing, the estimated protection offered by the PrEP remaining in the body from HIV transmission via anal intercourse was 97% 24 hours after the time of the first missed dose, 96% after three days, 93% after five days, and was still 90% a week later. (Source from AidsMap)

However, studies only demonstrate that level of protection for cis men having anal sex. It is especially important for cis women and trans men to avoid missing doses of PrEP.

Your provider can help you strategize about ways to remember to take PrEP daily.

If you miss a dose of PrEP, continue with the next dose. Taking two doses to make up for a missed dose is unnecessary.

IS PREP SAFE TO TAKE WITH OTHER PRESCRIPTION DRUGS?2019-09-18T16:36:52-05:00

For the most part, yes, but it is important that you list any drugs you are currently taking when completing the health questionnaire.

WHAT IF I TEST POSITIVE FOR HIV OR AN STD?2020-04-02T17:38:56-05:00

If you test positive for HIV or any other sexually transmitted disease, your provider will reach out to you with treatment options.

WHAT IS PEP?2020-08-20T14:00:33-05:00

PEP stands for post-exposure prophylaxis. It’s like emergency contraception but for HIV, because it can prevent you from becoming HIV-positive when taken after a potential sexual exposure to HIV. It’s a 28-day medication regimen involving the same drug used as PrEP plus another HIV treatment drug. It must be started within 72 hours of the potential HIV exposure, and is most effective when started as soon as possible, ideally within the first 24 hours. We prescribe it for free, like all our services.

If you are taking PrEP every day as prescribed and have waited for it to reach full efficacy in your system, you already have a maximum level of protection from HIV, so you would not need to start PEP if you were potentially sexually exposed to HIV. If you have missed a lot of doses of PrEP and then have a potential sexual exposure to HIV, it’s worth reaching out to your PrEP provider to find out whether they think you need to start PEP.”

“Can a person with HIV on treatment with an undetectable viral load transmit HIV?

No, they cannot. A person who is on effective HIV treatment and whose viral load is undetectable cannot transmit HIV to their sexual partners, regardless of whether they use condoms together or whether their sexual partners use PrEP. This groundbreaking development in HIV prevention is publicized with the slogan U=U, which stands for undetectable equals untransmittable. For more information, see Prevention Access Campaign’s FAQ on their website.

Someone in a relationship with a person living with HIV who has an undetectable viral load may still choose to use PrEP to reduce their or their partner’s anxiety about the idea of HIV transmission, even though there is no actual chance of transmission, or to give the HIV-negative partner a sense of control over HIV prevention in the relationship.

CAN A PERSON WITH HIV WHO HAS AN UNDETECTABLE VIRAL LOAD TRANSMIT HIV?2020-07-13T16:01:26-05:00

No, they cannot. A person who is on effective HIV treatment and whose viral load is undetectable cannot transmit HIV to their sexual partners. This groundbreaking development in HIV prevention publicized with the slogan U=U, which stands for undetectable equals untransmittable.

Someone in a relationship with a person living with HIV who has an undetectable viral load may still choose to use PrEP to reduce their or their partner’s anxiety about the idea of HIV transmission, even though there is no actual chance of transmission, or to give the HIV-negative partner a sense of control over HIV prevention in the relationship.

QUESTIONS YOU MAY HAVE

Answers About PrEP

WHAT IS PREP?2020-08-20T13:48:13-05:00

Pre-Exposure Prophylaxis (PrEP) is a single daily dose pill for HIV-negative individuals. People exposed to HIV can prevent contracting it with the assistance of PrEP.

To date, there are two FDA-approved medications for PrEP, Truvada® the original PrEP approved in 2012, and now Descovy®, which was approved in 2019. Studies have shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily.

IS PREP SAFE? WHAT ARE THE SIDE EFFECTS?2020-04-02T16:57:24-05:00

PrEP is safe, and the regimen is generally well-tolerated. The original pill used for PrEP, Truvada, has been used to treat people living with HIV since 2004. PrEP can cause mild side effects, including upset stomach, headaches, and weight loss, especially at the beginning of the regimen.

A very small percentage of patients have issues with their kidneys or bones. That’s why we perform several tests on your first visit to see if you are at risk. We’ll also continue to monitor your health at regular intervals.

Descovy (TAF/FTC) was approved as PrEP in 2019 after a scientific study demonstrated that Descovy is not inferior to Truvada in terms of efficacy for cis men and trans women.

The main difference between Truvada and Descovy as PrEP for cis men and trans women is that for a very small percentage of prospective PrEP users, Truvada might be contraindicated due to bone mineral density or kidney function issues. Descovy can still be safely used in those cases because it has less of an effect on bone mineral density and kidney function than Truvada does. However, this does not mean that Descovy is an overall “safer” drug or that Truvada is “unsafe.”

WHAT IS THE DIFFERENCE BETWEEN TRUVADA FOR PREP AND DESCOVY FOR PREP?2020-07-13T15:00:57-05:00

Truvada (TDF/FTC) was the first medication approved for use as PrEP, back in 2012.

Descovy (TAF/FTC) was approved as PrEP in 2019 after a scientific study demonstrated that Descovy is non-inferior to Truvada in terms of efficacy for cis men and trans women. It is not FDA approved as PrEP for use by people who may be sexually exposed to HIV through vaginal sex because it has only been studied so far in trans women and cis men.

For a side-by-side comparison of Truvada and Descovy’s use as PrEP, please see this brief informational article from the San Francisco AIDS Foundation, which runs a PrEP clinic similar to ours:

https://www.sfaf.org/resource-library/side-by-side-comparison-truvada-and-descovy-for-prep/

The main difference between Truvada and Descovy as PrEP for cis men and trans women is that while that for a very small percentage of prospective PrEP users, Truvada might be contraindicated due to bone mineral density or kidney function issues, Descovy can still be safely used in those cases because it has less of an effect on bone mineral density and kidney function than Truvada does. However, this does not mean that Descovy is an overall “safer” drug or that Truvada is “unsafe.”

MCPC prescribes both forms of PrEP. Like all our services, they are both free for the patient, including the cost of the medication itself, the lab work and appointments to monitor them.

WHAT IS THE COST?2020-08-20T13:49:23-05:00

We provide all our services at no cost to our patients, regardless of their insurance status, income, or citizenship status.

These services include PrEP prescriptions and necessary monitoring tests, PEP prescriptions, STD testing, and some forms of STD treatment. We can help patients who have tested positive for HIV get connected with HIV treatment.

WHO CAN TAKE PREP?2020-07-13T15:12:58-05:00

Anyone who wants to stay HIV-negative and thinks there is a chance that they may be exposed to HIV sexually or through sharing injection equipment at some point in the future. For example, if you think there’s a chance you may end up choosing to have anal, vaginal, and/or oral sex without condoms, PrEP can benefit you by giving you confidence you’ll stay negative while doing so, regardless of your partner’s HIV status.

IS PREP EFFECTIVE?2020-07-13T15:13:34-05:00

Studies have shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily.

HOW DOES PREP WORK?2020-07-13T15:17:54-05:00

PrEP works to prevent HIV from establishing itself in someone’s body even if they’re exposed to HIV through sex or sharing injection equipment.

Being on PrEP involves taking a pill every day and having an appointment every three months with your PrEP provider to check in and get tested.

HOW OFTEN DO I HAVE TO TAKE PREP?2020-07-13T15:17:23-05:00

In the United States, the only PrEP dosing regimen approved by the FDA is daily dosing.

The pill does not have to be taken at the same time every day to be effective, but often, people are less likely to forget to take a daily pill when they take it at the same time every day and pair it with another daily ritual, like when brushing their teeth in the morning or at night.

HOW LONG UNTIL PREP BECOMES EFFECTIVE?2020-07-13T15:20:07-05:00

According to the CDC, PrEP reaches maximum protection from HIV for receptive anal sex at about 7 days of daily use. For receptive vaginal sex and injection drug use, PrEP reaches maximum protection at about 21 days of daily use.

DOES PREP PROTECT AGAINST OTHER SEXUALLY TRANSMITTED DISEASES?2020-04-02T17:33:17-05:00

PrEP does not protect against other STDs.

IF I AM USING HORMONES, CAN PREP INTERFERE?2020-07-13T15:20:52-05:00

PrEP has not been shown to alter hormone levels. When taken daily, PrEP is just as effective for people using hormones as it is for people who are not using hormones.

DO I HAVE TO TAKE PREP FOREVER?2020-07-13T16:14:06-05:00

No, it is not necessary to take PrEP forever. With medical direction, it is possible to safely stop and re-start taking PrEP at different times throughout one’s life. Be sure to follow the direction of a knowledgeable healthcare provider when starting or stopping PrEP to ensure you’re still HIV-negative while using PrEP and you’re informed about how many doses are necessary before and after sex to get full protection.

If you’re ever considering stopping PrEP because you have gotten into a monogamous relationship with someone you believe to be HIV-negative, please note that a significant portion of HIV transmissions occur in the context of relationships that were thought to be monogamous, and HIV is most transmissible in the few months after someone acquires it, at which point they usually haven’t yet been diagnosed. PrEP can help give you peace of mind even during monogamous relationships.

DO I NEED A PRESCRIPTION FOR PREP?2020-07-13T15:24:05-05:00

Yes, PrEP is a prescription medication and requires lab monitoring.

HOW FAST CAN I GET MY PREP?2020-07-13T15:25:24-05:00

In most cases, it is delivered to your address in less than one week of your PrEP appointment. We have challenges with some patients’ insurance plans which sometimes causes us to deliver outside of that time frame.

HOW DO I GET MY PREP PRESCRIPTION?2020-07-13T15:26:16-05:00

If you and your Music City PrEP provider determine that PrEP is right for you, they will send your prescription immediately to one of our partner pharmacies (Avita Pharmacy and CVS Specialty Pharmacy) or another pharmacy if you prefer. Once your insurance or your financial assistance is processed, you’ll receive a call from your pharmacy to confirm the address where your prescription should be mailed, and it will arrive within 2 to 3 days.

If you do not feel comfortable having prescriptions shipped to your home or workplace, you can have them shipped to us and pick them up from us, or if you fill with CVS Specialty, they can ship your prescription to one of their retail locations.

WHAT HAPPENS IF I MISS A DOSE?2020-08-20T13:52:27-05:00

Daily PrEP is somewhat forgiving with missed doses, which is an advantage it has over condoms, which provide no protection when they are not used. From the write-up of a study on PrEP’s protection:

In terms of stopping PrEP, after 30 days of daily dosing, the estimated protection offered by the PrEP remaining in the body from HIV transmission via anal intercourse was 97% 24 hours after the time of the first missed dose, 96% after three days, 93% after five days, and was still 90% a week later. (Source from AidsMap)

However, studies only demonstrate that level of protection for cis men having anal sex. It is especially important for cis women and trans men to avoid missing doses of PrEP.

Your provider can help you strategize about ways to remember to take PrEP daily.

If you miss a dose of PrEP, continue with the next dose. Taking two doses to make up for a missed dose is unnecessary.

IS PREP SAFE TO TAKE WITH OTHER PRESCRIPTION DRUGS?2019-09-18T16:36:52-05:00

For the most part, yes, but it is important that you list any drugs you are currently taking when completing the health questionnaire.

WHAT IF I TEST POSITIVE FOR HIV OR AN STD?2020-04-02T17:38:56-05:00

If you test positive for HIV or any other sexually transmitted disease, your provider will reach out to you with treatment options.

WHAT IS PEP?2020-08-20T14:00:33-05:00

PEP stands for post-exposure prophylaxis. It’s like emergency contraception but for HIV, because it can prevent you from becoming HIV-positive when taken after a potential sexual exposure to HIV. It’s a 28-day medication regi