That Little Pill
Dear Dr.
Dick,
I try to use condoms when I can, but I definitely slip 'n slide. I don't want to catch the bug - ya know, HIV. I've heard there's a little pill that can prevent it. Tell me mo' 'bout it... pretty please?!
"Pretty 'n Pink"
Dear PnP,
It sounds like & quacks like - PrEP (Pre-exposure Prophylaxis).
Guys who are HIV-negative and at high risk for getting HIV can take PrEP. How does it work? You take a pill once a day, every day, to lower your risk of getting HIV.
The pill contains HIV medicines that prevent HIV from making copies of itself when it gets in the body. Studies show that PrEP can reduce your chances of catching HIV, however, taking PrEP does not guarantee that you won't get HIV.
The iPrEx study, which tested PrEP use in gay and bisexual men, found that participants were 44% less likely to get HIV than men who didn't take the pill. Furthermore, the guys who took PrEP everyday as prescribed (instead of missing or forgetting doses), reduced their risk of HIV infection by 90%. This year, the CDC released the results of the Bangkok Tenofovir Study--which tested PrEP in men and women who inject drugs. The study showed that participants who took PrEP every day had a 74% lower chance of getting HIV. However, some PrEP studies have found no benefit, probably because people didn't consistently take their medication.
It's important to keep in mind that PrEP alone won't stop you from getting infected with HIV. Some guys think that if they take PrEP, it's a ticket to ride bareback without the risk of HIV. PrEP should be one part of your safer sex and safer use practices.
Here are basic guidelines. GUYS WHO TAKE PrEP SHOULD:
- Use condoms every time for anal and vaginal sex.
- Talk to their partners about their HIV status and using protection.
- Get tested regularly for STIs, and get treated if an STI pops up.
- Get tested every 2-3 months for HIV.
- Take their PrEP meds every day.
*If you take PrEP and use crystal, you should still use brand new needles and works every time. Don't share or reuse!
Talk to your doctor if you are interested in PrEP.
Before you can start PrEP, you'll need to test negative for HIV. Once you're on PrEP, your doctor will check-in with you regularly to talk about any side effects, your sexual safety practices, and make sure you are taking the medication as prescribed. You'll also get a blood test every 2-3 months to check for HIV and make sure the medication isn't damaging your kidneys or other organs. A common side effect of PrEP is upset stomach.
You shouldn't take someone else's PrEP drugs either. Only take it when it's prescribed for you by a doctor!
THINK IT OVER:
- If you take PrEP, you have to take it every day for it to prevent HIV infection. You can't just take it the day before you plan to hook up with a hottie. Plain and simple, PrEP only works when you take it everyday. This can be hard for some guys, with all the other things going on throughout the day. Setting a phone alarm is one way to remember the medication.
- If you don't have insurance, PrEP can be super expensive. However, there are medication assistance programs like start.truvada.com.
Read More:
Check out the PrEP Factsheet by Public Health Seattle King County here: PrEP Q&A: Using HIV Drugs to Prevent HIV Infection <http://www.kingcounty.gov/healthservices/health/communicable/hiv/publications/~/media/health/publichealth/documents/hiv/PrEPfacts.ashx>
Here's an editorial from OUT Magazine: Why Are We Not Talking About PrEP? <http://www.out.com/news-opinion/2013/07/24/michael-lucas-comes-out-hiv-negative-sexually-active-man-prep>
Yours truly,
Dr. Dick
