What to know about taking daily PrEP to remain negative for HIV.
PrEP (pre-exposure prophylaxis)is a type of medication taken before possible contact with HIV (Human Immunodeficiency Virus), a virus that can weaken the immune system by attacking certain white blood cells. PrEP generally refers to a once-daily pill that is taken to lower your chances of getting HIV from sex or sharing injection equipment such as needles.
The first pill introduced had the brand name Truvada, which generically is a bit of a mouthful (emtricitabine-tenofovir disoproxil fumarate), or TDF/FTC for short. A newer introduced brand name pill is called Descovy which, generically, isn’t any easier to pronounce (emtricitabine-tenofovir alafenamide), or TAF/FTC. Both were created by pharmaceutical manufacturer Gilead Sciences, and both have long been quite expensive. The patent for Truvada recently expired, which means it can finally be manufactured for a lower cost. Generic Truvada, or TDF/FTC, is the form of daily PrEP offered by us here at FOLX.
TDF/FTC can be taken with or without food and can be taken when drinking alcohol or using drugs. TDF/FTC can also be split in half or crushed if needed to help take the pill.
Folx on PrEP need to take just one pill a day. Many people find it helpful to take their pill at the same time each day alongside something else you do normally, like brushing teeth or drinking coffee. You can also opt for a daily alarm or calendar reminder. Daily PrEP is 99% effective at preventing HIV infection through anal or vaginal sexual activity and at least 74% effective when exposed to HIV through injection drug use.
When routines may be disrupted (traveling, staying out overnight, etc), you can carry extra pills to ensure you still take your PrEP pill daily.
There’s no evidence that more than one pill a day offers extra protection. In fact, taking too many could be bad for your health.
It takes about 7 days for PrEP (TDF/FDC) to provide protection from HIV from anal sex, and 21 days to provide protection for vaginal sex or injectable drug use.
We are people and sometimes forget to take our meds.The general rule of thumb is if it’s under 12 hours from when you normally take your PrEP, you can still take it, but if it’s been more than 12 hours from the normal time, just wait for your next dose.
About 1 out of 10 people experience side effects including gas, bloating, softer/more frequent stools, or nausea. Often these are mild and generally go away after the first month on PrEP. Taking the pill with a snack/meal or at bedtime can help with side effects.
If you’re experiencing other side-effects, don’t hesitate to reach out with questions.
PrEP is not 100% effective at preventing HIV and also does not protect against other sexually transmitted infections (STIs) such as chlamydia or gonorrhea. So if you need the extra protection, condoms and regular STI testing are still generally recommended. For those sharing injection equipment, PrEP does not protect against hepatitis C.
We encourage those who would like to stop taking PrEP to contact the clinician who prescribed it, to make sure it’s safe to stop. To be fully protective, PrEP should be taken for 7 days after a likely exposure to HIV. After stopping PrEP, it’s advised to get an HIV test 4 weeks later.
If someone is already positive for HIV and starts taking PrEP (TDF/FDC), the virus could become resistant to the medication, which means that it will no longer work for HIV treatment. Therefore it is required to be tested for HIV when starting or restarting PrEP after being off of it for 7 days or more.
People taking PrEP should stay in touch with their clinician as long as they are on the medication. HIV testing is required every 3 months after starting, and creatinine (kidney function) tests are required when starting PrEP and then every 3-6 months.
FOLX is currently able to prescribe daily PrEP with TDF/FTC, and the process begins here. For existing FOLX members interested in adding a PrEP prescription to their plan, reach out to your clinician through your Athena patient portal or reach out to our member advocates at firstname.lastname@example.org. And for those who want to know more, read up on all things sexual health here, and feel free to reach out to us at email@example.com.