PrEP: An Opportunity to Decrease Your Risk of HIV

Summary

PrEP is an effective antiviral medication for preventing HIV in high-risk individuals, and there is a need for increased awareness and prescription of PrEP among healthcare providers and patients.

Abstract

PrEP, or pre-exposure prophylaxis, is a significant advancement in HIV prevention, reducing the risk of infection by 99% when taken daily. Despite its effectiveness, there is a notable gap in its utilization, with only 18% of eligible individuals receiving a prescription. This gap is partly due to low awareness among healthcare providers, who often overlook discussing PrEP with patients who could benefit from it. The CDC has outlined specific criteria for who should consider taking PrEP, which includes individuals with HIV-positive partners, those engaging in high-risk sexual behavior without condom use, and those with a recent STD diagnosis, among others. The article emphasizes the importance of proactive patient engagement in asking about PrEP and seeking information, especially if healthcare providers do not initiate the conversation. It also underscores the necessity of continued condom use to prevent other STDs, as PrEP does not offer protection against them.

Opinions

The author believes that there is a significant missed opportunity in HIV prevention, as many healthcare providers do not discuss PrEP with at-risk patients.
The article suggests that physicians may be uncomfortable discussing HIV prevention beyond traditional advice like monogamy and condom use.
There is an opinion that proactive patients who advocate for their own health can drive improvements in the care provided by healthcare professionals.
The author recommends considering an AI service for those interested in learning more about PrEP and other health-related topics, indicating a belief in the value of AI for health education and cost-effectiveness.

What is PrEP and who should take it?

One million people in the US are at risk of acquiring HIV, with about 40,000 new cases diagnosed annually. Many still think of HIV as a disease limited to men who have sex with men. The reality is that HIV is increasing among all demographics, especially young people. It is time that patients and health care professionals change the way we think about HIV prevention.

What is PrEP?

PrEP stands for pre-exposure prophylaxis. PrEp therapy is a prescription antiviral medication to prevent HIV infection for those at risk. When taken daily, PrEP is highly effective at preventing the acquisition of the HIV Virus. It can reduce the risk by 99%.

To be most effective, it must be taken every day and not only when you have sex or only after potential exposure. PrEP is not a vaccine. This is a common misconception. It is also not like the morning after pill. It is an antiviral medication that helps prevent the spread of the HIV virus. The most common medication is Truvada®

Who should take PrEP?

The CDC guidelines for PrEP therapy are:

Having an HIV positive sexual partner

Having had anal intercourse or receptive vaginal intercourse in the past six months without condom use

Having been diagnosed with an STD such as gonorrhea, chlamydia, or syphilis in the past six months.

Having had sex for money, food or drugs

Recent incarceration

IV drug use

Dependence on drugs or alcohol

My doctor never mentioned PrEP

It is highly likely that your healthcare provider never mentioned PrEP. 2/3 of newly diagnosed HIV patients had at least one visit to a health care provider in the previous six months. This represents a huge missed opportunity and should be eye-opening for those in healthcare. Studies show only 18% of those who qualify for PrEP are prescribed it.

Awareness of PrEp as an option is still low for doctors and patients. In my experience, physicians are uncomfortable covering HIV prevention beyond recommending monogamy and condom use. We mention PrEp to those engaging in prostitution, IV drug use, and those with an HIV + partner. We are guilty of missing the more common scenario: Patients who are sexually active without condoms and have been recently diagnosed with an STD.

Be a proactive patient

If you meet any of the above criteria, you owe it to yourself to ask for information from your provider. If your provider is unaware of PrEP then it is even more important to bring it up. Proactive patients push providers to improve the care they provide. Do not be intimated. Ask for information. If you feel the provider is not meeting your needs, then remember it is your right to get a second opinion.

Do I still need condoms?

Safe sex practices with latex or polyurethane condoms are recommended. Condoms should still be used even if you are on PrEP as it does not prevent gonorrhea, chlamydia, syphilis, trichomoniasis, HPV or any other STD. This is very important because having another STD increases the risk of acquiring HIV.