Truvada and PrEP: What is Truvada?
According to a 2016 CDC (Centers for Disease Control) report, men who have sex with men (MSM) accounted for 67% of all HIV diagnoses and 83% of diagnoses among males. Diagnoses also increased by 4% among African American gay and bisexual men, while it has declined by 16% in women. Despite increasing awareness and approval of HIV preventive meds, the number of HIV infections, between 2011 and 2015, seemed to rise in some population groups.
In 2012, HIV pre-exposure prophylaxis was approved by the US FDA for uninfected persons who are at high risk of infection. It includes taking antiretroviral drugs daily before potential HIV exposure. The only sanctioned pills for PrEP is Truvada. But PrEP is more than just an anti-HIV pill. PrEP is a program that requires regular visits with your healthcare provider, routine HIV and STD screening, sexual health counseling, medical monitoring, and adherence support. While there are more people now who have access to PrEP, there are still so much to be done. HIV rates remain high in young MSM groups: gay black men, transgender women, and bisexual men.
What is Truvada?
Truvada is the only FDA-approved antiretroviral PrEP regimen for individuals who are at high risk of HIV infection. Good candidates for treatment include those who do not always use male or female condoms, patients who do not know the status of their partners, those who have been diagnosed with STIs and people who inject drugs. 2 The combination pill contains two potent drugs emtricitabine and tenofovir disoproxil fumarate. These drugs are also commercially available in separate preparations. Truvada is also used in combination with other antiretroviral meds to treat patients who are already infected. It has been available for more than a decade for such indication, but was only approved for PrEP use in 2012. HIV-positive individuals should not take Truvada alone, as it requires another drug dolutegravir (Tivicay) or raltegravir (Isentress) to be effective. Truvada works by preventing the virus from reproducing and establishing itself into your system. There is still no cure for HIV, so once the virus invades your immune system and replicates, they’ll be there for life. If it remains untreated, it will progress into full-blown AIDS – the last stage of HIV, which is fatal.
How to qualify for PrEP?
Before securing a prescription for Truvada, you must first test negative for HIV. For the drug to be effective, it must be taken daily. Missing a dose or altering your dose will put you at risk of contracting the virus should you get exposed. The most important things for PrEP to be successful are adherence and consistency. You should be open and honest with your healthcare provider about your sexual activity and HIV risks. You will be advised to visit your doctor every months to screen for HIV, pregnancy, and other sexually transmitted infections. You will also be monitored for potential side effects and toxicities from PrEP medications.
What Truvada doesn’t do?
Truvada is not a vaccine. Taking it doesn’t mean you will be immune to the virus, but taking it properly and consistently will lower your risk by over 90%. While there are many individuals who would stop using condoms while on PrEP, one should be aware that Truvada wouldn’t protect anyone from getting STIs such as chlamydia, herpes, gonorrhea, and syphilis. To further reduce your risk, Truvada must be used in combination with safer sex practices. 4 Taking Truvada while you have an undiagnosed HIV infection can result to drug resistant HIV strains. Health care providers must observe if there are signs and symptoms of acute HIV infection and immediately test for the patient’s status. Patients with hepatitis B virus (HBV), who cease to take Truvada, may experience acute worsening of HBV. Closely monitor the patient’s hepatic function for several months before discontinuing treatment. Anti-HBV therapy may be initiated if necessary.
Because there is no cure for HIV and a vaccine is still being explored, the only way you can reduce your chance of being infected is by taking PrEP and protecting yourself from exposure through abstinence, condom use, and abstaining from injection drug use. Taking Truvada is not an excuse to have condomless sex or doing risky sex with multiple partners. Consult your healthcare provider if you have other options aside from Truvada. If accidental exposure occurs, ask if you are eligible for post-exposure prophylaxis (PEP).