PrEP is an abbreviation for pre-exposure prophylaxis, a medical term for a treatment to prevent the transmission of a disease or infection. For the purposes of this posting here on ReNude Pride, the disease is HIV, the virus that causes AIDS. In the language and literature of the bisexual, men who have sex with men (MSM) and same gender loving community, PrEP is often referred and used instead of the commercial medication Truvada (emtricitabine and and tenofovir disoproxil fumarate). It is a once a day pill that helps prevent the transmission of HIV.
Truvada is a prescription medication that helps reduce the sexual transmission of HIV-1 by as much as 90% and the injection drug-use transmission of HIV-1 by as much as 70%. However, once prescribed, it must be taken daily and used together with other safer sex practices (such as latex condoms and new needles and syringes). HIV-1 is the most common strain of the virus and the effectiveness of Truvada in stopping the spread of HIV-2 is not known at this time.
In the USA, there are certain criteria that must be met before a doctor prescribes Truvada to an individual. Among these are the following:
- a person must be HIV-negative for both HIV-1 and HIV-2
- the person must be at risk of contracting HIV-1 and weigh at least 77 pounds (35 kg)
- understands that Truvada alone does not prevent pregnancy nor prevent other sexually transmitted infections (STIs).
In the state where I live, the Commonwealth of Virginia, PrEP is available through the Virginia Department of Health. Once it has been prescribed by a physician, it is free to everyone who resides within this jurisdiction. At this time, of the fifty states comprising the USA, Virginia and one other are the only localities where PrEP is provided at no cost.
Given the notorious conservative political climate and rampant homophobia in this state, the fact that Virginia is only one of two states that offers free Truvada medications is remarkable. Virginia, back in the 1990s, approved a constitutional amendment that outlawed gay marriage. This remained in effect until the U.S. Supreme Court overturned the amendment in June, 2014. The state also banned any needle exchange program as a tool in HIV prevention and only reversed this ban in light of the opioid crisis and only then following the deaths of family members of several politicians from opioid use.
One of the popular misconceptions about PrEP – which is commonly used instead of the commercial name truvada – is that it eliminates the need for condoms. This myth is unfounded. Condoms have been scientifically proven to significantly reduce HIV and other STI infections. Truvada, although it has proven efficacy in HIV-1 prevention, is not effective in preventing other STIs. Condoms are still a necessary prevention strategy to eliminate the transmission of HIV-2 and STIs. Both PrEP and condoms offer the best defense against unwanted infections.
The lower efficacy rate of truvada for injection drug-use transmission of HIV-1 is primarily due to the judgment impairment that substances cause in the accompanying safer-sex practices of individuals. This altering of mental status also affects the ability to use a condom properly or even using a condom – period.
As a Red Cross trained and endorsed HIV/AIDS prevention educator and as a current volunteer with an AIDS service organization, I know the importance of PrEP in providing communities with an additional resource in fighting against alarming infection statistics. For more than thirty years, we have all been living in the age of AIDS. We know how to prevent transmission. Hopefully, every tool we implement will be the “magical” one that will enable us to finally triumph over this tragedy.
For additional information on PrEP, as well as a source for these statistics, please click on the links listed below: