What is PrEP?
PrEP stands for “Pre-Exposure Prophylaxis”, meaning it is a tool to stop infection (“prophylaxis”) that is taken before you are exposed to HIV.
Current clinical guidelines for PrEP recommend daily use of the medication (either Truvada or generic emtricitabine/tenofovir disoproxil fumarate) for maximum HIV prevention benefits.
PrEP is endorsed by the World Health Organization for people who are HIV negative and at risk for becoming positive. It has been shown to be as high as 99% effective at reducing risk for HIV when taken every day (without missing a dose)1.
PrEP works by disrupting HIV and preventing it from establishing a foothold in the body and causing a systemic infection.
PrEP does not protect against other sexually transmitted infections, and it is not a cure for HIV.
PrEP vs. Truvada
PrEP is an acronym that describes the overall prevention method (Pre-Exposure Prophylaxis). It isn’t a new concept. Many other drugs are also taken prior to infection to prevent illness (e.g. Malaria medications before going travelling).
Truvada is the brand name for an antiviral pill that contains two medications, Emtricitabine (FTC) and Tenofovir Disoproxil Fumarate (TDF). Currently, Truvada is the only recommended and approved medication to be used as PrEP, although generic versions of the drug are now available in Canada and are equally effective as well as significantly cheaper. The generics versions are Teva-Emtricitabine/Tenofovir, APO-Emtricitabine/Tenofovir, and Mylan-Emtricitabine/Tenofovir.
Research is currently ongoing, but in the future additional antiviral medications may be approved to be used as PrEP.
Other Key Facts
PrEP should be seen not only as a daily pill that prevents HIV, but a comprehensive sexual health plan that links you to ongoing care. In addition to getting a prescription from your doctor, PrEP will require ongoing visits with your doctor every three months to screen for HIV, side effects from the medication, and sexually transmitted infections.
Results from the DISCOVER Trial which enrolled 5,300 mostly gay and bisexual men in Canada, Australia, the U.S. and Europe found the drug Descovy to be equally as effective as daily Truvada for HIV prevention. Those that used daily Descovy suffered fewer side effects, including smaller changes in kidney function and slightly less bone loss.
Descovy has not yet been approved in Canada for use as an HIV prevention tool.
On Demand Dosing
Imagine if you only had to take PrEP each time you planned to have sex to protect yourself, rather than every single day. That would mean that instead of spending $250 on medication you would spend significantly less, depending on your level of sexual activity.
1 Peter L. Anderson P. Glidden D. Liu A. et al. Emtricitabine-Tenofovir Concentrations and Pre-Exposure Prophylaxis Efficacy in Men Who Have Sex with Men. Retrived June 7, 2017 from: http://stm.sciencemag.org/content/4/151/151ra125