Your guide to PrEP (Pre Exposure Prophylaxis)

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Vermont CARES is so excited to announce our new Prevention program called “Let me PrEP u”. The goal of this program is to provide information and referrals and encourage conversations about PrEP.  If you are interested in learning more about PrEP contact our HIV Prevention Specialist Kathy Hennis at Kathy@vtcares.org

The information below will answer most of your questions about PrEP.

 

What is PrEP?

Pre-exposure prophylaxis, or PrEP, is a pill taken by HIV negative people to reduce the likelihood of contracting HIV. PrEP is used for those at high risk for the virus. Taken once daily, PrEP works by limiting the ability of HIV to establish a permanent infection in the body if a person is exposed to HIV.

Currently, only one medication is approved as PrEP. The brand name of this drug is Truvada and it is one pill that people who are HIV positive take to lower their viral load. Truvada itself is a combination of two drugs (tenofovir and emtricitabine). People who are HIV positive take more medicine than just Truvada, but when taken alone, Truvada can be an incredible prevention tool for those who are HIV negative. In fact, when taken consistently, PrEP has been shown to reduce the risk of HIV infection by 92%. Read on to see if PrEP is right for you.

 

Who should take PrEP?

PrEP is intended for HIV negative people who are at high risk of contracting HIV. Per the guidelines from the Center for Disease Control and Prevention, people who may be at high risk and should consider PrEP are:

For sexual transmission,

  1. Anyone who is in an ongoing relationship with an HIV-positive partner.
  2. Anyone who is not in a mutually monogamous relationship with a partner who recently tested HIV negative.
  3. A gay or bisexual man who has had anal sex without a condom or been diagnosed with an STD in the past 6 months.
  4. A heterosexual man or woman who does not regularly use condoms during sex with partners of unknown HIV status who are at substantial risk of HIV infection (for example, people who inject drugs or have bisexual male partners).

For people who inject drugs,

  1. Anyone who has injected illicit drugs in the past 6 months and who has shared injection equipment or been in drug treatment for injection drug use in the past 6 months.

For pregnancy,

  1. For heterosexual couples where one partner has HIV and the other does not, PrEP is one option to protect the uninfected partner during conception and pregnancy (and therefore safeguard the child as well).

People who use PrEP must be able to take the pill every day and see a medical provider every 3 months for follow up care and repeated HIV testing. If you think you are a good candidate, read on to see more information and local resources.

 

Are there side effects?

There are some side effects to be aware of with PrEP, as there are with all medications. However, most of the side effects of PrEP are minimal, which is necessary to provide medication to otherwise healthy people. Some people experience gastrointestinal problems for the first month after starting the medication, but this usually soon subsides. Blood tests are done before starting PrEP and while on PrEP to make sure the medicine is not having an adverse effect in the body. PrEP has been shown to be very safe for those whom it is prescribed and no serious side effects have been reported.

 

Can I stop using condoms if I’m on PrEP?

That is not recommended. When taken consistently, PrEP is very effective, however, PrEP does not protect against other STIs like gonorrhea, chlamydia, or syphilis. PrEP should not be used in place of condoms but should be used as an additional prevention method. To see more ways to protect yourself from HIV, visit our page on safer sex.

 

Where do I get PrEP?

There are several options to think about when choosing to look for a doctor to prescribe PrEP. Remember, this prevention method is for those at high risk for contracting HIV. Therefore, whoever you choose to see will ask you some questions about your sex life and/or your drug use to determine if this drug is right for you. It is good to find a provider you feel comfortable having these conversations with. There will also be lab work that needs to be done to determine if the drug will be a good match for your body. And, as stated above, there will be follow up appointments with your doctor every 3 months for repeating blood work and HIV testing.

Primary Care Physician – Going to your primary care physician is always an option. There are some PCPs that know more about PrEP than others, because it is a fairly new intervention (though very well tested). Giving your PCP’s office a call beforehand to see if they have been prescribing PrEP and feel comfortable doing so can be a good idea. It is also important to think about whether you are comfortable talking openly and honestly with your PCP about your sex life or drug use. This is vital for you to receive adequate care. A knowledgeable PCP you feel comfortable with can be a great resource!

Planned Parenthood – All Planned Parenthood health centers in Vermont are currently prescribing PrEP. PPNNE can also be a great resource for other STI testing and prevention education. We highly recommend using their services. Contact your local clinic to make an appointment.

Comprehensive Care Clinics – The CCC is the HIV/AIDS clinic at The UVM Medical Center, Brattleboro Memorial Hospital, and at the Northeastern Vermont Regional Hospital. The doctors there are very knowledgeable about HIV and currently prescribe PrEP to those at high risk of contracting the virus.

Contact:

-Burlington – 802-847-4594. 111 Colchester Ave.

-Brattleboro – 802-257-8860. 17 Belmont Ave.

-St. Johnsbury -802-748-2578. 1290 Hospital Drive.

Other providers we recommend:

-Tara Chasnoff, NP. Community Health Centers of Burlington. 802-864-6309. 671 Riverside Ave, Burlington, VT.

-Leo Kline, NP. Community Health Centers of Burlington. 802-864-6309. 671 Riverside Ave, Burlington, VT.

-Devika Singh, Ph.D. Central Vermont Medical Center, Infectious Disease. 802-225-5400. 130 Fisher Rd, Berlin, VT.

*If you are a provider and would like to be added to this resource list, please get in contact with us by emailing our HIV Prevention Specialist – Kathy@vtcares.org

 

Does insurance cover PrEP?

Most insurance companies will cover PrEP. However, if you have a high deductible, no insurance, or your insurance will not cover PrEP, there are several medication assistance programs available to help.

Gilead Co-Pay Assistance Program

-Can cover PrEP co-pays and deductibles up to $6,000/yr

-Not income sensitive

-Need to be on Gilead medication and have private insurance (Not Medicare or Medicaid)

Patient Access Network Foundation

-Copay assistance only

-Can help cover PrEP if using EITHER private insurance or Medicare/ Medicaid.

-Household income taken into account

Truvada for PrEP Medication Assistance Program 

-Website will direct you to phone number to call to find out eligibility

 

Research

Many people feel better after reading the research about certain new drugs. We certainly understand that and encourage you to look into it. Here are some good links to the biggest clinical trials and studies done on PrEP, from the Center for Disease Control and Prevention’s website.

 

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