HIV PREVENTION

What if you could get up to 99% protection from HIV... for free?

You have HIV prevention options

PrEP (Pre-Exposure Prophylaxis) allows you to dramatically reduce your chance of getting HIV from sex by 99%, and from injection drug use by 74%. When taken as prescribed, PrEP is highly effective for preventing HIV.

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What happens if I have been exposed to HIV+?

PEP (Post-Exposure Prophylaxis) is a safe and effective form of prevention for use only when you have been exposed to HIV.

Whether a condom broke during sex, needles were shared, or blood, semen, or rectal secretions were exchanged in any way - know that you have a choice in preventing HIV in those situations. Time is crucial and this oral treatment must be started within 72 hours after the exposure.

Frequently asked questions about HIV prevention

How is HIV transmitted?

The Human Immunodeficiency Virus or HIV is spread by direct contact with infected body fluids, including blood, semen, rectal fluids, vaginal secretions, and breast milk. This means that the HIV contained in one of these body fluids must get into the bloodstream by direct entry into a vein, a break in the skin, or through the mucous linings (such as the eyes, mouth, nose, vagina, rectum, or penis). Other body fluids such as urine, saliva, vomit, etc. do not pose a risk unless visible blood is present.

What is PrEP?

PrEP is a new and emerging HIV prevention intervention in which high-risk HIV-negative individuals take an antiretroviral (ARV) to reduce their individual risk of acquiring HIV.

PrEP is one pill, once a day. There is currently one medication FDA-approved for this purpose – Truvada. Truvada was approved for HIV treatment in 2004 and for prevention in 2012.

PrEP is a powerful HIV prevention tool and can be combined with condoms and other prevention methods to provide even greater protection than when used alone. People who use PrEP must commit to taking the drug daily and seeing their healthcare provider every 3 months for HIV testing and other follow-ups.

Some private physicians are not yet prescribing PrEP. The Alliance for Positive Health can help interested individuals find the information to make a decision, and navigate the systems including how to talk with their doctors about PrEP. For additional facts about PrEP, visit the Department of Health.

How well does PrEP work?

The PrEP medication works very well at preventing a person from getting HIV. Everyone taking PrEP should be sure to take the medication as agreed upon with the healthcare provider, but it is especially important for cis-gender women and transgender men who engage in vaginal intercourse to take it consistently each day to be fully protected during receptive vaginal intercourse. The more days a person misses a dose, the less protective the medication will be for any exposures that occur during that time period. If you are interested in more specific data regarding how well PrEP works, below is a list of links to the major clinical trials.

Can I get the PrEP medication from my regular healthcare provider, or do I have to go to a special doctor?

It depends on your doctor. Any physician, nurse practitioner or physician assistant can prescribe PrEP. It is important to have a healthcare provider who you can work with to individualize PrEP to your needs and circumstances. Not all healthcare facilities are prepared to administer long-acting injectable PrEP. The New York State Department of Health has prepared a directory of healthcare providers that prescribe PrEP that can be found here

What are the side effects of the PrEP medications?

All three approved medications, Truvada, Descovy, and Cabotegravir, are recognized as well-tolerated medications with few side effects. In clinical trials, only a small number of people found the side effects serious enough to stop taking the medication. People taking PrEP should discuss any side effects they experience with their healthcare provider. In many cases, side effects are only short term and can be managed. Two important health issues related to taking PrEP include kidney function and bone density. Your healthcare provider will ask if you have a history of kidney disease and will periodically order lab work to monitor your kidney function. Bone density will be monitored as needed. The NYSDOH is aware that lawsuits claim harm to individuals taking Truvada. However, scientific evidence shows that when taken as directed, Truvada is safe and effective. Since there are risks to taking any medication, individuals should speak with their healthcare provider about the benefits, risks (side effects), and possible alternatives for every medication they choose to take in order to understand the best choices for their specific situation.

Would I have to take PrEP for the rest of my life? What if I want to stop?

PrEP is not intended to be a life-long program. Rather, it is a program where the healthcare provider works with you to develop an individualized plan with as many renewals of the prescription as you and the healthcare provider agree to. For many people, life circumstances change over time and the risk for HIV may be reduced or eliminated. You should discuss the issue of how long you want to take the PrEP medication with your provider. If for any reason you want to stop taking the PrEP medication, consult with the healthcare provider who prescribed it, or another provider who is familiar with PrEP. Generally speaking, cis-gender men taking on-demand PrEP should continue taking the PrEP medication for at least 2 days after any possible exposure. Anyone taking daily PrEP should continue taking the medication for 28 days after the last possible exposure.

Is PrEP the same thing as PEP?

No.

PEP (Post-Exposure Prophylaxis) means taking medicine to prevent HIV after a possible exposure. The sooner you start PEP, the better. Every hour counts. If you’re prescribed PEP, you’ll need to take it daily for 28 days and PEP must be taken within 72 hours after your HIV exposure.

PrEP (Pre-Exposure Prophylaxis) is a new and emerging HIV prevention intervention in which high-risk HIV-negative individuals take an antiretroviral (ARV) to reduce their individual risk of acquiring HIV. PrEP is one pill, once a day.

What is PEP?

PEP (post-exposure prophylaxis) means taking medicine to prevent HIV after a possible exposure. The sooner you start PEP, the better. Every hour counts. If you’re prescribed PEP, you’ll need to take it daily for 28 days and PEP must be taken within 72 hours after your HIV exposure.

What are the side effects of the PEP medications?

PEP can cause mild side effects, including nausea, upset stomach, fatigue and headaches. These symptoms often get better or go away after the first week of taking PEP. To prevent nausea, take PEP with a snack or before bed to make nausea less noticeable.

I prefer sex without a condom, so I don't always use them. Would PrEP still work to prevent HIV if I don't use condoms?

If a person takes the PrEP medication consistently as directed, it provides a high level of protection against HIV. Condoms provide protection against sexually transmitted infections (STIs). People who are on the PrEP medication but are not using condoms may be exposed to an STI. It is important to be aware that having an STI can increase a person’s chance of getting HIV if exposed to the virus. Some STIs don’t have symptoms or symptoms may disappear on their own for periods of time. If you are not using condoms regularly, it would be especially important to have regular testing for STIs and to get treated as soon as possible if you have an STI. Screening for chlamydia and gonorrhea should include swabs of a person’s genitals, rectum and mouth. Learning about the signs and symptoms of STIs is helpful in identifying whether you or one of your partners has an STI. Condom use is recommended but choosing to not use condoms routinely should not prevent you from being prescribed PrEP.

How can I reduce my risk of getting HIV?

There are many ways to reduce your risk of contracting HIV. The basic rules dictate that you avoid swapping bodily fluids; blood, secretions (anal and vaginal), and semen. You should also avoid behaviors that make you more prone to take risks such as drug and alcohol use (especially using used needles).

I have sex partners who are living with HIV and have an undetectable viral load because they are on HIV treatment. Do I still need to take PrEP?

Individuals living with HIV who are taking HIV treatment consistently and have an undetectable viral load for at least 6 months cannot transmit the virus to an HIV-negative partner through sexual activity. In sero-discordant or magnetic couples (one person is living with HIV and the other not living with HIV), PrEP may be used by the HIV-negative partner for additional protection.

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