Pre-exposure Prophylaxis Background

In August 2021, the Imbokodo study on HIV vaccine on 2600 women revealed no protection against HIV. Where's in June 2022, Tel Aviv University revealed that a one-time injection might be the answer to a permanent cure (Alessio D. Nahmad et al.).Today, many discoveries for HIV treatment may not have been in practice, yet some careful steps have immediate and valuable impacts on preventing HIV. Initial patient treatment with HIV can help prevent them from more infections and diseases.

A form of such approach of medication used for HIV is termed Antiretroviral Therapy. It aims to lower the level of HIV, which viruses are unable to transmit. When the level of the virus is low, the immune system is ready to fight back and protect the body from further disease spreading. The food and Drugs Administration (FDA) has approved more than 20 medications for HIV cure. This article explains how one such medication is helpful in prevention and cure.

What is PrEP?

Pre-exposure prophylaxis is an FDA-approved oral medication for preventing HIV. It is a combination of the Truvada pill, having 99% effectiveness in preventing HIV risk. Truvada contains two active substances, emtricitabine (200 mg) and tenofovir disoproxil (245 mg). for HIV treatment, the recommended dose is one pill a day. It is used from age 12 onwards, adulthood.

When is PrEP taken?

If you have used precautionary measures during sex past six months, avoided anal sex, have cut down on alcohol and tested negative for sexually transmitted diseases, then PREP, Truvada is a good call prescription for you. It is FDA approved medicine and uses a single pill as a daily dose. Truvada contains two medications, tenofovir (Viread) and emtricitabine (Emtriva). There is no limitation regarding food or meal; it can be taken anytime during meals or after.

How are Prep taken/ OPTIONS?

Ask your healthcare practitioner to suggest a better dose of PREP. Taking Prep is divided into two doses or ways:

  • Daily Regular dose
  • On-demand dose

Regular / DAILY DOSE

  • The daily dose is recommended for
  • Women for seven days
  • People exposed to vulnerable situations for HIV
  • Difficulty using Truvada

On-Demand PrEP:                

  • Taken when needed (two tablets 2-24hours before sex, one tablet
  • 24 hours after sex and a further tablet 48 hours after sex
  • Bisexual men
  • Transgender during hormone therapy
  • Cis-gender women, cis-gender men

Long-Acting Injectable PrEP:

  • Long-acting PrEP (CAB-LA) is taken by injection for people who are comfortable with injections rather than tablets and can visit the hospital daily.
  • It is used with oral cabotegravir for 5 weeks for injection to be tolerated well. The second dose is given after 4 weeks after the first dose.

Types of PREP

Currently, PrEP tablets and vaginal PrEP rings are approved BY FDA for use.

There are two combinations of anti-HIV drugs approved to provide a protective ring against HIV to be used as PrEP tablets are:

  • Truvada®event based or on demand ( emtricitabine and tenofovir disoproxil fumarate) . it is used by all having risk of HIV during sex
  • Descovy® ( emtricitabine and tenofovir alafenamide) (slight effectiveness for viginal HIV transmission by FDA ). It is used by trans men and woman

Depending on your health condition, present diseases and infection, ask your healthcare practitioner to guide you

Vaginal rings

  • Vaginal rings as anti-HIV silicon having drug dapivirine ( approved by World Health Organization) 
  • The course of one month

Prep Effectivity

Effectivity of Prep is supported by

  • The Centers for Disease Control and Prevention (CDC) 2014 recommended it as a daily PrEP for HIV prevention.
  • The World Health Organization issued in 2015 based on the results of two European studies.
  • Preventive Services Task Force in 2019 recommended that clinicians offer daily oral PrEP to all people at high risk of acquiring HIV.

Risk factors/safety

Prep is safe and has no significant health side effects. Yet some show mild effects like nausea, loss of appetite,r fatigue, stomach pain, headaches, rash kidney damage. The organ damage is probably due to increased creatinine and transaminases in the liver and kidney. These side effects take up to one month to vanish.
Other risks include reduced bone mineral density, which can be tackled by using alternative medicines ( vitamin D and calcium supplements).

Reasonable care by regular checkups and tests is advisable to avoid further organ issues and physical differences. For further recommendations about stopping or changing dosage, consulting a doctor is advisable.