Truvada Gives Hope for Those at Risk for HIV

New HIV Prevention Strategy Approved by FDA

New hope in AIDS prevention. BigFive Images/Getty Images

A recent report showed that Truvada – the pre-exposure prophylaxis (PrEP) used to prevent new HIV infections – is as safe to take as aspirin. With a regimen of just a single pill taken once a day, it’s no surprise that more and more people want to know whether Truvada is right for them, how to get it, and about potential risks and side effects.

New HIV infection rates have been climbing over recent years, with a 12 percent increase accounting for almost 50,000 infections in the US in 2013.

With this number rising and 1.3 million Americans currently living with HIV, PrEP could potentially be what finally slows infection rates.

So here’s the lowdown on PrEP and everything you need to know before starting Truvada.

What Is Pre-exposure Prophylaxis (PrEP)?

Put simply, PrEP is an HIV-prevention strategy. While it is a course of medication that can prevent anyone from contracting HIV-1, it is recommended primarily for HIV-negative individuals who are regularly at risk for transmission through (knowingly or unknowingly) having sex with HIV-positive partners.

Available since July 2012, Truvada is currently the only FDA-approved PrEP. Interestingly, condoms have not been tested or approved by the FDA for use during anal sex, making this pill truly unique and an important innovation in prevention.

Truvada is made up of two drugs – Viread and Emtriva – that work in tandem to prevent HIV-1 from altering the genetic material of healthy T-cells.

When used correctly, it’s a great tool for those at high-risk for infection, giving them a way to stay ahead of the game.

Wait, There Are Two Types of HIV?

Yep. HIV-1 is the most common strain of the virus and is generally the type people talk about. HIV-2 is primarily found in Western Africa and is a less infectious and more slow-growing strain.

Truvada is currently only approved for preventing HIV-1, though some early studies show it may make infected users less infectious.

Read more on HIV strains and types.

Who Takes Truvada?

Though men who have sex with men are considered the group at highest risk – making up 56 percent of the HIV-positive population in the US – transgender women, intravenous drug users, and heterosexual couples can also be exposed. Unfortunately, according to the CDC, almost 13 percent of Americans with HIV don’t know they are infected. This makes PrEP especially valuable in communities where the transmission risk is high, but regular HIV testing carries a stigma. It is also good news for straight couples trying to conceive, as Truvada prevents an HIV-infected man from passing on the virus to the child.

If proactive in maintaining their HIV-negative status, PrEP users will likely never need post-exposure prophylaxis (PEP). Considered emergency treatment, PEP consists of two to three antiretroviral medications taken for 28 days that prevent HIV from replicating.

This treatment is most often used by healthcare workers accidentally exposed to the virus, or after a single high-risk event like unprotected sex, a shared needle or sexual assault. PEP must be taken within 72 hours of contact with the virus to be effective and – much like the morning after pill – is not to be used for regular prevention.

There are, however, some people for whom Truvada is not appropriate. Before receiving a prescription, potential users must undergo extensive physical exams to ensure proper kidney and liver function. If not healthy, Truvada can have damaging effects on these organs. And though most insurance companies cover the costs, $13,000 for a year’s supply may be prohibitive for some.

How Effective Is Truvada?

If taken daily, Truvada has been found to consistently prevent HIV in over 95 percent of sexually transmitted and 70 percent of IV drug-use transmitted cases. While it’s not advisable to skip doses, research shows that even with three missed pills a week, Truvada can still be up to 90 percent effective. For those who take doses just twice a week, one study found it still had the potential to be 76 percent effective. But before you go skipping doses, Truvada needs to be taken at least seven days in a row for men and 21 days for women to achieve maximum protection.

Potential Risks, Concerns, and Side Effects

Though long-term studies are needed, short- and mid-term use of Truvada is considered safe for healthy adults. Mild side effects like nausea, headache, and weight loss were reported by 2-4 percent of users, with the same number experiencing kidney dysfunction. 

Most experts recommend PrEP for individuals who regularly engage in unprotected sexual behavior with partners known or suspected to have HIV, but they stress that it should be just one step in a thorough prevention regimen. Experts urge total adherence, which includes testing organ function, for STIs, pregnancy and HIV every three to six months.

The main concern of popularizing Truvada is that users will neglect safe-sex practices, with 35 percent reportedly discontinuing condom use. Though PrEP is highly effective at preventing HIV, experts are quick to remind users that there are other sexually transmitted diseases and illnesses that condoms protect against.

If you want even more details on the specifics of PrEP, check out this fantastic fact sheet by the San Francisco AIDS Foundation.

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