Center for Applied Research
for Men and Community Health
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Does this mean I need to take PrEP for the rest of my life once I take it?
No, it does not! PrEP is not a lifetime strategy. Like birth control pills, you take the pills only when you are in the period where you need the protection the most. When you’re single and sexually active, taking PrEP daily - whether or not you think you will have sex that day - is important. This is because it takes four to seven days of dosage adherence for you to reach maximum protection from HIV.
I’m afraid taking PrEP will encourage me to do risky behavior.
Well, PrEP can’t control your personal choice BUT never assume that people who are taking PrEP are automatically taking more risky behavior. Just because you’re given a life vest, it doesn’t mean you’re okay with your boat sinking, right? Does wearing a motorcycle helmet encourage you to drive recklessly? On the other hand, PrEP is an answer to the fact that behavior change among adults is difficult. Smokers know that tobacco is dangerous, yet they have a hard time quitting. Exercise and healthy diet are known to be important, yet obesity is still rising. We are facing the same problem with the fight against HIV. We all know that using condoms will prevent HIV, but we also know that correct use of condoms does not always happen every time.
The best way to encourage behavior change is to provide people with options. After all, the best prevention option is the one you decide to use correctly and consistently.
Should I just take PrEP before having sex??
No, you shouldn’t. It takes at least four to seven days of dosage adherence for you to reach maximum protection from HIV. Here’s a breakdown according to iPrex study.
If you take 7 pills per week, your estimated level of protection is 99%. If you take 4 pills per week, your estimated level of protection is 96%.
And REMEMBER to continue taking PrEP at least 28 days after a possible exposure.
This whole thing is new. And what about the side effects? I will wait a little bit more to be on board.
PrEP is a prophylactic approach and the medical world has been doing this since a long time ago. Anti-malaria pills, for example, has been around for decades to help travelers avoiding malaria infection in tropical countries. These travelers are expected to start taking antimalarial drugs few weeks before and during their journey.
However, just like how anti-malaria pills are giving you protection against malaria vector mosquitos but not the dengue fever mosquitos and other tropical parasites, PrEP won’t protect you from other sexual transmission infections such as gonorrhea and syphilis.
For the first few weeks of starting PrEP, some people complain about nausea, vomiting, fatigue, and dizziness, with these minor symptoms eventually resolving themselves over time.
What is PrEP?
Pre Exposure Prophylaxis (PrEP) is an HIV prevention approach where HIV-negative individuals use HIV medication to significantly reduce their risk of becoming infected if they are exposed to the virus. PrEP is a combination of two drugs, tenofovir and emtricitabine, in one pill that is taken one time a day. Common brands of PrEP available in Vietnam are Truvada, Ricovir-Em, and Teno-Em. When you read or hear “PrEP pills”, it’s the tenofovir + emtricitabine pills that they’re talking about. PrEP prevents HIV infection in our body by blocking the enzyme that’s used by the virus to make more copies of itself.
How effective is PrEP?
Several scientific studies have shown that PrEP is very effective at preventing HIV infection. In fact, there are no cases in the world of MSM getting HIV infection while taking PrEP. HIV infection usually only occurs if MSM stop taking PrEP or if they do not take it every day.
According to the PROUD study , in which 545 men who have sex with men (MSM) were enrolled, PrEP reduced the number of infections up to 86%.
According to another research, iPrEx study, in which 2499 MSM and transgender women were signed up, people who take PrEP pills daily acquire up to 99% level of protection.
Who does recommend PrEP?
With 2.7 million people becoming infected annually worldwide, World Health Organization (WHO) and United States Centers for Disease Control and Prevention(CDC)recommend PrEP as an important intervention to complement existing HIV prevention tools among HIV-negative MSM, particularly to those who are in relationship with HIV-positive person or at substantial risk of HIV such as those who don’t regularly use condom during intercourse
Do we need new prevention tools?
Condoms are a great protection against HIV, but there are many cases when many of us are forgetting or choosing not to use condoms. Reasons like getting caught up in the moment, feeling that condoms block emotional intimacy, having difficulty to keep an erection, or too drunk to use condoms are often heard.
Also, external factors like homophobia, discrimination based on sexual orientation and gender expression, racism, poverty and homelessness, may encourage risk behavior among marginalised MSM while also amplify substantial health discrepancies across various socio-economic groups among them.
A scientific estimation indicates that, without a more effective intervention, MSM will make up half or more of all new HIV infections in Asia by 2020.
New prevention tools are urgently needed to change the game. Now that PrEP has been shown to be effective in clinical trials, the next step is to ensure how you and other MSM around the world have access to PrEP.
So all I need is just the prescription, right?
Yes and No. Yes, because you need to be prescribed by a health practitioner to take PrEP. No, because there’s more than just a prescription entailed in taking PrEP. PrEP is a program. After your first prescription, you’ll be asked to come back to your doctor at least once in three months to do repeat HIV testing and other health checkups including STI screening and kidney function tests.
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