PrEP & PEP PROGRAM AT BRIDGING ACCESS TO CARE
Bridging Access to Care (BAC) believes in informing our clients about all of the options available to them so they may choose the tools that suit them best and keep them happy and healthy. Reach out to the staff in our PrEP/PEP program to learn if PrEP/PEP is the right choice for you. We would be happy to answer any questions you may have regarding PrEP or PEP, how it works, financial assistance programs available to pay for its cost, and the steps necessary to stay on PrEP or PEP. If you’ve already decided PrEP/PEP is the form of HIV prevention for you, we can even provide you with a referral to a clinic near you that is knowledgeable and experienced in prescribing PrEP/PEP.
WHAT IS PrEP and PEP?
PrEP stands for Pre-Exposure Prophylaxis. PrEP is a way for people who don’t have HIV but who are at a very high risk of getting it to prevent HIV infection by taking a pill every day. The pill—Truvada®, contains two medicines that are also used to treat HIV (Tenofovir and ep the virus from taking hold in your body. 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. But people who use PrEP must commit to taking the drug every day and seeing their health care provider for follow-up every 3 months.
PEP stands for Post-Exposure Prophylaxis. PEP consists of two pills that are taken for 28 days. People take PEP “post” or after exposure to HIV, within 36 hours of a high-risk exposure. If you start taking PEP within 36 hours after being exposed to HIV, your likelihood of becoming infected is greatly reduced.
HOW DOES PrEP and PEP WORK?
The idea behind PrEP is that if an HIV-negative person takes Truvada®, there will be enough of the medication in the body to greatly reduce the risk of becoming HIV-infected through sex. It takes up to seven (7) days of daily oral Truvada® to reach levels high enough in the body to protect the user against HIV-infection. The medications in PrEP and PEP stop the virus from multiplying. In order to survive, HIV needs to make more copies of itself and spread throughout the bloodstream. The medications in PrEP and PEP do not allow HIV to multiply, so the body can eliminate the virus from the body before infection can occur.
WHAT DOESN’T PrEP DO?
PrEP does not protect a person a person against other sexually transmitted diseases (STIs) like chlamydia, gonorrhea, syphilis or herpes. PrEP is not a cure for HIV and doesn’t work on its own as treatment for someone already living with HIV.
WHO SHOULD USE PrEP?
We recommend PrEP for you if you are HIV negative and:
- You do not always use condoms
- You have sex with multiple partners
- You are in an open relationship
- You are in a relationship with an HIV positive partner
- You have sex under the influence of alcohol or drugs
- You inject drugs that were not prescribed by a doctor
- You are a sex worker or exchange sex for compensation
HOW EFFECTIVE IS PrEP?
The level of HIV protection through the use of PrEP varies widely depending on how consistently PrEP is used. The bottom line is that for PrEP to be considered as much as 99% effective in preventing HIV through sexual intercourse, it must be taken every day as prescribed. It is also important to know that PrEP is not 100% effective in preventing an HIV infection. PrEP does not protect against other sexually transmitted infections (STIs) such as gonorrhea, syphilis, or Chlamydia. PrEP, therefore should be used with condoms. Many people don’t feel any different while taking PrEP. It doesn’t mean that the medication isn’t working. If you’re taking PrEP correctly and consistently, you can be confident that the drug is working to help protect your body from HIV infection.
What are the SIDE EFFECTS?
Truvada® may have side effects, but most people on PrEP or PEP do not experience any side effects. You should consult a medical provider if you have any concerns. One out of ten people experience short-term bothersome side effects that include upset stomach, vomiting, loose or watery stools, runny nose, gas, itching, headache, and dizziness. These effects usually subside after the first few weeks of taking the medication. One tip is to consider changing the time you take the drug; for example, taking it at night might be a good way to help you sleep through the nausea.
People who are on PrEP need to:
o Get tested for HIV every 3 months.
o Get tested for other STDs every 3 months.
o Come to the clinic for medical screening and refills every 3 months.
o Pick up a refill of their medication every month.
o Remember to take the pill every day.
People who are on PEP need to:
o Maintain contact with your medical provider over the time you are taking the pill.
o Get tested for HIV 30-days and 90-days after starting PEP.
o Get tested and treated for other STDs.
o Remember to take the pill every day for 28 days.
o Figure out a strategy to avoid a new exposure after you are finished with PEP.
ACCESS TO PrEP
There should be no barriers if an individual decides that PrEP is the ideal mode of HIV prevention for him or her. At BAC, there are many opportunities to get access to PrEP at little or no cost. This includes the PrEP Assistance Program (PrEP-AP). This program allows BAC to provide uninsured individuals the services needed to access and stay on PrEP for free. To get Truvada® for PrEP, you will need a prescription from a medical provider, so your first step is to make an appointment at a health center or clinic that has primary care and/or sexual health services and accepts patients without insurance. In selecting a clinic, you may want to ask whether they have providers who are able to prescribe PrEP and are open to discussing PrEP with their patients. Doctors, nurse practitioners, and physician assistants are all qualified to write PrEP prescriptions. Anyone on PrEP should regularly visit his/her doctor and have an open relationship with their doctor.
PAYING FOR PrEP
There are still options for individuals without insurance and who are unable to pay for PrEP out of pocket. Additionally, Gilead’s Truvada® for PrEP Medication Assistance Program will provide eligible HIV-negative adults in the United States who do not have insurance obtain access to PrEP. To find out if you are eligible for this medication assistance program, call 1-855-330-5479. Or call us at BAC so we can help you get started right away. While PrEP medication for the uninsured is covered by Gilead’s assistance program, the accompanying monitoring and care services are not. The Pre-Exposure Prophylaxis Assistance Program (PrEP-AP) will cover those costs. Depending on where you receive your care, eligible providers can offer a specific set of services including but not limited to HIV testing, counseling, sexually transmitted disease testing and supportive primary care services, consistent with clinical guidelines at no cost. Depending on your individual circumstances, you may be able to get insurance now. When choosing a plan, you’ll want to consider whether Truvada® for PrEP is covered by the plan and at what cost (i.e., what the co-pay is for Truvada®).