By Paramasivam Ananth

It’s estimated that 42 million people are living with HIV/AIDS worldwide and 50% of all adults with HIV infection are women predominantly infected via heterosexual transmission. Unprotected sex is the most common way for contracting HIV. If you have had unprotected sex (including if a condom broke or came off during sex) or shared drug injecting equipment with somebody you know is HIV positive, or is from a group at high risk of HIV, such as gay men or African migrants, then you may be able to access a short course of HIV treatment intended to reduce the risk of you becoming infected with HIV….
Talk to your doctor about pre-exposure prophylaxis (PrEP). PrEP is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day. Studies have shown that PrEP is highly effective for preventing HIV from sex if it’s used as prescribed, but PrEP is much less effective when it isn’t taken consistently.


Purpose of PEP post-exposure prophylaxis, or PEP for short. PEP has been used for many years for healthcare workers who have had possible exposure to HIV, for example, after accidentally pricking themselves with needles used on people who were known to be HIV-positive or at risk of HIV. PEP is not a ‘cure’ for HIV. PEP may prevent HIV from entering cells in the body and so stop you from becoming infected with HIV. PEP isn’t 100% effective. However, there have been very few reports of HIV infection after the use of PEP. PEP normally consists of three anti-HIV drugs, from two of the different classes, usually two from theNRTI class, plus a boosted protease inhibitor. PEP should be taken for a month, and it is important to take all the doses, at the right time and in the right way. PEP is not 100% effective, so it would make good sense not to rely on access to PEP if you are having unprotected sex or sharing drug injecting equipment. Condoms, when used properly, are an effective way of preventing the spread of HIV and most other sexually transmitted infections. PEP won’t stop you becoming infected while you’re taking it, so it’s sensible to use condoms during that period as well.
If you are a woman and not using other forms of contraception, then if you have had unprotected sex you may also wish to consider emergency contraception. You can buy the emergency contraceptive pill from chemists, and it is usually also available from GPs, sexual health clinics and A&E departments. However, it is important to let the doctor or pharmacist know if you are on HIV treatment, as some anti-HIV drugs can interfere with the way the emergency contraceptive pill works, and you will need to take an increased dose. As with PEP, you need to take the pill within 72 hours of having sex, and ideally sooner. An alternative and very effective method of emergency contraception is to have an intrauterine device (IUD) fitted. Talk to your doctor about the best option for you.
In other circumstances, including oral sex when a man who is known to be HIV positive has ejaculated into your mouth, PEP would be considered if there are other factors involved that could increase the risk of transmission. These factors include the presence of another sexually transmitted infection or sexual assault.
PEP is safe but may cause side effects like nausea in some people. These side effects can be treated and aren’t life-threatening. If you stop the treatment before the full 28 day course, it may not work and you may seroconvert and become HIV positive. If side effects cause you discomfort, tell your doctor, as he or she may be able to adjust your treatment to help alleviate the side effects.
Side Effects: Nausea: 9% of those who received Truvada reported nausea in the first month. Headaches: 4.5% of participants who received Truvada reported headaches. Weight loss: 2.2% of those who received Truvada reported unintentional weight loss of more than 5%.
PEP is a 28 day course of Highly Active Antiretroviral therapy or HAART. HAART is “highly active” because it consists of two or more different antiretroviral drugs. Antiretroviral drugs are medicines that slow down or stop HIV from replicating inside the body (HIV is a type of virus known as a “retrovirus“). HAART is the therapy that many HIV positive people use to keep their infection under control. Different combinations of antiretroviral drugs, known as “cocktails”, are used in PEP. Although no single HAART cocktail has been proven to be more effective then others when used for PEP, the United States Centers for Disease Control and Prevention (CDC) recommends the following HAART cocktails for PEP:
A combination of Efavirenz (brand name Sustiva), plus lamivudine (known as 3TC, brand name Epivir) or emtricitabine (known as FTC, brand name Emtriva), pluszidovudine (known as AZT) or tenofovir (known as PMPA, brand name Viread)
A combination of lopinavir/ritonavir (sold in a combined form, brand name Kaletra), plus lamivudine (known as 3TC, brand name Epivir) or emtricitabine (known as FTC, brand name Emtriva) plus zidovudine (known as AZT)
PEP should be used only in emergency situations and must be started within 72 hours after a recent possible exposure to HIV. Not every doctor or hospital understands or provides PEP, so check the PEP now database to confirm that your hospital or doctor provides PEP.
Learn more about how to protect yourself and get information tailored to meet your needs from CDC’s HIV Risk Reduction Tool (BETA).
PrEP Q&A: Using HIV Drugs to Prevent HIV Infection | Also available in Spanish.
This factsheet answers common questions about PrEP.
Washington State PrEP Drug Assistance Program (PrEPDAP)
This program provides assistance in paying for PrEP.
The suggested monthly wholesale price for Truvada is roughly $1,500. However, prices in the Atlanta area have ranged from $1,300 to $1,500 per month, according to ARCA’s Thompson. That’s the price most individuals interested in the regimen have assumed they will have to pay. But that’s not entirely the case. We have listed below are resources for payment assistance and providers in your area.
Other Resources Truvada Payment Assistance: truvada-patient-assistance CDC Website on PrEP: research/prep/ Gilead Sciences PrEP Website: contains information about the drug, its use for PrEP, and information about the Medication Assistance Program. https://start. PrEPLine: 855-448-7737 (toll-free) provides expert guidance to clinicians about precribing PrEP.
PrEP providers in your area: A number of local agencies and organizations in the United States have programs to provide PrEP access. These programs are listed below in alphabetical order. If you have information about additional programs, contact us. PrEP is not being rolled out outside the United States, but there are many trials and demonstration projects taking place elsewhere. If and when PrEP becomes available in other countries, we will expand this list.

  • Alabama

  • Birmingham

  • 1917 PrEP Clinic at the University of Alabama

  • California

  • Database of California PrEP Providers

  • Los Angeles

  • Demonstration projects in the LA area

  • Palm Spring

  • DOCK provides PrEP referrals

  • San Diego

  • List of San Diego PrEP clinics

  • Colorado

  • Denver

  • Denver STD Clinic

  • Florida

  • Fort Lauderdale

  • Pride Center provides PrEP referrals

  • Miami

  • How to Get PrEP

  • Georgia

  • Atlanta

  • Pride Medical Absolute Care Intown Primary Care

  • Fulton County

  • Fulton Health Department

  • Hawaii

  • Wailuku and Waimea

  • Mango Medical

  • Illinois

  • Database of Chicago/Illinois PrEP Providers

  • Cook County

  • Estimated PrEP out-of-pocket cost under state health insurance marketplace plans

  • Indiana

  • Indianapolis

  • LifeCare

  • Kansas

  • Kansas City

  • Family Health Care

  • Maryland

  • Baltimore, Anne Arundel, Howard and Talbot County

  • Chase Brexton Health Care

  • Massachusetts

  • Boston

  • Fenway Institute PrEP demonstration Projects

  • Michigan

  • List of Michigan providers

  • For more information visit the Michigan Department of Health&Human Services

  • Minnesota

  • Minneapolis

  • List of Minneapolis providers

  • Mississippi

  • Toll-free call center: 1-844-YES-PREP

  • Louisiana

  • New Orleans

  • NO/AIDS PrEP Clinic

  • New York

  • PrEP Assistance Program: 1-800-542-2437

  • Buffalo

  • Evergreen Health Services

  • New York City

  • List of NYC PrEP providers

  • Rochester

  • Trillium Health

  • New Mexico

  • Albuquerque

  • UNM Medical Group Truman Health Services

  • North Carolina

  • Map of North Carolina PrEP providers

  • Ohio

  • List of Ohio PrEP providers

  • Oregon

  • List of Oregon PrEP providers

  • Pennsylvania

  • Philadelphia

  • Mazzoni CenterFight Community Health CentersStrawberry Mansion Health Center

  • Pittsburgh

  • Pittsburgh AIDS Center for Treatment (PACT)

  • Rhode Island

  • Providence

  • Miriam Hospital

  • Texas

  • Austin

  • Austin PrEP Access Project

  • Houston

  • Houston Area Community Services

  • Washington

  • List of Washington State PrEP providers

  • Washington, DC

  • Whitman-Walker Health

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