PrEP and PEP medicine - A.J.
PrEP vs. PEP: What’s the Difference and What’s More Effective?
It’s possible to prevent HIV transmission through medicine called PrEP an PEP.
HIV can spread between people during sex or when sharing needles, however, certain medications can help stop new infections from occurring. A therapy that’s used to prevent a condition rather than treat it is known as prophylaxis.
There are two main forms of prophylaxis for HIV: Preexposure prophylaxis, or PrEP, consists of medications that reduce the chances of a future infection. People who are at risk of contracting HIV, such as those who have multiple sexual partners or use injectable drugs, can take PrEP to help protect their health. Post-exposure prophylaxis, or PEP, includes drugs taken by people who may have been exposed to the virus.
PrEP: For Those at Risk
Doctors may recommend PrEP for people who are HIV-negative but are at a high risk of being exposed to the virus. Note that many people whose partners are HIV-positive no longer need PrEP — scientific evidence shows that people with HIV who achieve an undetectable viral load while on treatment cannot transmit the virus to others.
However, PrEP can help anyone of any gender or sexual identity.
When to consider PrEP:
When you have sex without a condom and have multiple partners, have a partner who has multiple partners, or don’t know whether your partner has HIV
If you are sexually active with someone who is HIV-positive but are unsure if their HIV is undetectable for at least 6 consecutive months or if they are continuing to take their HIV medications
Have had a sexually transmitted infection (STI) in the past six months
inject drugs, especially if you share needles with other people
Sometimes have unprotected sex with people who inject drugs
It may also be a good idea to take PrEP medications if you and your partner are trying to get pregnant. If PrEP protects you from HIV during pregnancy, it will help prevent spreading the virus to the baby.
PrEP can be a good way to stay safe and healthy if your lifestyle puts you at risk of HIV. Talk to your doctor to learn more about these medications and see if they would be a good fit for you.
PEP: For Emergency Situations
You may be able to take PEP if you don’t currently have HIV but may have been exposed. PEP may be a good idea if you have experienced the following in the past 72 hours (three days):
You may have come into contact with HIV during sex (for example, you had unprotected sex or the condom broke).
You shared needles or other drug-related equipment with someone else.
You were sexually assaulted.
You had a possible HIV exposure while working (for example, you accidentally stuck yourself with a needle while working as a health care provider).
If you think there is a chance you came into contact with HIV, take quick action. Go to an emergency room or call your doctor. The sooner you start PEP, the better. PEP isn’t meant to be used on a regular basis. If you frequently find yourself dealing with possible exposures, PrEP may be a better option.
How To Take PrEP and PEP
PrEP: You can take PrEP via an oral medication, or a medication injected into the muscle.
PrEP pills are usually taken once daily. However, some people take this medication “on demand,” or as needed, taking two doses two to 24 hours before sex and then one pill every 24 hours for two days after. PrEP injections are given in a clinic or doctor’s office every two months. You will need to undergo testing every three months while taking PrEP pills or every two months if you’re on injectable PrEP to check your HIV status and be screened for other STIs.
PEP treatment usually contains some of the same drugs found in PrEP, along with an additional drug. PEP medications are taken once a day for four weeks (28 days). You should do HIV testing while taking PEP and after completing treatment. If you have potentially been exposed to the virus, start taking PEP as soon as possible. Treatment should begin within 72 hours of exposure.
How PrEP and PEP Work
During an HIV infection, HIV enters your immune cells and produces many copies of itself. PrEP and PEP drugs help stop the copying process, helping to prevent HIV from establishing itself as a chronic infection in the body.
PrEP and PEP Effectiveness
The goal of both PrEP and PEP is to prevent new HIV infections. Each form of prophylaxis is highly effective.
PrEP can reduce your chance of an HIV infection by up to 99% during sex. It can also lower your infection risk by more than 74% during injection drug use.
PrEP is most effective when taken as prescribed, whether daily or on demand. If you use the injectable PrEP, you need to keep getting the shots as scheduled. If you don’t use PrEP as recommended, your risk of an HIV infection will increase. PrEP doesn’t prevent pregnancy or protect against STIs, so it’s still important to use latex or polyurethane condoms when having sex. PEP treatment is also very effective. PEP is more likely to fail if you don’t start taking it right away or if you miss doses or continue to experience potential exposures (for example, unprotected sex) while using the medications.
Are PrEP and PEP Safe?
PrEP and PEP side effects are generally mild. In many cases, they eventually ease or disappear. Side effects of PrEP and PEP medications include: Nausea, headache, tiredness, diarrhea. Injectable PrEP may lead to symptoms at the injection site such as tenderness and swelling, as well as fatigue, muscle aches, fever.
Ask your doctor if PrEP can be safely combined with your current medications. In some cases, PEP can interfere with other medications. Make sure to tell your doctor about all the medications you are taking so that they can identify any potential problems.
