By Brad Lundahl, Program Manager
There is a lot of misinformation out there about PrEP, the once-a-day pill to prevent HIV. Equality California knows that PrEP is an invaluable tool in the fight to end HIV, so we took the time to debunk some common myths and misconceptions about PrEP!
1. PrEP is unaffordable. PrEP is covered under most private insurance plans, including Medi-Cal and Covered California. Additionally, Gilead, the manufacturer of PrEP, offers a number of medication and co-pay assistance programs.
2. PrEP doesn’t work. PrEP, when taken consistently, is up to 99% effective in preventing the transmission of HIV–that’s as effective as birth control! It is recommended by the Center for Disease Control, the World Health Organization, and the U.S. Department of Health and Human Services, among other major public health agencies. The research and development of PrEP was driven by community activists, scientists, and leaders in the field of HIV research and advocacy.
3. Up to 99% effective = 1/100 chance of contracting HIV. PrEP is up to 99% effective at preventing HIV – this result has been supported by numerous studies. That does not mean there is a 1% chance of you contracting HIV during sex, but that your risk of contracting HIV is 99% lower than if you weren’t on PrEP. What does that mean? Well, without PrEP your risk of contracting HIV during unprotected receptive anal sex with an HIV positive partner who is not on medication is 1.43% or about 1 in 70. If you are on PrEP, that is reduced by 99% to 0.0143% or 1 in 7000.
Click here to learn more about the effectiveness of PrEP and how you can access it affordably>>
4. People who use PrEP are promiscuous. PrEP empowers men and women to take control of their sexual lives. People are having sex whether they are taking PrEP or not, so why not provide tools for people to engage in safer sex?
5. If I take PrEP, I don’t need to use condoms. PrEP only prevents against HIV transmission. The Center for Disease Control, as well as many other major public health organizations, recommend PrEP in conjunction with condoms to both maximize effectiveness and prevent against other sexually transmitted infections.
6. Using PrEP increases your risk of other STIs. While preliminary studies showed an increase in sexually transmitted infections among PrEP users, public health experts suggest that this may be due to PrEP users receiving mandatory STI testing every three months. As more people get tested more regularly, more STIs are being detected and also treated.
7. PrEP has bad side effects. For most people, PrEP has no side effects. Common side effects include nausea, dizziness, headaches, or weight loss, but these are mild and subside in a few weeks. Very rare side effects include modest declines in kidney function and bone density, but these resolve once treatment is discontinued. One recent study finds PrEP to be as safe as aspirin.
8. If I start PrEP, I’ll need to take it forever. While it is important to take PrEP consistently every day while you are using it, you can stop your PrEP regimen altogether if you no longer need it. Many people choose to discontinue PrEP if they enter a committed, monogamous relationship, or if they are not engaging in high-risk sexual activity, such as unprotected anal sex. If there are periods in your life where you are more sexually active – PrEP is a great option!
9. If I start PrEP, antiretroviral drugs will not work for me in the event that I do become infected. It is important to remain HIV-negative while taking PrEP. If you are HIV-positive and take PrEP, you may risk developing a drug-resistant strain of HIV. While on PrEP, your doctor will regularly test you for HIV to ensure that you remain negative. In most cases, those who sero-convert while on PrEP do so because they either stop taking the medication or do not take it consistently. Even then, it is rare that individuals developed a drug resistance to Truvada, the medication used in PrEP. However, in the cases where that does happen, the patient is placed on other anti-retroviral medications to manage the HIV.
10. PrEP resistant-strains of HIV are common. Strains of HIV resistant to Truvada used in PrEP are extremely uncommon. While there have been two confirmed cases of individuals on PrEP contracting HIV from a PrEP-resistant strain of the virus, despite daily use of the medication, it remains vanishingly rare. For example, in a study of 600 MSM in San Francisco on PrEP, not a single person contracted HIV over 2.5 years of study.
11. I can just take PrEP right before I know I’ll be having sex. PrEP takes around 20 days to build up in your system to reach maximum effectiveness. For optimal protection, take PrEP consistently, every day. But, if you miss a dose, that’s fine. Just resume your regular routine the following day. In the event where have missed multiple consecutive doses of PrEP and have had unprotected sex which may have exposed you to HIV, contact your doctor about PEP, the post-exposure prophylaxis drug that, when taken within 72 hours of a potential HIV exposure, will significantly reduce your risk of infection.
PrEP is a safe and effective way to prevent the transmission of HIV and empower people to take control of their sexual lives. If you are interested in learning more about PrEP, check out our website which has tons of great resources, and talk to your doctor to discuss if PrEP is right for you! If you have any additional questions, please contact Brad Lundahl at brad@eqca.org or 323-848-9801.
Supported by grant funding from Gilead Sciences, Inc. Gilead Sciences, Inc. has had no input into the development or content of these materials.