PrEP Yourself For The Truth About Truvada

If you’re at risk of contracting HIV, it’s important to talk to your doctor about getting on a daily pill called Truvada. This drug can reduce your chances of getting infected by up to 92%. But there are still some things you should know before taking PrEP (pre-exposure prophylaxis), so let’s get into it.

Truvada Prep

Get Tested Regularly

Before taking Truvada, or any other HIV medication, make sure you get tested regularly for HIV. A full test includes both a viral load test and an antibody test to check for antibodies produced by your immune system in response to the virus. If these are negative, get tested again in three months (or sooner if you have had sex without condoms).

Condom use, getting tested for STDs regularly, and avoiding risky behavior are still the most important factors in remaining STD-free, but another step can be added to the list: PrEPing yourself for sexual activity. PrEP, or pre-exposure prophylaxis, is a breakthrough in preventing the spread of human immunodeficiency virus (HIV). With one medication (brand name: Truvada), people with a high risk of contracting HIV can help eliminate their chances of becoming infected. But what exactly is Truvada and what do we know about it?

PrEP is a pill that prevents HIV infection. It contains two drugs—tenofovir and emtricitabine—that are used together as part of treatment for people who have been diagnosed with AIDS or HIV infection. Truvada, the brand name for PrEP, prevents the transmission of HIV with a once-a-day pill. Biotechnology company Gilead Sciences, Inc., the manufacturer of the revolutionary (and controversially expensive) hepatitis C medication drug Sovaldi, received approval and an endorsement from the Centers for Disease Control and Prevention (CDC) for Truvada in May 2015. The drug, which has been declared a breakthrough drug for its ability to reduce HIV infection rates by more than 90 percent in patients who take the pill daily, is a combination of two commonly prescribed antiviral HIV medicines, tenofovir, and emtricitabine alone. The guidelines released by the CDC recommend that all people who are at high risk for contracting HIV take the daily pill, which does not cure HIV but has been proven effective at rates of up to 99 percent in clinical trials. So if the drug is so effective, why aren’t more people taking it?

Side Effects of Truvada

The most common side effects are headache, nausea, and diarrhea. These can be managed by taking your medication with food or an antacid if you have heartburn. If you experience any severe side effects or other adverse symptoms, contact your doctor immediately.

Side effects may be worse in the first few weeks but will usually improve over time as your body adjusts to the medication and becomes immune to its effects.

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How Common Is Truvada?

At least 2,300 people had a prescription for Truvada in 2012 and 2013, not including prescriptions for HIV-positive people using the medication to treat their condition. While the drug was approved by the FDA in 2004, it was only for patients who already had a positive HIV diagnosis. The preventative use of Truvada for high-risk HIV-negative people was approved in 2012. People with a high risk of contracting HIV are defined as men who have sex with men, transgender women who have sex with men, people who have sex with multiple sex partners or have sex with an HIV-positive partner, sex workers, and people who share needles or use intravenous drugs.

One major criticism of the drug being hailed as a miracle for the gay community is that the perceived protection offered by Truvada will discourage the use of condoms and increase the likelihood of engaging in risky behaviors. Michael Weinstein, president of the AIDS Healthcare Foundation, the world’s largest non-government HIV/AIDS healthcare services provider, was criticized for calling Truvada a “party drug” that will lead to a decrease in condom use by gay men.

In a two-and-a-half year study designed to test the real-world application of the medication and conducted by Kaiser Permanente in San Francisco, over 600 people were given Truvada for daily use — 99 percent of the participants were gay or bisexual men who used the medication for an average of approximately seven months. Not a single participant, some of whom reported having multiple sex partners in a short amount of time, were diagnosed with HIV during the study, suggesting that the medication can prevent HIV in 100 percent of cases when taken as prescribed. The study did, however, confirm that condom use went down with use of Truvada: 41 percent of participants admitted to using condoms less often. About 30 percent of participants contracted an STD other than HIV in the first year of the study; that number jumped to 50 percent in the second year.

How Effective Is Truvada?

Truvada is a daily medication that you’ll need to take every day for it to remain effective. If you miss a dose, it’s important to take two doses of Truvada at the same time on the next day—if you don’t, your risk of getting HIV could increase.

If you miss two doses in a row and have sex without using another form of protection, talk with your doctor immediately. Your doctor will likely recommend that if possible, you should restart their Truvada regimen and begin taking active pills from the beginning (rather than continuing where they left off).

Another issue with Truvada, like Gilead Science’s miracle hepatitis C medication, is the price. A one-month supply of Truvada can cost between $1,300 and $1,700 without insurance, which may cover the prescription. Also, many healthcare providers aren’t familiar with PrEP and Truvada, so many patients have to not only request the medication but educate their doctors on why the medication is right for them. Some people seeking Truvada have been referred to an infectious disease specialist if their physician isn’t familiar or comfortable with prescribing Truvada for HIV prevention.

With 1.1 million people living with HIV in the United States already, preventing the 50,000 new cases of HIV that are diagnosed in the U.S. every year is a priority in health care. Truvada promises to provide a powerful method for stopping the spread of HIV.

No Cure For HIV

Truvada is not a cure for HIV. If you become infected despite taking Truvada, it’s necessary to take medications to suppress the disease indefinitely. The only way to be sure that you won’t transmit HIV sexually is by taking PrEP consistently and correctly every day. It’s important to remember that while PrEP can prevent HIV transmission, it doesn’t protect against other sexually transmitted diseases. If your partner is not on PrEP and has an STD, there is no way for you to know if he or she was infected with that STD before starting PrEP. And even if your partner does have an STD when he or she begins using Truvada as prevention (PrEP), there may still be some risk from unprotected sex over time because of potential drug resistance issues related to these infections.

PrEP is an incredibly useful tool in the fight against HIV. But it’s also not a magic bullet and you can still get HIV if you use it incorrectly or forget to take it.

PrEP is not 100% effective, but the CDC recommends everyone at risk of contracting HIV take PrEP as part of their overall prevention strategy. If you’re at risk, make sure you talk with your doctor about whether PrEP would be right for you—and if so, how best to incorporate it into your life.

HIV is a serious disease that can have devastating consequences if left untreated. That’s why PrEP is an important tool in our fight against it. We know there are still some who are wary of taking Truvada as a preventive measure, but we hope you’ll be reassured by the facts on this page and consider PrEP as an option for protecting yourself from HIV infection. In conjunction with taking PrEP we also recommend getting tested regularly to help prevent the spread of HIV.