All About PrEP, The Pill For HIV Prevention

What is PrEP?

Pre-exposure prophylaxis (or PrEP) is medicine taken to prevent getting human immunodeficiency virus (HIV). It can be pills or an injection. PrEP is highly effective for preventing HIV when taken as prescribed. Pre-exposure prophylaxis is not a new concept: it has been used for other conditions. If you’re traveling to a country where malaria is common, for example, your doctor will prescribe medication that you begin taking before traveling to prevent from contracting malaria. Birth control is also a form of pre-exposure medication, as it prevents pregnancy.

How is PrEP prescribed?

It is prescribed as a pill that is taken once a day or as an injectable once every 8 weeks. Research is currently looking into injectables with longer waits between shots.

Is there a maximum length of time PrEP should be taken?

There is really no length of time PrEP is meant to be taken — it should be taken as long as the person is at high risk for contracting HIV.

Are there any side effects?

Oral PrEP (pill form) could potentially contribute to decreased bone density (aka the thinning of bones), so it’s important to have it monitored by a doctor. People who have kidney disease must also be carefully monitored by their doctor when taking PrEP, as it could influence kidney function.

The most common side effects of injectable PrEP are pain or lumps at the injection site. It can cause liver problems which will be carefully monitored by your doctor while taking PrEP.

How effective is PrEP?

The Centers for Disease Prevention and Control (CDC) says that when taken daily, PrEP is about 99% effective at preventing HIV from sex, and about 74% effective at preventing HIV in people who inject drugs. PrEP is less effective when taken inconsistently.

Who should consider getting a prescription for PrEP?

The CDC has guidelines to determine who is at risk for contracting HIV:

• Men who have sex with men.
• Someone who is in a sexual relationship with someone else who is infected with HIV.
• People who have unprotected anal intercourse.
• People who have sex for money, drugs or housing (or other transactional reasons).
• People who use stimulant drugs, like methamphetamine or cocaine.
• People who share injection equipment.
• People who have had at least one sexually transmitted infection within the last year.
• People who have taken non-occupational post-exposure prophylaxis (nPEP), especially several courses of it. (nPEP is taken after exposure to HIV. It must be taken within 72 hours of exposure in order to be effective.)
• You may choose to take PrEP, even if the behaviors listed above don’t apply to you.

Please speak with your provider if you are interested in starting PrEP.

How long has PrEP been in use?

PrEP was approved for use by the Food & Drug Administration (FDA) in 2012.

How can I get a prescription?

Find a primary care doctor or HIV specialist you are comfortable with who prescribes PrEP and start a discussion with them, saying you’d like to be on the medication that prevents HIV infection. Be honest with your doctor and let them ask the questions they need to know in order to prescribe it to you.

Covering/Affording PrEP

Most insurance plans and state Medicaid programs cover PrEP. Under the Affordable Care Act, PrEP must be free under almost all health insurance plans. That means you can't be charged for your medication, clinic visits, and lab tests needed to maintain your prescription.

If you don't have insurance or Medicaid coverage, there are other programs that provide PrEP for free or at a reduced cost:

• Co-pay assistance programs help lower the costs of PrEP medications. Income is not a factor in eligibility.
• ViiVConnect offers a program to help pay for PrEP shots.

Other Resources for PrEP

If your insurance is not accepted at Henry Ford, please see these resources for STI testing and PrEP:

• City of Detroit Sexually Transmitted Diseases Clinic
• Free Home HIV Test Kit for Wayne County Residents
• Planned Parenthood Detroit
• Corktown Health
• Michigan State Department of Health and Human Services Clinic Finder
• CDC GetTested Clinic Finder
• Mistr
• Nurx
• QCare+
  

Henry Ford Health is now happy to offer TelePrEP!

What is TelePrEP?

TelePrEP is a virtual program where you can get HIV and STI (sexually transmitted infection) prevention care. This virtual program means you will spend less time in your provider’s (doctor or nurse practitioner) office and will have fewer barriers to get the prevention medicine you need.

How does it work?

You will have a video visit with a doctor or nurse practitioner every 6 months and labs every 3 months. You must have MyChart to be in this program.

How do I get started?

To get started, scan the QR code below or click this link.

To scan the QR code:
1. Open the camera on your smartphone.
2. Place the QR directly in the center of the camera and the link should appear on the screen.
3. Click the link to go to the webpage.