by: Christiana Funmi Ogunmodede
It is the 1st of December, and the appearance chocolate calendars can lastly come out. Nevertheless, earlier than we begin munching away, let’s not neglect at the moment can also be World AIDS day. Each year we come collectively to boost consciousness about HIV, and this yr isn’t any totally different.
This yr we talk about HIV pre-exposure prophylaxis (HIV PrEP), a agency cornerstone in England’s action plan to realize an 80% discount in new HIV circumstances by 2025 and nil new transmissions by 2030. Discover out what PrEP is, the way it happened, the place to entry it without spending a dime, tips on how to take it and the way efficient it’s.
What Is HIV PrEP?
PrEP stands for pre-exposure prophylaxis. It includes taking medicine earlier than unprotected intercourse to cease you from catching HIV. PrEP is just not the identical as HIV post-exposure prophylaxis (PEP), which is taken after intercourse to forestall HIV an infection. For extra details about PEP, see our earlier article on it here. The 2 HIV medicines generally used for PrEP are tenofovir disoproxil (TD or TDF) plus emtricitabine (FTC).
What Is The Historical past Behind PrEP?
The idea of HIV PrEP dates again to 1995 when scientists in the US experimented with macaque monkeys. The monkeys got an experimental HIV prevention drug after which uncovered to simian immunodeficiency virus (a virus much like HIV). The scientists discovered that the experimental drug prevented the monkeys from changing into contaminated with the simian virus. There have been subsequent research after this, and in 2007, the primary large-scale HIV PrEP scientific trial (Iprex study) began. Three years later, the outcomes had been printed, which confirmed a 44% discount in HIV infections when the topics took HIV PrEP. Different scientific trials befell in England in 2012 and 2017, which additionally demonstrated the effectiveness of PrEP. Finally, in 2020, HIV PrEP grew to become extensively obtainable within the UK without spending a dime to these deemed to be at excessive threat of getting HIV.
The illustration under summarises key occasions within the historical past of HIV PrEP.
How To Take PrEP?
There are two methods of taking HIV PrEP: day by day dosing and event-based dosing.
Daily dosing: This includes taking ONE pill day by day. That is the really helpful possibility for ladies taking PrEP and for transgender girls on hormone remedy. The time to HIV safety is 7 days for vaginal intercourse.
Event-based dosing: Also referred to as the “on demand” dosing. PrEP is barely taken when wanted utilizing the 2-1-1 dosing schedule. This implies TWO tablets are taken 2–24 hours earlier than having intercourse, one pill 24 hours after intercourse and one other pill 48 hours after intercourse. This regime is barely really helpful for males who’ve intercourse with males solely, because it has solely been proven to be efficient for anal intercourse.
How Efficient Is HIV PrEP?
PrEP may be very efficient for HIV prevention. The Iprex study – the primary HIV PrEP examine in people, confirmed that taking HIV PrEP reduces the incidence of HIV an infection by 44%. The PROUD study confirmed that HIV PrEP reduces the danger of HIV an infection by 86% in males which have intercourse with males. The Terrence Higgins Belief (The UK’s main HIV and Sexual Well being charity) additionally states that “HIV PrEP gives nearly 100% protection against HIV”.
While PrEP is efficient for HIV prevention; it doesn’t defend towards different sexually transmitted infections (STIs) similar to syphilis, gonorrhoea and chlamydia. Due to this fact, it’s extremely really helpful that people that use HIV PrEP have common STI screening each 3 months. You possibly can keep on prime of this utilizing our inexpensive at-home testing kits.
The place Do I Get PrEP From?
You will get free PrEP out of your local NHS sexual health clinic when you meet the eligibility standards. Alternatively, you should purchase PrEP online if you don’t qualify without spending a dime PrEP however nonetheless want to use it.
In England, HIV PrEP is free if any of the factors under applies:
- You might be HIV-negative with a HIV-positive companion, their HIV stage is just not but undetectable, and also you anticipate that you should have condomless intercourse with them (excluding oral intercourse)
- You’re a man or transgender girls who has intercourse with males, you may have had condomless intercourse (excluding oral intercourse) within the previous 3 months, and you might be prone to proceed to take action within the subsequent 3 months
- When reviewed by specialist employees, you might be assessed to be at excessive threat of buying HIV an infection. This may increasingly embody:
- You probably have condomless intercourse with companions from nations the place HIV is extra prevalent similar to South-East Asia, Southern Africa
- You’re a business intercourse employee and have condomless (excluding oral) intercourse.
Earlier than issuing PrEP, the clinic will make sure you meet a number of of the above standards and carry out some baseline blood checks (together with HIV and kidney perform). That is to make sure that you’re not HIV-positive and have wholesome kidney perform earlier than beginning PrEP. Additionally, you will doubtless be supplied a full STI display (together with syphilis, gonorrhoea and chlamydia. Then, you might be issued three months’ provide at a time, with repeat provides issued so long as you continue to meet the eligibility standards.
In Wales and Scotland, there could also be extra eligibility standards. Your native sexual well being clinic will be capable to advise you about this. I-base has a useful guide on safely shopping for PrEP on-line when you dwell within the UK. It is usually vital to say that you could nonetheless get recommendation and help out of your native NHS sexual well being clinic even when you resolve to purchase HIV PrEP on-line.
PrEP: The Current & The Future
It’s been 38 years since HIV was first recognized, and loads has modified. PrEP means we are able to stop HIV in these at larger threat. HIV is also no longer a death sentence because of the a number of courses of HIV medication obtainable. The UK authorities continues to work arduous in the direction of lowering HIV transmission. They’ve met the UNAIDS 90-90-90 goal for the final 3 years, i.e. 90% of these dwelling with HIV are recognized, 90% of these with HIV are getting remedy, and 90% of individuals on remedy don’t have HIV detectable of their blood.
Yoxly is pleased with the achievements thus far. We proceed to do our half to boost consciousness about HIV, and we additionally ask that you simply do the identical, too. So hopefully, in 2030, we are able to look again and have fun reaching the formidable goal of zero new HIV transmissions.
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Christiana Funmi Ogunmodede is an Antimicrobial Pharmacist working for the Royal Berkshire NHS. In her position inside the NHS, Christiana specialises in pharmaceutical administration for microbial illnesses, infectious illnesses, sexual well being and HIV.
