PrEP and PrEP 2-1-1

Written by Janna Mustafina MSN, FNP-C

At eCareNow we offer services for HIV prophylaxis. In other words, you can request a prescription from our provider(s) for HIV prophylaxis. PrEP stands for pre-exposure prophylaxis. We prescribe an FDA (Food and Drug Administration) approved antiviral agent Truvada. Truvada is a combination of two medications: Tenofovir Disoproxil Fumarate (TDF)  and Emtricitabine. The other brand name for this medication is Descovy. The patients will take 1 tablet once a day before any possible HIV exposure. 

 

Here are very frequently asked questions (FAQ):

 

         1. I want to start PrEP to prevent HIV but I do not know if it is for me. Who is PrEP for? 

 

First, you must be HIV negative in order to be eligible for PrEP. PrEP is for prevention purposes only. Second, you must be at risk for HIV based on your sexual life history. Statistically, some populations bear a heavy burden for the largest numbers of HIV infections. To get an idea if you are at high risk for HIV infection review those population groups:

 

  1. Gay or bisexual men of all races and ethnicities. 

  2. African Americans and/or Latinos

  3. Latinos

  4. Men who have sex with men (MSM).

  5. Injection drug users

  6. Transgender infdividuals

 

If you think you belong to any of the above categories please connect with me or your health care provider to discuss PrEP regimen.

 

        2. How can I get medication for HIV prophylaxis?


To request a prescription for Truvada, you will need to schedule a Telehealth appointment with our provider. 

If you are eligible, we will prescribe you the medication that you can fill in your pharmacy of choice. Please be advised, we strictly follow CDC guidelines and it is recommended to have full STD check and routine blood work to evaluate your kidneys and liver functions for safe prescribing. The process is very simple and our patients are satisfied with the fast and easy services prior to starting Truvada. 

 

        3. Do I have to take Truvada every day for PrEP?

 

It’s  a good question and it depends on a couple of factors. Based on evidences, PrEP strategy works for anal sex only. It does not show to be effective for vaginal sex or oral sex. 

PrEP on demand schedule:

  • 1st dose - Take 2 tab 2-24 hours prior anal sex

  • 2nd dose - Take 1 tab 24 hours after anal sex

  • 3rd dose - Take 1 tab 24 hours after 2nd dose. 

If you practice mixed type of sex such as anal, vaginal, or oral - you will need to take Truvada daily.

 

        4. What are the side effects of Truvada?

 

Most medications can cause “start-up” side effects. Truvada’s most common side effects are gastrointestinal distress such as belly pain, nausea, diarrhea. Those side effects are usually mild and go away as your body adjusts to it.  Truvada should be taking with cautious by patients with kidney disease, therefore, the blood work prior and during PrEP therapy is important to monitor kidney functions to prevent kidneys toxicity. 

 

        5. Is PrEP lifelong regimen?

 

No, You can stop taking Truvada if your sexual life has changed and you do not think you are at high risk for HIV infection any longer. If you want to stop Truvada for HIV prevention, please discuss with your health care provider to establish a plan.

 

         6. I have no health insurance, is Truvada affordable?

 

Truvada is an expensive medication. Most insurances cover it without significant co-pay or no co-pay at all. However, there are also great patient assistance programs for those who have no insurance. Please speak to your provider about those options. 

 

         7. What else should I be aware of?

 

Please note the PrEP program is for HIV prevention only. It does not protect you from other STDs such as Chlamydia, Gonorrhea, Syphilis. Using condoms is important to protect yourself from those other than HIV STDs while on PrEP. 

 

Reference links:

1. Patient handout about PrEP 2-1-1

https://preprx.ucsf.edu/sites/g/files/tkssra2846/f/wysiwyg/PrEP-OI%202-1-1%20handout%20w%20Strut%20table.pdf

2. What is PrEP (Basic information from CDC)

https://www.cdc.gov/hiv/pdf/library/factsheets/prep101-consumer-info.pdf

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