We will be continuing our talk on HIV & AIDS awareness with a discussion on prevention. To recap, HIV is most commonly spread through anal or vaginal sex with a person who is HIV positive, but it can also be spread through sharing needles or syringes with an HIV positive person. Those most at risk of contracting HIV in the United States include men who have sex with men and transgender women who have sex with men. Additionally, Black Americans and Hispanic/Latino Americans are at higher risk of HIV compared to other ethnic groups. Other high-risk groups include people who have unprotected sex or have multiple sexual partners. Although these groups are most at risk, anyone could potentially become infected with HIV, so it is extremely important to protect yourself and others by using safe sex practices with condoms, avoid sharing needles and syringes, and learning your HIV status.
How do I learn my HIV status, you may ask? There are many testing centers across the United States where you can learn your HIV status. To find a testing location near you, go to https://gettested.cdc.gov/ and type in your zip code. You can also go to your doctor’s office, health department, or attend local screening events in your area. It’s important to know what kind of test you are receiving when you give your blood sample. Some may allow you to know your status within 30 minutes while others may not be able to tell until it has been several weeks or months since a potential exposure. Therefore, ask the healthcare providers conducting the screening for information on the type of test you are receiving and/or if you might need follow up testing.
The Center for Disease Control (CDC) recommends that sexually active men who have sex with men and transgender women who have sex with men are encouraged to be tested every 3-6 months while other high-risk patients (patients who have unprotected sex, multiple sexual partners, and/or share needles or syringes) are encouraged to be tested yearly. Regardless of your risk factors, the CDC recommends that everyone ages 13-64 are recommended to receive at least one HIV test in their lifetime.
Aside from getting tested and using safe sex practices, there are also medical treatments that those in high-risk groups can take to prevent HIV infection. These treatments are commonly known as PrEP which stands for pre-exposure prophylaxis. Those eligible for PrEP include those with ongoing risk for HIV infection through unprotected sex, sex with a partner with HIV, diagnosis of a sexually transmitted disease within the past 6 months, and/or injectable drug use. According to the CDC, those that take PrEP consistently reduced their risk of HIV infection from sex by more than 90%. It is important to note that patients starting PrEP must be HIV negative prior to starting therapy and will need follow-up HIV testing every 3 months throughout therapy. There are currently two once-daily options for PrEP on the market called Truvada and Descovy.
If you become HIV positive while on PrEP, these medications alone are not enough to treat the virus and additional medication is needed. Descovy and Truvada are only used to prevent against HIV infection therefore, proper condom usage is still recommended to protect against other sexually transmitted diseases. Additionally, use of either medication can cause a worsening of Hepatitis B infection, therefore if you are positive for Hepatitis B, it is important to not suddenly stop taking your medication without talking to your healthcare provider.
Another form of prevention is called PEP or post-exposure prophylaxis. PEP is used to prevent HIV infection after a potential exposure. If exposed to HIV either through unprotected sex (broken condom), sexual assault, or a healthcare worker needle stick, then within 72 hours of the potential exposure (about 3 days) visit your doctor, emergency room, or urgent care to start on PEP right away.
PEP is a 28-day combination therapy typically with once daily Truvada (emtricitabine/tenofovir disoproxil fumarate) and twice daily Isentress (raltegravir). Other medications can be used as alternative regimens, but this combination is most common. It is important to note that this therapy is only for use in patients who do not have frequent exposure to HIV especially through sex and needle sharing. These patients are recommended to speak to their healthcare providers about PrEP mentioned above.
At ValedaRX, we have the privilege of servicing patients who take PrEP medications. We offer counseling services with our pharmacists who will advise our patients of any precautions they may need to take before or during the use of these medications, such as whether you can be pregnant or breastfeeding while on these medications. We do everything in our power also to make sure that our patients are paying the lowest amount for their copays, meaning we file Prior Authorizations with their insurance companies as well as applying for grants and finding copay cards to help reduce the financial burden. Our clinical staff also routinely checks up on these patients to make sure they are adhering to their therapy and taking their medications as directed. We are grateful that we can give such personalized care to each patient based on their specific and specialized needs.
Thanks for taking the time to learn a bit more about testing and HIV prevention. Our next and last discussion our HIV/ADIS awareness series will focus on treatment for HIV/AIDS.
For more information on PrEP, visit the following websites:
For more information on PEP, visit: https://www.cdc.gov/hiv/basics/pep.html
About Valeda Rx
Valeda Rx is an independent national specialty pharmacy, servicing 49 US States and the District of Colombia, with California pending. We are focused on improving the care for patients living with complex and chronic conditions such as Hepatitis C, HIV, Multiple Sclerosis, Rheumatoid Arthritis, Psoriasis, Crohn's, Oncology Diseases and more. Our Care Team puts patients’ needs first, treating each as though they were part of our own family.
By working together to coordinate the right medication for the right therapy at the right time for our patients, we support and guide the improvement of patient outcomes. Whether you are a patient, caregiver, prescriber or partner, you will receive the type of independent care and attention and service you not only need, but that you also deserve.