Arnold Solof, MD

PrEP and PEP to Prevent HIV

Definitions:

  • PrEP = Pre-exposure Prophylaxis
  • PEP = Post-exposure Prophylaxis

PEP

It seems that not so long ago there was post-exposure prophylaxis for HIV, but we didn’t have good data on it to confirm that it worked or how well it worked.  We did it because it made sense and was the best we could do.  Now, this has been studied reasonably well and we have confirmation of its efficacy.  It is not cheap, but it is frequently covered by medical insurance or the liability policies of our employers.

So what are some examples of exposure that one would want Post-exposure prophylaxis?

  1. think you may have been exposed to HIV during sex (for example, if the condom broke)
  2. shared needles
  3. were sexually assaulted

Detailed Information on PEP from the CDC

PrEP

Even newer is the development of protocols/treatments that prevent HIV before exposures to it.  It is also expensive but frequently covered by insurance.

What are some examples of situations in which you would consider Pre-exposure prophylaxis?

  1.  Daily PrEP use can lower the risk of getting HIV from sex by more than 90% (eg. HIV Infected Sex Partner or live in an area with a high incidence of HIV)
  2.  Daily PrEP use can lower the risk of getting HIV from injection drug use by more than 70%

Detailed Information on PrEP from the CDC

The drugs used have occasional side effects and some people may not be able to use them because of this.

Although not perfect, until we get an effective vaccine, it is a useful tool/option to have.


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