Do you feel any fear or risk about the virus called HIV? Perhaps you are thinking about the possibility of contracting HIV due to your lifestyle, relationships, or other reasons. If there is such a risk, there is now a very effective way in modern medicine to protect yourself from it. We are talking about it today. That is the drug treatment called PrEP.
Simply put, what is PrEP?
The full name of PrEP is Pre-Exposure Prophylaxis . Let's understand it in Sinhala.
- Pre-Exposure means 'before exposure'. That is, before exposure to the virus.
- Prophylaxis means 'treatment to prevent a disease'.
So, in simple terms, PrEP is a drug treatment that is taken in advance to protect against the HIV virus before it enters the body. It is a medical safety measure used to protect against HIV, just like using mosquito nets to protect against dengue.
So what is HIV?
As you know, HIV (Human Immunodeficiency Virus) is a virus that attacks our body's immune system, the soldiers that fight disease. This virus is mainly transmitted by:
- Having unprotected sex with an HIV-infected person.
- By sharing contaminated needles, syringes, etc. used by someone infected with HIV with another person.
If HIV infection is not controlled, over time it can develop into a serious condition called AIDS (Acquired Immune Deficiency Syndrome). When AIDS develops, the body's immune system is almost completely destroyed. That is why it is so important to prevent HIV infection. PrEP is a very powerful tool for that.
Who is eligible to use PrEP?
This treatment is for people who are not HIV-positive but are at high risk of getting HIV. Find out if you are at risk.
- Would you have sex with someone who is HIV positive?
- You don't know for sure whether your sexual partner has HIV or not?
- Are you an injecting drug user? Or do you share needles with someone who is HIV positive or doesn't know it?
- Are you a woman planning to get pregnant? And are you at risk for HIV? If so, PrEP can protect you from passing the virus to your baby during pregnancy and while breastfeeding.
The important thing is that PrEP is not a drug given to people who are already infected with HIV. It is a drug taken by people who do not have HIV to prevent it from developing.
What should you do before starting PrEP?
PrEP is not a drug you can just walk into a pharmacy and buy. It requires a prescription from a doctor.
When you see your doctor, he or she will often do these tests before starting you on PrEP:
1. HIV test: Before starting PrEP, you need to be 100% sure that you are not infected with HIV.
2. Kidney function test: Since some PrEP medications can affect the kidneys, your kidney health will be checked.
3. Testing for other sexually transmitted diseases: People at risk for HIV may also have other sexually transmitted diseases (STIs), so they are also tested for these diseases.
- Hepatitis B
- Hepatitis C
- Syphilis
- Chlamydia
- Gonorrhea
After checking all of this, if you have no problems using PrEP, your doctor will recommend the PrEP medication that is most suitable for you.
What types of PrEP are available in Sri Lanka and the world?
There are several main types of drugs for PrEP. Your doctor will choose the one that is most suitable for you.
| PrEP type | Description | Who is it suitable for? |
|---|---|---|
| Daily pills (Oral PrEP) Ex: Truvada®, Descovy® | This is the most commonly used method. You take one pill at a set time every day. The drugs in these pills prevent the HIV virus from entering and spreading into the body's cells. | Suitable for all, including men, women, and transgender people (especially Truvada®). The pill Descovy® is currently approved for people who are registered as male at birth. |
| Injectable PrEP (taken every two months) Ex: Apretude® | This is a good option for those who forget to take their daily pills. Treatment begins with two injections, one month apart. After that, the injection only needs to be taken every two months . | Suitable for everyone , including men and women. |
Are there any side effects of PrEP?
Like any medication, PrEP can cause minor side effects. However, these are often temporary and go away within a few weeks of starting treatment.
| PrEP type | Common minor side effects | Rarely seen serious side effects |
|---|---|---|
| Daily pills | Diarrhea, nausea, stomach ache, headache, fatigue, weight loss. | Kidney damage, bone thinning, liver damage, lactic acidosis. |
| Vaccines | In addition to the above side effects, there may be swelling, pain, a lump under the skin, and warmth at the injection site. | The above mentioned severe side effects. |
If these side effects persist or become severe, tell your doctor immediately.
How effective is PrEP?
This is the most important thing. When used exactly as directed , PrEP is a very effective way to protect yourself from HIV.
- Reduces the risk of HIV transmission through sexual contact by about 99% .
- Needle sharing reduces the risk of HIV transmission by about 74% .
Imagine how much security this is.
A few things to know when taking PrEP
1. PrEP does not prevent other sexually transmitted infections (STIs)!
Remember this very well. PrEP only protects against HIV. To protect against other STIs like syphilis, gonorrhea, and chlamydia, you must always use a condom.
2. Don't miss your medication!
Especially if you take pills every day, you need to take them exactly on time, without missing a single day. Failure to do so will reduce the effectiveness of the medication.
3. Interactions with other medications may occur.
If you are taking medication for other conditions (e.g. epilepsy, tuberculosis), be sure to tell your doctor. Some medications may interact with PrEP.
4. Scheduled medical examinations.
Throughout the time you are using PrEP, you should see your doctor at least once every 3 months for an HIV test and other necessary tests.
What time should I see my doctor?
If anything like this happens while taking PrEP, seek medical advice immediately.
- If you suspect you may have been infected with HIV (for example, if you had unsafe sex without a condom), you may need to go to the Emergency Treatment Unit (ETU) at this time.
- If the side effects are severe or do not improve over time.
- If you develop symptoms of liver disease, such as yellowing of the skin or eyes, or dark urine.
- If you experience mental changes such as depression and anxiety.
- If you find out you are pregnant or feel there is a possibility of pregnancy.
PrEP is a very valuable tool in our fight against HIV. If you are at risk of HIV, don't be afraid or embarrassed about it, talk to a trusted doctor. He or she will give you the right guidance.
Take-Home Message
- PrEP (Pre-Exposure Prophylaxis) is a medication that people who are not infected with HIV but are at risk for it take in advance to protect themselves from the virus.
- This medication should only be taken on medical advice, and HIV and other tests should be performed before starting it.
- While PrEP can reduce the risk of HIV by about 99%, it does not protect against other sexually transmitted diseases, such as syphilis and gonorrhea.
- Condom use is mandatory to protect against other sexually transmitted diseases.
- While taking PrEP, it is very important to see your doctor at least once every 3 months for regular checkups.
- If you think you are at risk for HIV, don't be afraid to talk to a doctor and ask if PrEP is right for you.
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