The LGBT Health & Development Program

Youth Blog – Filling your HIV Prevention Toolbox


Posted on January 17th, 2017 by IMPACT in Featured, Life & HIV, Youth Blog. No Comments

Written by Jim Carey, M.P.H., Research Project Coordinator, 2GETHER Project

Every 9½ minutes, someone in the U.S. is infected with HIV [1].  Simply telling someone to “use a condom” is not always effective at preventing new infections. We need new tools in our toolbox to fight this opponent.

What is Biomedical HIV Prevention?

HIV is primarily spread through sex. Biomedical HIV prevention involves methods that include medicines or are medically based. Pre-exposure prophylaxis (PrEP) and Post Exposure prophylaxis (PEP) are currently available through your healthcare provider. Other strategies are being researched and developed.

What is currently available?

Currently, two biomedical prevention options are available: PrEP and PEP. While these may sound similar, they’re used in very different ways. PrEP is taken before exposure to HIV and PEP is taken after a potential exposure to HIV. Right now, the best biomedical HIV prevention option for sexually active people is PrEP.

PrEP

PrEP is a pill you take once a day, every day to prevent HIV. A lot of research has been done proving that PrEP works. [2] When taken as directed, it is more than 92% effective. Keep in mind that it takes up to 7 days to reach protective levels for anal sex and 20 days for everything else [1]. However, PrEP doesn’t give you any protection against other STIs, like gonorrhea and chlamydia. So, while PrEP can reduce your risk of HIV infection if taken daily, we recommend combining strategies like condom use with PrEP to reduce your risk even more.

PEP

PEP, on the other hand, consists of taking a full HIV medication regimen for 28 days after a potential exposure to HIV. PEP may be considered when things happen like not using a condom or if a condom breaks during sex. Taking PEP reduces the likelihood of infection by over 82% [3]. PEP must be started as soon as possible or within 72 hours after the potential exposure.

What is still being researched?

HIV Vaccines

Vaccines for HIV are still being researched and are not currently available. Two main types of vaccines are being researched: preventive vaccines and therapeutic vaccines. [2] Preventive vaccines are for HIV-negative individuals. The hope is that vaccination will prevent infection if that person is ever exposed to HIV. Therapeutic vaccines are designed for people living with HIV. The vaccines will help their body manage their virus, potentially without the need for additional medications.

HIV Microbicides

Microbicides are substances that can kill or fight viruses and bacteria. These could be delivered in various ways, including rings, gels, films, enemas, lubes, or inserts. Researchers are studying both vaginal and rectal microbicides to see if they can prevent sexual transmission of HIV. A safe, effective, desirable, and affordable microbicide against HIV could help to prevent many new infections.

Remember, the choices on the buffet of HIV prevention tools is growing! Talk to your healthcare provider if you are interested in any of these new options. It is up to you to choose what feels best for you and your sweetie (or sweeties) to put in your toolbox to stay HIV free! Stay safe, sexy, and have fun!

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References:

[1] How common is HIV? (2010). Department of Health and Human Services. Retrieved January 13, 2017 from: https://www.hhs.gov/opa/reproductive-health/sexually-transmitted-infections/hiv/index.html

[2] Grant RM, Lama JR, Anderson PL, et al. (2010). Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. New England Journal of Medicine, 363 (27) 2587-2599.

[3] Roland ME et al. (2005). Seroconversion following nonoccupational postexposure prophylaxis against HIV. Journal of Clinical Infectious Diseases.  41 (1), 1507-1513.

[4] PrEP 101 Fact Sheet, Centers for Disease control and Prevention (2014). Retrieved December 20, 2016 from: https://www.cdc.gov/hiv/pdf/library/factsheets/prep101-consumer-info.pdf

[5] How Vaccines Work. (2014). HIV Vaccine Trials Network. Retrieved December 15, 2016 from: http://www.hvtn.org/en/science/hiv-vaccine-basics/how-vaccines-work.html





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