Does Circumcision Prevent Hiv
Circumcision has been shown to reduce the risk of men getting HIV from an HIV-positive woman, compared to uncircumcised men. Studies in heterosexuals have shown that male circumcision reduced the risk for HIV in the man by 50% to 60%.
However, circumcision should be used along with other methods of HIV prevention. Additional measures, such as correct condom use with lubricants or preventive medications in high-risk groups are also needed. Male circumcision has not been shown to lower the risk of HIV in women, gay or bisexual men.
What Is The Risk Of Hiv Transmission
The risk of HIV transmission differs with the type of exposure however, it is relatively low for individual exposures. Data on HIV transmission are estimated from observational trials involving couples in which only one partner has HIV infection,1 patients with nonoccupational exposure to needles,2 recipients of blood transfusions from HIV-positive sources3 and estimates from sexual contacts .1,4,5 Estimated risks of transmission for each type of exposure, per 10 000 exposures, are summarized in Table 1.6
How Well Does Prep Work
PrEP is most effective when taken consistently each day. CDC reports that studies on PrEP effectiveness have shown that consistent use of PrEP reduces the risk of getting HIV from sex by about 99% and from injection drug use by at least 74%. Adding other prevention methods, such as condom use, along with PrEP can further reduce a persons risk of getting HIV.
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What Are Some Of The Safety Concerns Associated With Taking Prep
Although the drugs used in PrEP are generally well tolerated, they are still capable of causing side effects. In clinical trials these side effects were generally mild and temporary, and they affected only between 1% and 10% of participants. Some of the possible side effects include nausea, vomiting, diarrhea, headache and dizziness. Side effects caused by PrEP may negatively affect a persons quality of life and ability to adhere to their medication schedule.
The use of PrEP has been associated with more concerning toxicities in a small number of people, such as small decreases in kidney, bone and, rarely, liver health. Promisingly, these changes were reversible after stopping PrEP. The TAF + FTC formulation is generally not associated with the kidney and bone risks of TDF + FTC.
A person can develop resistance to the drugs in PrEP if they are HIV positive when they start PrEP. Drug resistance can limit a persons future treatment options, so it is important to ensure that they are HIV negative before starting PrEP.
A person can also develop drug resistance if they become HIV positive while taking PrEP. In clinical trials, the risk of developing drug resistance was low for people who were HIV negative when they started taking PrEP.
Educating The Public About Hiv And Aids
Healthcare professionals play a vital role in helping people understand the differences between HIV and AIDS. Statistics reported by the CDC demonstrate the positive effect that public education about HIV and AIDS has on new infection rates:
- HIV infection rates among gay and bisexual men declined by 7% between 2014 and 2018.
- Infection rates among Blacks/African Americans also fell by 7% in the period.
- Infection rates among all heterosexuals dropped by 10%, and among heterosexual men, rates dropped by 13%.
However, HIV infection rates continued to climb among certain ethnic groups:
- Rates increased by 6% among American Indians and Alaska Natives .
- Rates grew by 55% among Native Hawaiians and other Pacific Islanders .
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Sharing Needles And Injecting Equipment
If you inject drugs, this could expose you to HIV and other viruses found in blood, such as hepatitis C.
It’s important not to share needles, syringes, injecting equipment such as spoons and swabs, or the actual drugs or liquids used to dilute them.
Many local authorities and pharmacies offer needle exchange programmes, where used needles can be exchanged for clean ones.
If you’re a heroin user, consider enrolling in a methadone programme. Methadone can be taken as a liquid, so it reduces your risk of getting HIV.
A GP or drug counsellor should be able to advise you about both needle exchange programmes and methadone programmes.
If you’re having a tattoo or piercing, it’s important that a clean, sterilised needle is always used.
Does Prep Have Any Side Effects
Most people who take PrEP dont experience side effects. Others may have some mild effects like nausea, loss of appetite and headaches. These usually disappear within the first month.
A small proportion of people taking PrEP may develop kidney damage, so it is very important to have kidney tests every 6 months when you are taking PrEP.If you have any concerns about side effects, see your doctor.
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Is It Ok To Switch Between Daily Prep And On
On-demand PrEP is only for cis-gender MSM. Other individuals are not eligible for on-demand PrEP because studies have not demonstrated that it is effective for other populations. Before switching from daily PrEP to on-demand PrEP, or vice versa, a cis-gender MSM should consult with their healthcare provider.
Has An Hiv Exposure Occurred
A very detailed history is essential in determining whether a person has been exposed to HIV. An exposure occurs when infected body fluids or mucosa from a person with HIV come into contact with the mucosa, blood stream or broken skin of someone else. Infectious fluids include blood, genital secretions, and amniotic, cerebrospinal, pleural, pericardial, peritoneal and synovial fluids. Urine, saliva, sweat, emesis and feces are not considered infectious unless they contain blood.
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Are There Any Other Hiv Prevention Options
There are many easy and effective ways to prevent HIV. Other than PrEP, HIV transmission can also be prevented by:
- Although there is a low risk of HIV transmission during oral sex, using male condoms on penises or dental dams on vulvas and anuses. This can also help to reduce the risk of other STIs from being passed on.
- Using clean, sterile injecting equipment.
- Achieving and maintaining undetectable HIV viral loads if you are HIV-positive by taking HIV antiretroviral treatment as prescribed.
- Getting regular sexual health checks.
- Taking post-exposure prophylaxis if you have potentially been exposed to HIV.
Depending on your risk factors and life circumstances, you may be more suited to other HIV prevention methods. It is important to find the right prevention method, or combination of methods, that works for you and your sexual partners.
Speak to your GP or sexual health clinician for more information.
has more information on PrEP.
Prep: Hiv Prevention With Truvada Or Descovy
In July 2012 the U.S. Food and Drug Administration approved the use of Truvada, an antiretroviral medication to prevent HIV infection in certain high-risk individuals. Truvada is a combination of two drugs and can be used in high-risk HIV-negative persons to lower their risk of infection. The medication works by preventing the virus from making copies of itself. Truvada is expected to become generically available in September 2020.
In October 2019, the FDA approved Descovy as the second drug for PrEP. Descovy is used in at-risk, HIV-1 negative adults and adolescents weighing at least 35 kg to reduce the risk of sexually acquired HIV-1 infection, excluding individuals at risk from receptive vaginal sex. In studies, Descovy was as effective as Truvada in HIV-1 prevention, but advantages were observed with regard to renal and bone laboratory secondary endpoints.
With oral PrEP, you must take the medication daily. It’s important not to miss any doses to help prevent resistance to these medications. It is used in combination with safer sex practices such as use of a condom. It can lower your risk of contracting HIV from sex by up to 99%, if taken correctly. However, you must be HIV-1 negative to start PrEP everyone is screened for HIV-1 infection before initiating PrEP. Regular tests for HIV status are required with PrEP.
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How Do You Get Prep
If you think PrEP may be right for you, visit your doctor or health care provider. PrEP is only available by prescription. Any health care provider licensed to write prescriptions can prescribe PrEP specialization in infectious diseases or HIV medicine is not required.
If you dont have a doctor, you can use the HIV Services Locator to find a PrEP provider and other HIV services near you. You can visit many community health centers for a PrEP consultation. More than 190 health centers in the 57 jurisdictions prioritized in the Ending the HIV Epidemic initiative are providing PrEP services. Many health centers in other jurisdictions also provide PrEP services.
Because PrEP is for people who are HIV-negative, youll have to get an HIV test before starting PrEP and you may need to get other tests to make sure its safe for you to use PrEP.
If you take PrEP, youll need to see your health care provider every 3 months for repeat HIV tests, prescription refills, and follow-up.
How Would I Know If Prep Is Right For Me
New York HIV State Clinical Guidelines indicate that healthcare providers should discuss PrEP as an HIV/STD prevention option for adults or adolescents who:
- Are attempting to conceive with a partner who is living with HIV
- Have multiple or anonymous sex partners or, have partners who have multiple or anonymous sex partners
- Participate in sex parties or clubs or have partners who do this
- Are involved in transactional sex, such as sex for money, drugs, or housing, including commercial sex workers and their clients, or have partners who do this
- Have been diagnosed with at least one STI in the previous 12 months
- Use of mood-altering substances during sex, such as alcohol, methamphetamine, cocaine, and ecstasy
- Inject substances, or have partners who inject substances, including illicit drugs and hormones
- Are receiving post-exposure prophylaxis and have ongoing high-risk behavior or have used multiple courses of PEP.
- Self-identify as being at risk without disclosing specific risk behaviors.
- Acknowledge the possibility of or anticipates risk behaviors in the near future.
It is important to weigh the pros and cons and have an open and honest conversation about PrEP with your healthcare provider before beginning PrEP. PrEP is always voluntary and only you can determine if PrEP is right for you.
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Aids Diagnosis Is More Complicated
AIDS is late stage HIV infection. Healthcare providers look for a few factors to determine if HIV latency has progressed to stage 3 HIV.
Because HIV destroys immune cells called CD4 cells, one way healthcare providers diagnose AIDS is to do a count of those cells. A person without HIV can have anywhere from 500 to 1,200 CD4 cells. When the cells have dropped to 200, a person with HIV is considered to have stage 3 HIV.
Another factor signaling that stage 3 HIV has developed is the presence of opportunistic infections. Opportunistic infections are diseases caused by viruses, fungi, or bacteria that would not make a person with an undamaged immune system sick.
Fda Approves Second Drug To Prevent Hiv Infection As Part Of Ongoing Efforts To End The Hiv Epidemic
The U.S. Food and Drug Administration today approved Descovy in at-risk adults and adolescents weighing at least 35kg for HIV-1 pre-exposure prophylaxis to reduce the risk of HIV-1 infection from sex, excluding those who have receptive vaginal sex. Descovy is not indicated in individuals at risk of HIV-1 infection from receptive vaginal sex because the effectiveness in this population has not been evaluated.
PrEP drugs are highly effective when taken as indicated in the drug labeling and can prevent HIV infection, said Jeffrey Murray, M.D., M.P.H., deputy director of the Division of Antiviral Products in the FDAs Center for Drug Evaluation and Research. This approval provides more prevention options for certain patients at-risk for acquiring HIV and helps further efforts by the FDA and the U.S. Department of Health and Human Services to facilitate the development of HIV treatment and prevention options to reduce new HIV infections.
PrEP, or pre-exposure prophylaxis, is an HIV prevention method in which people who do not have HIV take medicine on a daily basis to reduce their risk of getting HIV if they are exposed to the virus. Descovy for PrEP should be used as part of a comprehensive strategy, including adherence to daily administration and safer sex practices, including condoms, to reduce the risk of sexually acquired infections.
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What Are Prep And Pep
PrEP and PEP are medicines to prevent HIV. Each type is used in a different situation:
- PrEP stands for pre-exposure prophylaxis. It is for people who don’t already have HIV but are at very high risk of getting it. PrEP is daily medicine that can reduce this risk. With PrEP, if you do get exposed to HIV, the medicine can stop HIV from taking hold and spreading throughout your body.
- PEP stands for post-exposure prophylaxis. PEP is for people who have possibly been exposed to HIV. It is only for emergency situations. PEP must be started within 72 hours after a possible exposure to HIV.
How Can Service Providers Improve The Uptake And Correct Use Of Prep
Education and counselling activities related to HIV prevention should include information on the HIV prevention benefits of PrEP, along with information on other highly effective ways to help prevent HIV. These include the use of HIV treatment to maintain an undetectable viral load, post-exposure prophylaxis , condoms for sex and new equipment for using drugs. Encourage clients to choose the combination of strategies that will work most effectively for them as there are multiple ways to prevent HIV that can be combined in different ways. PrEP only helps to prevent HIV it does not prevent other STIs or blood-borne infections such as hepatitis C. Discuss how PrEP fits into a comprehensive plan for health, such as regular STI testing, using condoms and using new drug use equipment.
PrEP is not for everyone. You can support clients to decide whether PrEP is right for them. During discussions, help your clients consider their level of HIV risk and the possible side effects, as well as their ability to cover the cost , access a knowledgeable healthcare provider, adhere to a pill-taking regimen and attend regular medical visits. Each person has the right to decide whether or not to use PrEP as a prevention approach, on the basis of their own assessment of what is best for their health and well-being.
For people who are interested in taking PrEP, provide education on how to use it correctly, to maximize safety and effectiveness. Emphasize the following:
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What Should I Tell My Healthcare Provider Before Taking Truvada For Prep
- All your health problems. Be sure to tell your healthcare provider if you have or have had any kidney, bone, or liver problems, including hepatitis.
- If you are pregnant or plan to become pregnant. It is not known if TRUVADA can harm your unborn baby. If you become pregnant while taking TRUVADA for PrEP, tell your healthcare provider.
- If you are breastfeeding or plan to breastfeed. Do not breastfeed if you think you may have recently become infected with HIV. HIV can be passed to the baby in breast milk. Talk to your healthcare provider about the risks and benefits of breastfeeding while taking TRUVADA for PrEP.
- All the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. TRUVADA may interact with other medicines. Keep a list of all your medicines and show it to your healthcare provider and pharmacist when you get a new medicine.
- If you take certain other medicines with TRUVADA, your healthcare provider may need to check you more often or change your dose. These medicines include certain medicines to treat hepatitis B or C infection.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch, or call .1-800-FDA-1088.
Where To Get Prep
PrEP is now available free on the NHS in England from sexual health clinics.
Initially, PrEP was made available to 10,000 people in England as part of the IMPACT trial, which ended in July 2020.
In Scotland, PrEP is available through sexual health clinics. Visit the PrEPScot website to find out more information about how to access it.
In Wales, PrEP is available through sexual health clinics. For more information, see the Public Health Wales website.
All GUM clinics in Northern Ireland will be offering initial consultation and assessment appointments for a pilot trial, based at a centralised service in Belfast. This project will run for 2 years. There is currently no cap on numbers.
Taking PrEP has enabled me to trust again, have relationships and build bridges.
In clinical trials PrEP has been used in two different ways:
- taken regularly .
- only taken when needed .
This second method is often called on-demand or event-based dosing.
Both methods have been shown to be very effective, although on-demand dosing has only been studied in gay and bisexual men.
Daily dosing is recommended for women who need to take PrEP every day for seven days to be protected against HIV.
Daily PrEP is recommended for all trans people using hormone treatment as there isnt sufficient data to support other dosing options.
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Does Pep Cause Side Effects
Some people taking PEP may have side effects, like nausea. The side effects are usually not serious and often get better over time. If you are taking PEP, tell your health care provider if you have a side effect that bothers you or that does not go away.
PEP medicines may also interact with other medicines that a person is taking . So it’s important to tell your health care provider about any other medicines that you take.