How one prescription can protect you from HIV

Jonathan Kaupanger
June 28, 2018 - 1:18 pm

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More than one million Americans are living with HIV today but 15 percent have no idea they are infected with the virus.  Human immunodeficiency virus (HIV) attacks and weakens your immune system.  Unless treated, it will lead to serious infections and cancer.   Thats when HIV develops into AIDS. 

Gay and bisexual men still have the highest infection rates.  But where you live, the color of your skin and your age puts you in a higher risk group as well.  Diagnoses of HIV with white gay and bisexual men decreased by 10 percent from 2011 to 2015.  For African American and Latino gay and bisexual men, the trends have increased four and fourteen percent, respectively.

The southern United States has the highest HIV diagnosis rates.  This is because the south is generally behind other regions in some HIV prevention and care indicators.  For age, the highest number of infections are with people age 20 – 29.  The highest percentage of Americans who don’t know they are infected falls in the younger age group too.

The good news is that HIV infection rates are coming down in the U.S.  In just the last five years, the number of annual infections has declined eight percent.  One of the reasons for this decline is pre-exposure prophylaxis or PrEP.  This is a medication for people who don’t have HIV, but who are at risk of getting it. 

The brand name is Truvada, and it is actually two medicines that work together to treat HIV.  When a person is exposed to HIV, whether it’s through sex or injection drug use, these medicines work to keep the virus from starting a permanent infection.  “PrEP is an HIV medication which works to prevent the virus from spreading in one’s system and taking it in advance of being infected will block those sites where the virus can attach,” said Dr. Michael Kauth, Director LGBT Health Program for Veterans Health Administration. 

“The effect is that even if one is exposed to the virus, you won’t get infected.  If you take the medication as prescribed, there’s a very high effectiveness rate for the medication,” said Kauth.  When taken consistently, PrEP is shown to reduce HIV infections by 92 percent.  “So it is quite helpful if one is engaging in risky sexual behavior and not willing to stop doing that.  Or is not consistent in using condoms to reduce their risk of unproductive sex.”

VA will prescribe PrEP for veterans, but you’ll need to be tested for HIV first.  VA recommends that all veterans be tested at least once, even if you don’t think you have risk factors.  About 43 percent of veterans in the VA have been tested so far.  Normally tests are done with a blood sample and you’ll receive results in about two weeks. 

“It’s not necessary for every person to have a conversation about PrEP,” says Dr. Kauth. 

Taking any kind of medication adds risks to your health and can even cause negative effects even though there may be other benefits.   “If one is sexually active, and not in a monogamous relationship where one feels confident about that.  Or one doesn’t have a sexual agreement with their partner about the level of sexual risk that they are willing to accept, certainly it would be important to have that conversation with their healthcare provider – whether PrEP would be helpful or not.”

There are about 20,000 veterans in the VA system receiving treatment for HIV.  VA disability rating for veterans with HIV is currently rated 60 percent. You can get more information about VA’s HIV testing and PrEP here.

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