by Melinda Lejman | photo courtesy of Choices Memphis
EFFECTIVE PRE-HIV-EXPOSURE TREATMENT
FOCUS: According to the Centers for Disease Control, PrEP (pre-exposure prophylaxis) is only for those who are at ongoing high risk of HIV infection. Can you explain what defines “ongoing” and “high risk”?
Dr. Randolph: For PrEP, high risk is defined as men who have sex with men (MSM), IV drug users, individuals in
HIV discordant relationships (i.e: one partner is known HIV positive) and individuals who have two or more sexual partners. While any of those circumstances could be limited to one incident, individuals who continue high risk activities are faced with ongoing risk.
It should be noted that PrEP is not a vaccine for HIV. So how does it work?
The medication blocks HIV replication pathways; in doing so, reduces the likelihood for infection with HIV.
EFFECTIVE AFTER-EXPOSURE TREATMENT
PEP (post-exposure prophylaxis) is given to someone who believes they have been recently exposed to HIV. What kind of exposure does this cover and how does the treatment plan work?
This covers individuals who experience an isolated incident with a known HIV positive patient or an encounter whereby the HIV status is unknown, such as rape or occupational exposure (i.e: a needle stick injury). Patients must receive treatment within 72 hours of exposure.
Usually, two or three anti-retroviral medications are given for 28 days. Patients must have a history and physical exam performed, as well as screening for HIV and other sexually transmitted diseases. Kidney function will also be assessed. A prescription is written during the initial visit and a follow up is scheduled for re-screening and discussion to continue with PrEP.
How effective are PrEP and PEP in reducing a person’s contraction of HIV?
PrEP reduces the risk of HIV by 92% and PEP reduces the risk by 81%.
What are the costs at CHOICES for PrEP and PEP treatments?
The initial visit is $150. Laboratory fees range between $150 to $200. Most insurance plans will cover labs and the cost of the medication. For individuals without insurance, there may be financial assistance available for those who qualify.
Are HIV numbers rising or falling in Memphis and the surrounding areas? What factors contribute to these numbers?
Unfortunately, HIV numbers are rising exponentially among African American MSM and heterosexual women
with a larger increase in African American women. This is why it is extremely paramount that information is spread about PrEP. Lack of access to affordable health care, fear of the medical community and new drugs, and just lack of information certainly have an effect on rising HIV numbers.
What advice can you give our readers about these treatments as well as reducing their risk of HIV contraction?The most important advice I can give your readers is to use condoms and other barriers to protect themselves against infection. If they fall in a high risk group, they should strongly consider taking PrEP to lower their risk of acquiring HIV.
