Pre-exposure Prophylaxis (PrEP) for HIV: An Overview
1. What is PrEP? Pre-exposure prophylaxis (PrEP) is a medication taken to prevent HIV infection in people who are at high risk of getting the virus. It involves taking antiretroviral drugs that prevent HIV from establishing itself in the body after exposure.
2. Who should consider PrEP? PrEP is recommended for people who are at substantial risk of HIV infection, such as:
- Men who have sex with men
- Heterosexual men and women with partners who are at high risk of HIV
- People who inject drugs and share needles or equipment
- Sexual partners of people with HIV who are not consistently taking their HIV medication
3. Available PrEP Options Current PrEP options include:
- Oral medications:
- Truvada (emtricitabine/tenofovir disoproxil fumarate, FTC/TDF)
- Descovy (emtricitabine/tenofovir alafenamide, FTC/TAF) – not recommended for people at risk through receptive vaginal sex as it is less effective in preventing HIV through this route
- Injectable medication:
- Apretude (cabotegravir, CAB-LA) – long-acting injection given every 2 months
4. Effectiveness PrEP is highly effective when taken as prescribed. Studies show it reduces the risk of HIV infection by over 90% for people who take it consistently.
- Truvada/Descovy: Up to 99% effective with daily use (CDC, 2023)
- Apretude: Over 89% effective with on-time injections (HPTN 083 study, 2022)
5. Important Considerations
- Adherence: For oral PrEP, daily use is crucial. Missing doses significantly reduces effectiveness.
- Side effects: Common side effects include nausea, vomiting, and diarrhea. Long-term effects are still being studied.
- HIV testing: Regular HIV testing is required while on PrEP to monitor for potential infection.
6. PrEP and HIV Resistance There have been rare cases where HIV infection occurred while taking PrEP, potentially leading to drug-resistant strains. It's important to:
- Maintain high adherence to prevent this
- Seek immediate medical care if HIV symptoms develop while on PrEP
7. Where to Get PrEP
- In Thailand, PrEP is available through government programs and private healthcare providers. Many hospitals now offer PrEP services, including the Bumrungrad International Hospital HIV clinic in Bangkok.
8. Recent Updates (2025)
- Ongoing studies are evaluating new long-acting PrEP options that could be more convenient
- The World Health Organization continues to emphasize PrEP as a key prevention tool in global HIV response strategies
Important Note: If you're considering PrEP, consult with a healthcare provider to discuss your specific risk factors and determine the most appropriate option for you.
Would you like more specific information about any aspect of PrEP? For example, details about the medications, how to access them in Thailand, or advice on managing potential side effects?