Pre Exposure Prophylaxis (PrEP)

What is PrEP?

Pre Exposure Prophylaxis (PrEP) is a medication that is taken on an ongoing basis to reduce your risk of HIV infection. PrEP is a single pill taken daily which contains two medicines (tenofovir and emtricitabine) that are also used in combination with other medicines to treat HIV. The brand name of the pill used for PrEP is Truvada. When someone is exposed to HIV through sex or injection drug use, PrEP can work to prevent the virus from establishing a permanent infection.

PrEP is not 100% effective and is another tool for HIV prevention, not a replacement for safer sex. PrEP requires follow-up testing and medical care.

When is PrEP recommended?

The Centers for Disease Control (CDC) recommends PrEP be considered for people who do not have HIV but who are at substantial risk of contracting the virus. This may include people who have an HIV positive partner or people that don't regularly use condoms with their sex partners. In Rhode Island, as in many other places in the country, we are seeing the majority of new HIV infections among gay, bisexual, and other men who have sex with men and so PrEP may be more often indicated for this group.

PrEP is only for people who are at an ongoing substantial risk for HIV infection. (To prevent HIV after a single high risk event of potential HIV exposure -- such as sex without a condom or sexual assault -- post exposure prophylaxis or PEP can be used. PEP must be begun within 72 hours of exposure.)

If you are wondering if PrEP would be right for you, Brown students can call 401.863-3953 to make an appointment with a medical provider at Health Services.

Does PrEP have side effects?

Side effects including upset stomach or loss of appetite were reported in clinical trials but these were mild and usually resolved in the first month. Some people also reported mild headaches. Studies did not find any significant safety concerns with use of daily oral PrEP. You should tell your healthcare provider if these or other symptoms become severe or do not go away.

Does PrEP work?

Evidence from clinical trials suggests that PrEP can significantly reduce the risk of HIV infection, particularly when taken daily as prescribed. In all studies, HIV transmission risk was lowest for participants who took PrEP consistently.

  • In a study of gay and bisexual men, those who were given PrEP were 44% less likely to get HIV. Among the men with with detectable levels of medicine in their blood (meaning that they had been taking PrEP consistently), PrEP reduced the risk of infection by as much as 92%.
  • In a study of heterosexual men and women, PrEP reduced the risk of getting HIV by 62%. Participants who became infected had far less drug in their blood, compared with participants who remained uninfected.
  • In a study of HIV discordant couples (heterosexual men and women), PrEP reduced the risk of HIV infection by 75%. Among those with detectable levels of medicine in their blood, risk was reduced by up to 90%.

Does PrEP mean I don't need to use condoms?

PrEP, while a potentially powerful HIV prevention tool, does not provide 100% protection against infection (the clinical trials listed above found a range of 42-92% effectiveness). Taking PrEP will not protect you against exposure to any other sexually transmitted infections (STIs) besides HIV. You will get the most protection from HIV and other STIs by consistently using condoms during sex and by taking the PrEP medicine consistently.

How do I take PrEP?

PrEP involves one pill once a day on an ongoing basis. It is very important that the medication is taken daily without missing doses.

Where can I get PrEP?

PrEP is only available by prescription and ongoing medical care and testing is needed while on the medications. Please speak with your medical provider to learn more about PrEP and decide whether it is right for you. Brown students who believe they may need PrEP can make an appointment with a provider at Health Services by calling 401-863-3953.

Resources at Brown and in Providence

Brown Health Services
401.863-1330 (to speak to a nurse)
401.863-3953(appointments)

Miriam Hospital Immunology Clinic
401.793-4715

Brown University AIDS Program (BRUNAP)
401.863-6790
brunap@brown.edu

Links you can use

CDC's PrEP Question and Answer Page

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Text adapted from materials at the Centers for Disease Control (CDC) website.