The human immunodeficiency virus (HIV) attacks the body’s immune system and, if left untreated, can lead to acquired immunodeficiency syndrome (AIDS). HIV is particularly a problem in central Maryland, which has the third-highest infection rate in the country.
According to the Center for HIV Surveillance, Epidemiology and Evaluation, in some pockets of Baltimore, about 5 percent of people are infected. The number is even higher in African-Americans, transgender women and men who have sex with men. The most recent data shows that 38 percent of men who have sex with other men in Baltimore are already infected.
Fortunately, there is a new prevention strategy called Pre-exposure Prophylaxis (PrEP), which can help protect individuals at high risk of infection. Being “on PrEP” means taking a pill called Truvada® once a day.
PrEP is offered at the University of Maryland Center for Infectious Diseases (UM CID), in partnership with the Institute of Human Virology at the University of Maryland School of Medicine, and can be up to 99 percent effective at reducing HIV transmission if taken daily as directed.
PrEP serves as both an individual intervention and a population-based intervention. For each case PrEP prevents, it also prevent any future cases that would have been transmitted from that first person.
Unfortunately, many misunderstand this lifesaving strategy. Here’s how you can differentiate between the facts and the myths.
MYTH: Once prescribed, I will have to take PrEP every day for the rest of my life getting other sexually transmitted infections (STIs).
FACT: When someone begins a discussion with a PrEP expert at UM CID, the first step is talking about his or her true risk of HIV and what can be done to decrease that risk.
A person’s level of risk varies depending on sex partners, sexual activity and other habits. When any of these change—for example, if they start or end a relationship, move to another city, etc.—their risk may be very different. This is constantly re-evaluated to make sure each person is using the best risk reduction strategy. If the risk becomes low, or the person doesn’t want to take PrEP anymore, they can stop taking it.
MYTH: With PrEP I don’t have to use condoms because PrEP will reduce my risk of getting othersexually transmitted infections (STIs).
FACT: PrEP is one part of a risk reduction strategy, which should also include condom use, frequent HIV testing, and for some, a reduction in the number of sexual partners. Large studies show the infection taking PrEP as part of a comprehensive prevention program actually reduced their number of sexual partners. Other small studies showed that they had more partners.
Either way, the goal of the medical community is to ensure that people have sex in the safest manner possible in order to prevent HIV transmission, not to make judgments about behavior.
Studies on rates of STIs also have mixed results, but the first of STIs in some studies is most likely because people on PrEP have a full panel of STI testing done every three months. This frequent testing allows providers to detect infections that may not even have any symptoms yet.
If people test positive, they can be treated before problems arise and before the infection is passed to a partner.
MYTH: PrEP will make me sick.
FACT: Some people who take PrEP can have mild side effects in the first couple of weeks, including a headache, nausea and bloating. These should go away as their body gets used to the pill. Long-term side effects could include kidney or bone problems—PrEP providers will monitor for these issues as needed. PrEP does not cause HIV.
