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What is PrEP?
Pre-Exposure Prophylaxis (PrEP) is a preventive measure that uses antiviral medication before potential exposure to HIV. It’s aimed at individuals at high risk of contracting HIV. Unlike HIV treatment, PrEP helps prevent infection.
When taken consistently as prescribed, PrEP can reduce the risk of HIV transmission by up to 90%. It’s particularly important for those involved in high-risk sexual behaviors, such as having multiple partners, engaging with partners of unknown HIV status, or being a sex worker, as well as individuals with HIV-positive partners.
DESCOVY for PrEP
Descovy for PrEP is a daily prescription medication intended for adults and adolescents at risk of HIV. It helps reduce the chances of HIV transmission through sexual activity.
Emtricitabine/Tenofovir Alafenamide (FTC/TAF)
Descovy contains emtricitabine and tenofovir alafenamide (TAF), instead of tenofovir disoproxil fumarate (TDF). F/TAF offers higher concentrations of tenofovir in cells, achieving protective levels faster and maintaining them longer than F/TDF. This makes F/TAF potentially more effective, even if doses are occasionally missed.
In the DISCOVER study, F/TAF proved to be just as effective as F/TDF in preventing HIV (non-inferior), though more infections occurred in the F/TDF group compared to F/TAF (11 infections versus 6, excluding suspected acute HIV cases). While debates continue, the study confirms F/TAF as a reliable PrEP option.
What are Truvada and Descovy?
Truvada: Truvada was one of the first medications approved for PrEP, containing emtricitabine and tenofovir disoproxil fumarate (F/TDF). It’s highly effective at preventing HIV transmission when taken daily and is approved for use by those at risk of HIV through sexual activity.
Descovy: Descovy is a newer PrEP option that combines emtricitabine and tenofovir alafenamide (F/TAF). Compared to Truvada, Descovy delivers higher concentrations of tenofovir and sustains protective levels longer, which can benefit individuals who may miss doses occasionally.
Truvada vs. Descovy
Category | Truvada | Descovy |
---|---|---|
FDA Approval | August 2, 2004 | April 4, 2016 |
Approved for PrEP | 2012 | October 3, 2019 |
Generic Name | Emtricitabine 200mg + Tenofovir Disoproxil Fumarate 300mg | Emtricitabine 200mg + Tenofovir Alafenamide 25mg |
PrEP Indications | Adults and adolescents (min. 35kg) | Adult and adolescent men and transgender women (min. 35kg) |
Treatment Indications | HIV-1 Infection in adults and pediatric patients (min. 17kg) | HIV-1 Infection in adults and pediatric patients (min. 25kg) |
Pill Size | Larger | Smaller |
Kidney Concerns | Occurs in 3% of users with older PrEP versions | Descovy (F/TAF) concentrates higher intracellular levels |
Best For | Younger users, healthy kidneys | Older users, those with compromised kidney functions |
Daily Dose Recommended | Yes | Yes |
PrEP on Demand | Yes | No (limited studies) |
Anal Sex Use | Yes | Yes |
Vaginal Sex Use | Yes | No |
Cost (USA) | $30-250 per bottle (30 tabs) | $712-720 per bottle (30 tabs) |
Cost (Thailand) | $90 per bottle (30 tabs) | Generics available only |
Generic Cost (USA) | $100 per bottle (30 tabs) | $100 per bottle (30 tabs) |
How Does PrEP Help Reduce the Risk of HIV Infection?
PrEP works by blocking HIV replication in the body. When taken consistently, the medication binds to immune cells in the blood and genital tissues that HIV would typically target. While PrEP is highly effective, it’s not a cure and doesn’t protect against other STIs. Using condoms alongside PrEP is recommended for the best protection.
Precautions with PrEP:
Who Should Take PrEP?
PrEP is recommended for those at high risk of HIV, including:
Consult with a healthcare provider to determine if PrEP is suitable for you and to ensure regular follow-up care.
How to Take PrEP
PrEP can be taken in two ways:
Steps for Daily Dosing
The Importance of PrEP in HIV Prevention
PrEP plays a critical role in preventing HIV infection, especially in high-risk areas like Chiang Mai. By providing accurate information on PrEP's safety and effectiveness, individuals can make informed decisions and protect themselves and their communities.