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PrEP for HIV Prevention

Pre-Exposure Prophylaxis

There are varied prevention methods to help young adults remain HIV-negative. Most of these methods involve changing behavior to prevent HIV. Pre-Exposure Prophylaxis, referred to as PrEP, is a biomedical prevention method for people who are not HIV-positive but are at high risk of getting HIV. It requires taking a pill (Truvada) every day to prevent HIV infection. Combined with other behavioral strategies, PrEP offers an effective way to prevent young adults from contracting HIV and becoming HIV-positive.

How PrEP Works for HIV Prevention

PrEP involves taking an antiretroviral medication, Truvada, once a day before exposure to HIV. Truvada is a combination of two medications (tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC). Like the birth control pill, the medication is taken continuously and not just when engaging in sex or sharing needles. When taken as directed, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by more than 90%. This effectiveness decreases when PrEP is taken inconsistently. The higher the concentration of PrEP medication in a person’s system, the more effective it is at preventing HIV. PrEP does not protect against other sexually transmitted infections (STIs) or pregnancy, making other prevention methods necessary to address other sexual health needs.

Who Can Take PrEP

Since 2004, Truvada, the antiretroviral medication used for PrEP, has been approved as an HIV treatment medication for HIV-positive people ages 12 and older. In 2012, the Food and Drug Administration (FDA) approved Truvada for use as PrEP for HIV prevention in people over 18. Youth under 18 are not included in the FDA's approval for using Truvada as PrEP for HIV prevention. Also, there are no clinical guidelines or published protocols for providing PrEP to youth under the age of 18. Efforts are underway for using PrEP with minors who are at risk of HIV exposure.

Youth HIV Facts

Studies have shown that PrEP reduces the risk of getting HIV from sex by more than 90% when used consistently.
Source: 
Centers for Disease Control and Prevention

Linking Young Adults to PrEP

PrEP can only be prescribed by a health care provider. Therefore, young adults must be connected to health care providers who can screen them in order to prescribe PrEP. Youth-serving professionals can also help young adults learn about PrEP by adding information to their organizations' websites and printed materials, and by including PrEP in educational sessions.

Supporting Young Adults Taking PrEP

Young adults on PrEP need support to ensure that they are taking the medication daily and seeing their health care providers for follow-up appointments. These appointments include regular screening for HIV, STIs, and other adverse effects such as renal toxicity. As young adults may have other concerns in their lives that create barriers to doing this, it is essential to engage them in timely and appropriate conversations about medication adherence, STI prevention, or pregnancy prevention.

The cost of PrEP can pose a financial challenge for some young adults. They will likely need help to get health insurance, navigate their existing insurance, or leverage patient assistance programs to reduce the cost of the medication.