Prescribing PrEP with Confidence: Quick Videos to Get Started
Getting Practical with PrEP: Patient Candidacy, Medication Choices, and Side Effects
Short videos. Trusted facts.
With Dr. Jonathan Shuter, Dr. Uriel Felsen, Dr. Raffaele M. Bernardo, and Dr. Rasika Karnik
- Who is PrEP For?
- Options for PrEP
- Side Effects of PrEP
- View the entire webinar here
Who is PrEP For?
Transcript:
Dr. Uriel R. Felsen:
PrEP is for anyone that isn’t already living with HIV, and is at risk for acquiring HIV. So there are some ways to think about, some populations who may be more at risk for HIV. But I think the most important take home point for everyone to come home, you know, everyone who’s watching this to understand, is that it’s really for anyone that doesn’t already have HIV, and that is interested in protecting themselves from acquiring HIV, either through sex or through intravenous drug use.
Options for PrEP
Transcript:
Dr. Raffaele Bernardo:
So there are currently three medications that are FDA-approved for HIV pre-exposure prophylaxis.
Two of these medications come in the form of an oral tablet that’s taken once daily, and the third is actually the first long acting injectable for HIV pre-exposure prophylaxis. But all three are FDA-approved, and all three, as long as they’re taken as prescribed, are highly effective at preventing HIV infection. The two tablets are single fixed-dose combination tablets of two different medications of the brand names. One is Truvada, the other is Descovy, and the long acting injectable goes by the brand name Apretude. Apretude is given one month back to back for the first two months, and then every other month thereafter.
Dr. Uriel R. Felsen:
It’s important to remember that there are three choices, but not all choices are necessarily for all different folks. There’s an option, anybody that’s interested in PrEP, there is an option. Dr. Bernardo mentioned Descovy and Truvada. Both of them contain tenofovir and emtricitabine, but they contain different formulations of the tenofovir.
And currently, it’s really Truvada that is approved for cis men, cis women, and transgender men and transgender women, whereas Descovy is actually not approved for HIV prevention for anyone that’s at risk for acquiring HIV through vaginal sex. So that would be for cis women or potentially trans men.
Side Effects of PrEP
Transcript:
Dr. Jonathan Shuter:
These medications are extremely well tolerated. So almost anyone who puts any new pill in their mouth and swallows it could get some nausea. So there is, you know, a certain incidence of nausea and GI upset, associated with the two oral preparations. There were larger earlier concerns with the potential for renal effects and for bone effects with the tenofovir-containing preparations which are both of the oral medications. But most of those fears and concerns have been allayed by the collective experience that that significant renal toxicity or bone toxicity are rare.
And so those are really the common side effects with the pills. With the injection, it is basically what you would expect. With the injection, they get injection in site pain, and it is rare that that is severe enough that it causes discontinuation of the medicine, and that tends to get less with subsequent injections.
Dr. Raffaele Bernardo:
I’ll add, with the nausea that’s occasionally seen, almost always is self limiting, and within a week or so of daily use, the nausea actually goes away without any particular intervention. So I will often counsel my patients and say, while it’s rare, you may experience some nausea in the first few days. If it’s not too uncomfortable, keep taking your pill daily, and almost invariably the nausea self resolves within a couple of days when it happens. But to Dr. Shuter’s point, these side effects are typically very rare.
