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7 Common Questions About PrEP

Maybe you’ve heard of it before: there’s this little blue pill said to protect people from HIV. If taken daily, its magic can reduce the risk of getting HIV from sex by up to 99 percent.

Thankfully this little blue pill is not out of a fairytale; it’s very real. It’s called Pre-Exposure Prophylaxis–or, more commonly, PrEP.

Simply put, PrEP is a game-changer in the world of HIV/AIDS. The fear that’s burdened previous generations still exists but has been alleviated substantially. Yet despite its 2012 FDA approval, many people who should take PrEP do not, usually because a lack of awareness, issues related to access, or fear of potential side effects.

Thankfully, knowledge is power. Here are seven common questions about PrEP:

1. What exactly is PrEP?

PrEP is a combination of anti-HIV medications that can be taken by HIV negative individuals to prevent infection. It is not a vaccine, meaning you cannot just take it once to be immune to HIV infection. It must be taken regularly to ensure effectiveness.

Currently the FDA has approved two different types of PrEP: Truvada and Descovy.

Truvada – approved by the FDA in 2012 and is a combination of two antiretroviral medications:  tenofovir disoproxil and emtricitabine. Before starting Truvada, please discuss all possible side effects with your provider.

Descovy – approved by the FDA in 2019 and is a combination of two antiretroviral medications: emtricitabine and tenofovir alafenamide. Before starting Descovy, please discuss all possible side effects with your provider.

2. What’s the difference between Truvada and Descovy?

There are several slight difference between Truvada and Descovy. But the most significant is how Descovy impacts the bones and kidneys. Generally speaking, Descovy is less likely to cause bone density or kidney issues.

It’s also worth mentioning that Descovy cannot be prescribed for individuals with female sex organs as this population was not included in clinical trials.

3. Who should take PrEP?

The CDC says you should take PrEP if any of following apply to you:

  • You’re in an ongoing sexual relationship with an HIV positive partner.
  • You’re not in a mutually monogamous relationship with a partner who has been recently tested.
  • You’re a man who’s had unprotected anal sex with another man or you have been diagnosed with an STI in the past 6 months.
  • You’ve injected drugs in the last 6 months or plan to in the future, especially with shared needles or works.
  • Regardless of gender or sex, you do not regularly use a condom with partners whose status is unknown and your partner has risk factors for potential HIV exposure (basically, if any of the above apply to your partner, you should consider PrEP).

4. How often do I take PrEP?

Just once a day, at the same time every day, for as long as you want protection. If you’re on PrEP and plan to discontinue its use, please speak first with your physician, a nurse, or your case manager.

5. What happens if I miss a dosage?

If you miss a dosage, that’s OK. While your level of protection might be impacted, missing a dosage is better than stopping the medication completely. Just remember to take your pill the next day. Try using a pill organizer so you don’t forget.

6. How much does PrEP cost?

The Project offers free PrEP Benefit Navigation to help reduce overall cost. In most cases PrEP is provided at no cost to the client. Please contact us to learn more.

7. Do I really need to take PrEP?

Maybe? Maybe not! But it’s better to be safe than sorry. When in doubt, schedule a consult so we can discuss potential risk factors and how to best keep you healthy!

Contact Us to Learn More

We’re here to answer your questions and address your concerns. Visit tpqc.org/PrEP or call (309) 762-5433.

Featured

Baby Boomers: You Should Care About Hepatitis C

Were you born between 1945-1965? If so, you’re classified as a “baby boomer,” and your risk of having Hepatitis C is higher compared to other generations. The CDC found that 75 percent of those living with Hepatitis C are boomers. About 1 in 30 people with Hep C don’t know they have it.

Thankfully, Hepatitis C is easily diagnosed and can be cured. But when it’s not, the infection often causes liver cirrhosis, cancer, and even death.

Hold On. What Is Hepatitis C?

Hepatitis C is a virus usually spread when blood from a person infected enters the body of someone who is not infected, later causing inflammation of the liver. What’s dangerous is that Hepatitis C often has no symptoms, meaning those infected don’t even know they have it. The risk for long term health consequences remains even when there aren’t symptoms.

Why Baby Boomers?

The most likely reason is use of injection drugs during young adulthood in the 70s and 80s. When needles and works are shared, the risk for passing on particular infections goes up significantly. Hepatitis C is one of those infections.

Of course, testing for hepatitis C isn’t only recommended for baby boomers. The following should also get tested:

  • Former or current person sharing needles, syringes, or other equipment to prepare or inject drugs
  • Having sexual contact with a person infected with the Hepatitis C virus
  • Needlestick injuries in health care settings
  • Being born to a mother who has Hepatitis C
  • Sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes
  • Getting a tattoo or body piercing in an unregulated setting
  • You were treated for a blood clotting problem before 1987
  • You received a blood transfusion or organ transplant before July, 1992
  • You are on long-term hemodialysis treatment
  • You were ever incarcerated
  • You are a sexually active persons about to start Pre-exposure Prophylaxis (PrEP) for HIV exposure
  • You have had unexplained chronic liver disease and/or chronic hepatitis including elevated liver enzymes

Getting Tested Is Simple—and Free

Testing for Hepatitis C with The Project involves two simple steps:

  • A rapid Hepatitis C test done through a finger prick. These results are preliminary and come back in a little as 15 minutes.
  • A blood draw to confirm results.

A quick note about the finger prick test. If you have ever been exposed to Hepatitis C at any point, this result can come back positive. This doesn’t necessarily mean you have an active Hepatitis C infection. The finger prick tests for the presence of Hepatitis C antibodies which can be found during infection and after cure. This is why a blood draw to confirm results is so critical.

Getting Cured

So you’ve been diagnosed with Hepatitis C. What’s next?

The Project will coordinate your care with the goal of getting you cured. Because we have both an on-site lab and pharmacy, you’ll receive the bulk of your services in one location.

But of course, the first step is getting tested. Getting tested for Hepatitis C at The Project is simple, free, and confidential. You can schedule online, call 309-762-5433, or walk-in for testing at 1701 River Dr., Suite 110, Moline.

Mental Health & COVID-19: How to Care for Yourself and Others

If COVID-19 has you stressed or worried, you are far from alone. Gallup reports three in four Americans worry that themselves or a family member will be exposed to coronavirus. And with constant media coverage around the toll the virus is having on daily life, it’s hard not to fall into that statistic.

Now more than ever, mental health is important. How we care for ourselves mentally during a crisis can make or break a positive outcome.

To help others care for themselves mentally, TPQC Licensed Mental Health Counselor Jessica Slover answered five questions about mental health and COVID-19 based on her experiences as a clinician.

1. Self-isolating is difficult for anyone. Is there increased risk for folks living with a mental illness in having to self-isolate?

According to Slover, people living with a mental illness may have a tough time in self-isolation, especially if they’ve come to rely on social support.

“Isolation increases everybody’s risk for more problematic health outcomes,” Slover said. “Social support may have been a part of their plan for recovery. Self-isolation might actually increase their anxiety because they are afraid of relapsing or falling into past behaviors.”

A person living with a mental illness might already have a perception of loneliness, or that no one understands what they are going through. Self-isolation can take that perception and make it feel very real.

Slover added that as some providers cancel in-person appointments deemed not essential, this leaves patients neglected or, in a worst-case scenario, without access to necessary medications.

“Canceling these appointments can increase their anxiety because they don’t have their normal support system,” she said. “Which then causes increased stress, which in turn can exacerbate other health problems. It can create a vicious cycle.”

This cycle could lead to what’s called a trauma response, Slover notes. She describes it as the body going into a fight or flight mode, potentially manifesting in a number of different ways.

“Increased anxiety, excessive sleeping, heightened fear and arousal, irritability, crying spells, or feeling vulnerable. People have this all of sudden and ask why am I feeling this way? It’s because their body is responding to this real or perceived stress that they are under.”

2. Many people living with HIV have a traumatic history when it comes to their experiences during an epidemic. How can we as a society be supportive for those individuals?

For many people living with HIV, the fear and uncertainty that accompanies a virus like COVID-19 is something with which they’re all too familiar. Slover emphasizes the importance of acknowledging that unique perspective without necessarily having to understand it.

“The number one thing to remember if you know somebody living with HIV: don’t judge or minimize their behavior during this time,” she said. “The fear and unknown that comes with COVID-19 can cause them to feel like they are reliving that trauma all over again.”

What can you do?

“Try offering practical support,” Slover said. “Try to reach out and listen to what they tell you they need. Don’t force them to talk about anything they don’t want to talk about. But also let them know you are a safe person for them to open up to if they do want to share their experience or what they are feeling right now.

3. LGBTQ+ youth who previously relied on socialization and an accepting environment during school may now be at home with their parents/guardians with the inability to be their authentic selves. What recommendations do you have for those youth during such a challenging time?

According to The Trevor Project, LGBTQ+ youth are at an increased risk for anxiety, depression, substance use, and suicide. Social distancing as a result of COVID-19 can lead to a significant decrease in the positive social interactions LGBTQ+ youth need in order to thrive.

“LGBTQ+ youth can and are encouraged to reach out to those that they trust and feel supported by. Unfortunately, sometimes that isn’t family,” Slover said. “It is key to identify the people they trust and feel supported by and try having regular check-ins with them.”

Slover also recommends connecting with online resources. Local LGBTQ+ organizations are hosting virtual events to help the community stay connected despite social distancing.

For those isolating with people who are not affirming or accepting towards LGBTQ+ identities, Slover recommends distancing yourself from any negativity when possible.

“If possible—and I know this isn’t possible for everyone—but try to remove yourself from the situation,” she said. “If there is a conversation going on that you don’t feel comfortable with, try to leave. If you can go outside or get on the Internet, put your headphones in and listen to music—just somehow remove yourself from that toxic situation and try to connect with those you identify as safe and supportive.”

Lastly, Slover says to keep the positive self-affirmations going.

“Keep that positive internal dialogue going because that is something you can control. You can’t control what people around you will say; but you can control what you say to yourself.”

4. It’s critical that we follow social distancing recommendations while still caring for ourselves mentally. What are some tips you recommend to maintaining mental health?

  • Make a routine. Because right now we are experiencing a situation where we feel helpless and overwhelmed by the unknown, this all can increase anxiety. If you make a routine, even if it’s just waking up each morning at a certain time or always brushing your teeth at a certain time—it can give you a sense of control.

  • If you’re working from home, be sure you’re not accessible 24/7. It’s important to set those boundaries with your employer. If you end the day at 5 p.m. normally, do the same thing when you’re at home. It’s okay to set those boundaries and turn off anything that has to do with work and transition into your home time.

  • Allow yourself to feel. With this situation we are going to have so many different emotions, and we often want to push them all away to avoid discomfort. When we suppress our feelings, often times we can feel like they are worse. Try to acknowledge how you feel and what you need during this time. Have compassion for yourself; don’t judge or compare yourself to what others are doing. Everyone has their own situation and struggles and it is important to remember that our feelings and reactions are based on how we perceive the world and our place in it. We all react to trauma in different ways, no one way being right or wrong. Our responses are normal reactions to abnormal events.
  • Assess your time spent looking at social media. It’s very easy to get wrapped up in all of the news going on right now. Just to constantly be hearing about it, reading about it—it’s everywhere you look. It is important to ask yourself if being on social media is helping or causing more anxiety. It is okay to not talk about COVID-19. It doesn’t have to consume everything about your day.

  • Find distractions. Puzzles, watching Netflix, exercising, coloring, cooking, music, or even volunteering can be very therapeutic if you have the ability and it is safe.

  • Exercising is very good for your mental health because it helps to repair the nervous system. Exercise burns off the overload of adrenaline and cortisol that we have during stress, and it releases endorphins to increase calming effects and boost our mood.

  • Create a safe place within your home. If you’re able, find a place you can go to that allows you to escape. Even if it’s just for 15 minutes at a time, it helps.

  • Use grounding techniques to bring yourself to the present moment. Often our brain is going everywhere, stuck in the past or future, which can increase depression and anxiety. Grounding helps to bring us back to the present moment.

    One way is to engage our five senses because our senses tell our brains where we’re at. Try the 5-4-3-2-1 method:

    Identify 5 things you see—be as descriptive as possible
    • 4 things you can physically feel or touch
    • 3 things you can hear
    • 2 things you can smell
    • 1 thing you can taste
  • Mindful breathing. When we breathe properly (using our diaphragm and not our chest), we can regulate our nervous system, which helps cope with stress and manage trauma responses.

    Try putting one hand on your stomach and one hand on your chest. Breathe in through your nose for 4 counts, focusing on your stomach filling with air and rising instead of your chest. Hold for 4 counts. Breathe out through your mouth for 4 counts, similar to blowing out candles. Repeat as needed. 
  • Remember: you are resilient. You have survived 100% of the days you have lived.

5. What are the mental health services offered by The Project?

The Project provides free individual, couples, family and group counseling sessions to anyone living with HIV, LGBTQ+ individuals, and those who are victims of a crime like domestic abuse or sexual assault.

We are currently providing over-the-phone or virtual counseling sessions. To schedule, call 309-762-5433 and press zero.

For additional information pertaining to managing mental health during COVID-19, check out the Illinois and Iowa Department of Human Services websites.

PrEP vs. PEP: What’s the Difference?

In previous blogs, we wrote about two different types of medications that can prevent HIV transmission: PrEP and PEP. We realize, though, that understanding how these medications differ from one another can be confusing. So, we thought it worthwhile to explain how they contrast in detail.

With that having been said, check out the table below for a side-by-side comparison of these two very important medications:

Post-Exposure Prophylaxis (PEP)Pre-Exposure Prophylaxis (PrEP)
What is PEP? What is PrEP?
Medicine taken to prevent HIV infection after you may have been exposed to HIV.One pill a day medication taken that greatly reduces the risk of getting HIV before exposure occurs.
When is PEP right for you?When is PrEP right for you?
In the last 72 hours you:
• May have been exposed to HIV during sex (e.g. condom broke)
• Shared needles and works to prepare drugs, or
• Were sexually assaulted
You are HIV negative and:
• You’re a man who has sex with men
• Your partner is HIV positive
• You’re heterosexual and have unprotected sex
• You inject drugs and share needles
How effective is PEP?How effective is PrEP?
Very! But you must begin taking PEP within 72 hours to be effective.Very! When taken daily, PrEP is 99% effective in stopping HIV transmission from sex.
Where can you get PEP?Where can you get PrEP?
The Project offers PEP through same-day and walk-in appointments. You can also request PEP through your health care provider.The Project is a PrEP Clinic, and you can receive all your PrEP care and medication in one place. This includes on-site lab and pharmacy.
What is the cost of PEP?What is the cost of PrEP?
The Project is typically able to provide PEP at no cost to you.The Project is typically able to provide PrEP services at no cost to you.

Schedule a Free Consult

Have more questions? Want to get access to PrEP or PEP? You can schedule a free consult online or by phone at 309-762-5433.

Explaining PEP and Why It Matters

You had a fun, casual hook-up over the weekend. You met at a Halloween party, drank just a bit too much, and ended up bringing him back to your place.

The next morning you wake up to find him gone. You shrug it off.

Reaching over to your phone, you see a text from him. You smile; maybe he’ll want to grab coffee? Or a drink? From what you remember he was pretty cute, Dracula makeup and all.

You unlock your phone and read the text:

“Hey. Last night was great. There’s something I forgot to mention though…”

You can feel your heart pounding as you read the last few lines.

“Idk if it’s for sure, but the other day I was tested for HIV and they told me I maybe have it. I should have said something to you. But we were having a good time. I’m sorry.”

Your heart is about to leap out of your chest. You lunge towards the garbage can, hoping to find a used condom. But there’s nothing. You try to think back. Did we talk about condoms? Did he put one on? You were so drunk. Everything is a blur.

You grab your phone again, ignoring his message and going to Google instead.

“I was exposed to HIV. What should I do?”

PEP Can Stop Transmission After HIV Exposure

Many don’t know that there’s still time to stop HIV transmission after possible exposure. PEP, also known as Post-Exposure Prophylaxis, is a combination of medications taken within 72 hours of a possible exposure. It should be used in emergency situations only, even if the person taking it is unsure the exposure is legitimate.

When Should PEP Be Started?

Starting PEP is very time sensitive. The sooner it’s started within that 72-hour window, the better.

Who Should Take PEP?

In the case of our imaginary friend who hooked up with a guy who might be HIV positive, they should start PEP ASAP.

In general, anyone who suspects they’ve been exposed to HIV within the last 72 hours should take PEP. Some scenarios that would apply include:

  • You had unprotected sex or the condom broke with an individual who possibly has HIV
  • You were a victim of sexual assault
  • You shared needles or works with someone who may have HIV

How Long and How Often Is PEP Taken?

In most cases, PEP is taken 1-2 daily for 4-weeks or 28 days. It’s critical to stick with this schedule for PEP to stop HIV transmission. If dosages are missed, it’s possible the medication will not work.

Are There Side Effects?

Possible side effects are short term and include nauseous and fatigue. Be sure to speak with your provider if additional side effects occur.

Do Those on PrEP Need to Take PEP If Exposure Occurs?

Do Those on PrEP Need to Take PEP If Exposure Occurs?

PrEP, also known as Pre-Exposure Prophylaxis, is taken by those who are at a higher risk of getting HIV. When taken daily, it’s up to 99 percent effective in stopping HIV transmission from sex.

If PrEP is taken daily, PEP should not be necessary when exposure occurs. You can learn more about PrEP here.

I’ve Taken PEP for 28 Days. What Now?

Once you’re done with the medication, you’ll come in to The Project for an HIV test. Depending on your results, you and your care provider will discuss how to proceed.

Is PEP Expensive?

We typically provide PEP to our clients at minimal to no cost to them.

How Do I Get on PEP?

The Project is a PEP clinic, meaning we offer immediate access to the medication during our normal business hours. If you think you need PEP, either walk-in for an appointment or schedule online. Learn more at tpqc.org/PEP.

Becoming Oliver

Oliver is a typical 14-year-old boy. Relatively quiet at first, he happily chips in when the topic turns to video games or drawing.

“Minecraft. Guild Wars 2. I used to play Overwatch, but we’re trying to make my computer better,” he says.

Just above 5-foot, Oliver has pale skin and light brown hair. He is pensive as he leans back in his patio chair, his mother, Jenny, and stepfather, Zee, sitting just to his left. It is a perfect May evening, a lawn mower rumbling productively a few yards away, the sun gleaming through the trees.

“Oliver is one of the most interesting kids I’ve ever known,” his mother adds, the pair maintaining eye contact as they speak. “He’s built a wall because life’s been hard. But he has such a big heart and cares a lot about his community and the world.”

At just 14, Oliver’s life has been a challenge. He has a history of depression, ADHD, and has openly struggled with his gender identity. It is only recently with the help of counseling at The Project and his family’s support that he came out as transgender.

Defining Transgender

What does it mean to be transgender? GLAAD defines it as an, “Umbrella term for people whose gender identity and/or gender expression differs from what is typically associated with the sex they were assigned at birth.”

While it’s easy to get carried away with the semantics, simply put Oliver’s sex assigned at birth does not match his gender identity and/or expression. Doctors assumed him a girl because of his biological appearance, but in every way that matters, Oliver is a boy.

And he’s far from alone. Oliver is one of the estimated 1.4 million transgender individuals living in the United States according to the Williams Institute. That number has risen significantly in recent years with increased visibility and cultural acceptance.

“It more acceptable to talk about it,” said TPQC Mental Health Clinician Clyde Lipp, MS, LCPC. “There’s far less shame, guilt, and secrecy around the topic.”

Lipp began treating Oliver in July 2018 after working first with his mother, Jenny.

“Oliver was having problems in school,” Lipp said. “It started with depression, sadness, and suicidal thoughts. But what eventually came out in therapy as he became more comfortable were issues around gender confusion. He expressed a feeling of wanting to live as a male.”

Yet there was a sense of shame and fear that blanketed Oliver’s desire to live authentically, something TPQC Health Equity Director Viminda Shafer often sees as she works with youth.

“Acceptance has become more widespread, yes. But you still have so many kids afraid to come out and be themselves,” Shafer said. “Whether it’s because they fear being rejected by their families or think they’ll be bullied at school. There is still a lot of progress to be made.”

According to a national survey by GLSEN, 75 percent of transgender youth feel unsafe at school. A contributing factor might be the fact that nearly 60 percent of trans youth have been denied access to a restroom matching their gender identity.

“To a lot of us, a bathroom is just a bathroom,” Shafer said. “But to transgender youth, a bathroom serves as either a symbol of oppression versus acceptance.”

Feelings of oppression can cause significant mental health problems including depression and suicidal thoughts. In fact, the Human Rights Campaign reports about 50 percent of transgender male teens have attempted suicide in their lifetime.

The solution? Love and acceptance.

A Brighter, Beaming Future

Oliver remembers always feeling different. He fondly recalls cutting off all his hair in third grade.

“I was at a sleepover,” he said, smiling at the memory. “I cut it all off.”

“We went shopping after that,” Jenny added. “We bought you all boy clothes.”

Jenny described how strangers would see Oliver in public and assume he was a boy. Oliver loved what was then an unintentional error, neither he nor his mother correcting the commentators.

“He would beam from ear-to-ear. I just didn’t care to correct them. He was my son.”

Just nine months ago, Oliver began the formal transition process. Slowly but surely, he and his mom told their family and friends. And just six months ago he started going by “Oliver,” leaving his former—or “dead name” — behind.

“The first two weeks in particular were hard,” Jenny said. “It was constantly saying the wrong name and then having to apologize. My youngest has no patience for it though. If someone says the dead name, she jumps at them and corrects them.”

As for school, Oliver is transferring to Mid-City High School in the fall, a move both he and his family are excited about.

“When we were visiting, I noticed a rainbow flag sticker on the counselor’s door,” Oliver’s stepfather, Zee, said. “It gave me a good feeling.”

Lipp notes a remarkable change in Oliver’s behavior since coming out. “As this process was happening, you could see a change in Oliver’s mood,” he said. “His performance in school got better and his depression was significantly reduced.”

Without a doubt, Jenny says The Project’s free mental health counseling was a catalyst in helping Oliver to begin living as his authentic self.

“Clyde has been amazing. He is an incredible soundboard. He doesn’t sugarcoat things, and that’s so important,” Jenny said. “He holds you accountable for your end of the work. And that’s so important.”

Oliver and his family feel renewed. They look forward to a future that will undoubtedly present its challenges, but still filled with moments of authenticity and happiness.

Get Help with The Project

The Project provides free mental health counseling to LGBTQ+ folks and/or victims of crime. To learn more, visit tpqc.org or call 309-762-5433.