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. And for those using injection drugs, it’s up to 74 percent effective.

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 consists of two HIV medications: emtricitabine and tenofovir. Together they work to prevent an enzyme, HIV reverse transcriptase, from duplicating. This stops the virus from spreading when exposure occurs.

2. 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).

3. Is PrEP safe? What are the side effects?

By and large, PrEP is safe to take. A potential side effect to PrEP is occasional nausea when beginning the medication, but typically it goes away within a week or two.

Another possible long-term side effect is impaired kidney function, especially for those who have pre-existing conditions that put them at risk. However, every three months our team checks creatinine levels—an indicator of kidney function—to ensure they remain within a healthy range.

One last side effect is a slight loss in bone density. But according to the U.S. Department of Health & Human Services, the amount of decrease is clinically insignificant and reversible when PrEP is no longer taken.

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?

Your level of protection can reduce if a dosage is missed. However, it varies depending on how many dosages are missed per week. According to the iPrEx study:

  • For people who take 7 PrEP pills per week, their estimated level of protection is 99 percent.
  • For people who take 4 PrEP pills per week, their estimated level of protection is 96 percent.
  • For people who take 2 PrEP pills per week, their estimated level of protection is 76 percent.

Despite consistent protection, The Project highly recommends taking PrEP daily as prescribed.

6. How much does PrEP cost?

The Project offers PrEP Benefit Navigation to help reduce overall cost. In many cases the medication is provided free-of-charge. 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 or call (309) 762-5433.

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.