Welcome To Your Guide For PrEP, PEP, & HIV Prevention

Hey Guys & Gals, just wanted to share this great new educational campaign created in collaboration between The Institute Of Many and Dynamix International.

Reinforcing the message that U = U

When HIV is Undetectable, then it’s Untransmittable. Zero risk, and that’s a fact.

While the evidence has been out for a long time we know that successful treatment with HIV medications not only has huge health benefits for the person living with HIV, we also know that it makes HIV impossible to be passed on.

In this video I wanted to explain the best way to take PrEP when travelling, in particular when you are crossing time zones.

As noted in previous videos, Truvada for PrEP is a robust treatment and occasional changes in time of dosing will not have a major impact on it’s protection against HIV.

I recommend all people continue to take the medication at the same time they would normally take the  medication.

In this video I just wanted to share how to quickly check for any interactions between PrEP and prescription medications you may be taking.

While Truvada (Tenofovir & Emtricitabine) are a well tolerated medication there are a few drugs that can interact. In particular, medications that can affect the kidneys are always worth checking with your doctor.

The site I recommend to check for drug interactions is the University of Liverpools site:

Hey, guys. It's Dr. George here. I've just been part of a thread on Facebook where we were talking about the storage of Truvada, the drug that's used for HIV treatment, but also for HIV prevention. I just wanted to share some tips when it comes to the best way to store your medications.

Now the manufacturers, Gilead, have recommended that the drug be stored in a temperature-controlled environment, preferably around about 25 degrees centigrade, or between 15 degrees centigrade and 30 degrees centigrade. The reason for that is that the extremes of temperature could lead to degradation of the drug within the tablet and they're not able to guarantee its safety. It's best don't store it in the car, don't store it in the fridge. You can leave it on the table. Assuming that your room is of those temperatures, then it should be all okay.

Just wanted to say a special thanks to Mu Delta for kindly agreeing to share his experience of PrEP not only from a user perspective but also for someone in Europe. PrEP is now starting to increase in use in Belgium.

If you would like to learn more about PrEP be sure to enjoy the other videos of this website.

One of the more common questions for people who are going on to PrEP is, does this mean that I can stop using condoms? We know that condoms have a role in all sexual health, not just HIV prevention. Taking PrEP every day does greatly reduce the risk of HIV infection. Adding condoms into the mix can also help reduce the chance of transmission of some STIs. However, it is important to know that we understand that people are going on to PrEP because the condom is not always used when it comes to sexual encounters. However, we can encourage that as part of a full comprehensive sexual health protection that condoms can be a useful part of this.

PrEP does have some rare side effects that are very important to follow through with. The first one is that in some people, PrEP can reduce the function of the kidney. For this reason it's very, very important that when you're starting PrEP, that you have a very careful examination of the patient's medical history. Are they diabetic? Do they already have preexisting kidney disease? Are they on medicines that can affect renal function such as metformin or frequent doses of NSAIDs that could reduce the function of the kidney?

What are the contraindications of going onto PrEP? The number contraindication to go onto PrEP is that the person is already infected with HIV. For this reason, it's very important at the beginning of the screening process that we do a test for HIV. We're looking for HIV-1 antibodies, HIV-2 antibodies, and if we can use a fourth generation that checks for p24, this greatly reduces the window period. If somebody has had a potentially high risk exposure to HIV a month before they're considering starting PrEP, it's worthwhile to carefully monitor their status to make sure that the person has not had an exposure and infection with HIV beforehand. If the potential risk and exposure to HIV is within 72 hours, it's worthwhile talking with this patient about going PEP or post-exposure prophylaxis.

It's important to have a review of people's medications before they start PrEP. Any medicines that could affect renal function are worthwhile making sure that everything is okay. Examples include people who are on ACE-inhibitors, people who are on metformin, or who regularly use [inaudible 00:00:20], all of these drugs can affect kidney function so it's important that you review these medicines as well as making sure that their kidney function is okay. These are not contraindications to starting PrEP. However, it is good to know where you are starting from and if you are going to be adding any of these medications whilst the person is being treated on PrEP. It's worthwhile to carefully monitor renal status during this process.

If you have a patient who there may be a risk that they have been exposed to HIV one month before initiating PrEP, I like to organise a second appointment to confirm HIV status before the person starts taking the medications. My normal flow would be that I organise the full screening tests, and if the patient is importing medications, what I do is I bring them back when their medicines have arrived. This is a chance to discuss how to take PrEP, but also to do a second HIV test to confirm that they are HIV-negative.