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

How Does PrEP Prevent HIV Infection?

PrEP is a combination of two drugs: Tenofivir and Emtricitabine.

HIV is a virus that is make from a single strand of RNA, the ‘blueprint’ of DNA. To make copies of itself it must first be transformed into DNA where it can then incorporate into the cell’s DNA. From this point it is able to make millions of copies of itself hijacking the cell’s mechanics.

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  <a href="#Common_PrEP_Side_Effects"><span class="toc_number toc_depth_1">4</span> Common PrEP Side Effects</a>
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  <a href="#Rare_PrEP_Side_Effects"><span class="toc_number toc_depth_1">5</span> Rare PrEP Side Effects</a><ul>
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      <a href="#Reduced_Renal_Function"><span class="toc_number toc_depth_2">5.1</span> Reduced Renal Function</a>
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      <a href="#Reduction_In_Bone_Density"><span class="toc_number toc_depth_2">5.2</span> Reduction In Bone Density</a>
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  <a href="#Contraindications_For_PrEP"><span class="toc_number toc_depth_1">6</span> Contraindications For PrEP</a><ul>
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      <a href="#Renal_Disease"><span class="toc_number toc_depth_2">6.1</span> Renal Disease</a>
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      <a href="#Initiating_PrEP_in_Hepatitis_B_Positive_Patients"><span class="toc_number toc_depth_2">6.2</span> Initiating PrEP in Hepatitis B Positive Patients</a>
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  <a href="#Initiating_PrEP"><span class="toc_number toc_depth_1">7</span> Initiating PrEP</a><ul>
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      <a href="#The_First_PrEP_Appointment"><span class="toc_number toc_depth_2">7.1</span> The First PrEP Appointment</a>
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      <a href="#Medication_Review_Before_Starting_PrEP"><span class="toc_number toc_depth_2">7.2</span> Medication Review Before Starting PrEP</a>
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      <a href="#PrEP_Pre_Screening_Tests"><span class="toc_number toc_depth_2">7.3</span> PrEP Pre Screening Tests</a>
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      <a href="#High_Risk_Exposures_Before_Starting_PrEP"><span class="toc_number toc_depth_2">7.4</span> High Risk Exposures Before Starting PrEP</a>
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      <a href="#HIV_Positive_Test_Results_As_Part_Of_PrEP_Pre-screening"><span class="toc_number toc_depth_2">7.5</span> HIV Positive Test Results As Part Of PrEP Pre-screening</a>
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  <a href="#Guide_For_Patients_on_PrEP"><span class="toc_number toc_depth_1">8</span> Guide For Patients on PrEP</a><ul>
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      <a href="#Helping_People_Take_PrEP_Every_Day"><span class="toc_number toc_depth_2">8.1</span> Helping People Take PrEP Every Day</a>
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      <a href="#Use_Of_Condoms_While_On_PrEP"><span class="toc_number toc_depth_2">8.2</span> Use Of Condoms While On PrEP</a>
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  <a href="#Regular_Screening_For_PrEP_The_Quarterly_Visit"><span class="toc_number toc_depth_1">9</span> Regular Screening For PrEP: The Quarterly Visit</a><ul>
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      <a href="#My_General_Flow_For_The_PrEP_Follow_Up_Appointments"><span class="toc_number toc_depth_2">9.1</span> My General Flow For The PrEP Follow Up Appointments</a>
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      <a href="#Discussing_PrEP_Side_Effects"><span class="toc_number toc_depth_2">9.2</span> Discussing PrEP Side Effects</a>
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      <a href="#Routine_Quarterly_Sexual_Health_Screening"><span class="toc_number toc_depth_2">9.3</span> Routine Quarterly Sexual Health Screening</a>
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      <a href="#My_STI_Screening_Workflow"><span class="toc_number toc_depth_2">9.4</span> My STI Screening Workflow:</a>
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      <a href="#Technique_For_Chlamydia_Gonorrhoea_PCR_Throat_Swab"><span class="toc_number toc_depth_2">9.5</span> Technique For Chlamydia / Gonorrhoea PCR Throat Swab</a>
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      <a href="#Urinary_Tract_STI_Screening_Gonorrhoea_Chlamydia"><span class="toc_number toc_depth_2">9.6</span> Urinary Tract STI Screening: Gonorrhoea & Chlamydia</a>
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      <a href="#If_A_Person_Has_A_Positive_HIV_Result_While_On_PrEP"><span class="toc_number toc_depth_2">9.7</span> If A Person Has A Positive HIV Result While On PrEP</a>
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  <a href="#Importation_Of_PrEP"><span class="toc_number toc_depth_1">10</span> Importation Of PrEP</a><ul>
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      <a href="#Explaining_How_To_Import_PrEP"><span class="toc_number toc_depth_2">10.1</span> Explaining How To Import PrEP</a>
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      <a href="#Helping_Patients_Comply_With_PrEP_Importation_Laws"><span class="toc_number toc_depth_2">10.2</span> Helping Patients Comply With PrEP Importation Laws</a>
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      <a href="#Choices_For_Generic_Truvada"><span class="toc_number toc_depth_2">10.3</span> Choices For Generic Truvada</a>
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  </ul>
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  <a href="#PrEP_Tips_Tricks"><span class="toc_number toc_depth_1">11</span> PrEP Tips & Tricks</a><ul>
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      <a href="#Helping_Compliance_In_PrEP_Treatment"><span class="toc_number toc_depth_2">11.1</span> Helping Compliance In PrEP Treatment</a>
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      <a href="#What_If_A_Patient_Misses_A_Tablet"><span class="toc_number toc_depth_2">11.2</span> What If A Patient Misses A Tablet?</a>
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  <a href="#Thank_you_For_Your_Interest_In_PrEP"><span class="toc_number toc_depth_1">12</span> Thank you For Your Interest In PrEP</a>
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How Effective Is PrEP?

Who Is A Good Candidate For PrEP?

PrEP Only Protects Against HIV

How Does PrEP Work?

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I am fascinated at the response, or even that a response was required, by the editor of Attitude Magazine’s article on having a 3 month trial of PrEP.

What concerns me is the almost puritanical responses of people that reinforce slut shaming, “sex is bad” messaging infused with blaming of men choosing to control their own HIV status through medical means.

One of the more choice examples:

PrEP has been recently discussed in The Age newspaper after a recent PrEP user seroconverted to HIV positivein Melbourne Australia. Seroconverstion is when  a person becomes infected with HIV, going from HIV seronegative to HIV seropositive.

Hundreds of thousands of people use PrEP worldwide, but there have only been two confirmed cases of infection with a drug-resistant strain of the virus by someone taking the medication properly. A third case was reported in Amsterdam this year, and is still under investigation.

Is imported generic Truvada safe?

“Which generic version do I bring into Australia?”

Don’t Take PrEP With Psyllium (Metamucil™)

One important thing that I would like to note is the combination of Metamucil™ or psyllium husks and PrEP medication. When you take cilium husks, it’s designed as a way of helping keep bowel movements regular. It’s normally a teaspoon that’s mixed into a glass of water. It creates a gel-like substance inside the gut that helps absorb water and make your poo nice and soft.