HIV Care Program
TasP
Treatment as Prevention is abbreviated as TasP. It is one of the effective options for preventing the spread of HIV.
Define Treatment as Prevention Treatment
It is the prevention that refers to taking HIV drugs to prevent the sexual transmission of HIV. People living with HIV take HIV drugs as prescribed every day and obtain and maintain an undetectable viral load. Thus, there is no risk of sexually transmitting HIV to HIV-negative partners.
How Treatment as Prevention Works
TasP will work when HIV-infected people take HIV drugs exactly as prescribed and receive regular follow-up care (including regular viral load testing to ensure their viral load cannot be detected).
Take HIV Drugs to Stay Healthy and Prevent Transmission
If you are infected with HIV, it is essential to start treatment with HIV medications called antiretroviral therapy or ART as soon as possible after your diagnosis. Few terms associated with Treatment as Prevention areas.
Virus Suppression
If taken every day exactly as prescribed, HIV medications can reduce the HIV level (also known as viral load) in your blood to a superficial level. This is called virus suppression.
Important
It is called viral suppression because HIV drugs can prevent the virus from growing in your body and keep the virus at a deficient level or "suppressed." Virus suppression helps maintain health and prevent disease.
Undetectable Viral Load
If your viral load is so low that it does not show up in standard laboratory tests, this is called undetectable viral load. People living with HIV can take HIV drugs every day in full compliance with regulations, thereby obtaining and maintaining an undetectable viral load. Almost everyone who takes HIV drugs daily can reach an undetectable viral load, usually within six months of starting treatment.
Important
Reducing the viral load as much as possible is of great significance to health. If an HIV-infected person knows his condition, takes HIV drugs as prescribed every day, and obtains and maintains an undetectable viral load, he can live a long and healthy life.
Preventive Benefit
There is also a significant preventive benefit. People living with HIV take HIV drugs as prescribed every day and obtain and maintain an undetectable viral load. As a result, there is virtually no risk of sexually transmitting HIV to HIV-negative partners.
ent the virus from growing in your body and keep the virus at a deficient level or "suppressed." Virus suppression helps maintain health and prevent disease.
Things to Consider
Continue to take your HIV medication to keep it undetectable.
• When your viral load is suppressed, HIV will remain in your body even if it is undetectable. Therefore, you need to take HIV medicines every day as prescribed.
• When your viral load is undetectable, you are not actually at risk of transmitting HIV to HIV-negative partners through sex. However, if you stop taking HIV drugs, your viral load will rise quickly.
• If you have stopped taking HIV medications or cannot assume all doses as prescribed, please contact your healthcare provider as soon as possible.
• Your provider can help you get back on track and discuss the best strategies to prevent sexual transmission of HIV when you have no viral load detected again.
Is Treatment as Prevention effective? How do we know?
Large studies using new HIV drugs have shown that treatment is prevention. These studies monitored thousands of male-female and male-male couples, one of whom was infected with HIV while the other was not within a few years. When the virus suppressed hIV-positive partners, no HIV transmission was observed. This means that if you remain undetectable with a viral load, there is actually no risk of transmitting HIV to someone who has vaginal, anal, or oral sex with you.
Discuss with your HIV Care Provider
Talk to your healthcare provider about,
• The benefits of HIV treatment and which HIV medicine is right for you
• Discuss how often you should test your viral load to make sure it is still undetectable. If your laboratory results show that the virus can be detected, or if you experience problems with each dose of the drug, you can still use other methods to prevent HIV sexual transmission (such as condoms, safer sex, and pre-exposure prophylaxis (PrEP) for HIV-negative partners until your viral load is undetectable again.
• Taking HIV drugs to maintain an undetectable viral load does not protect you or your partner from other sexually transmitted diseases (STDs), so please discuss ways to prevent other STDs with your provider.
Discuss with your partner
TasP can be used alone or in combination with other prevention strategies. Discuss your HIV status with your sexual partner and decide together which prevention methods you will use. Some state laws require you to tell your sexual partner that you are infected with HIV under certain circumstances.
Preventive benefits of HIV treatment
In addition to preventing the sexual transmission of HIV, taking HIV drugs to achieve and maintain an undetectable viral load has other benefits:
Risk Reduction
It reduces the risk of mother-to-child transmission during pregnancy and childbirth. If a woman infected with HIV can take HIV drugs as prescribed throughout pregnancy, delivery, and birth, and if HIV drugs are given to the baby within 4-6 weeks after childbirth, the spread from pregnancy, childbirth, and childbirth can be reduced. The risk is 1% or less. Scientists do not know whether a woman infected with HIV can pass HIV to her baby through breastfeeding. Although it is unknown whether or to what extent the inability to detect or suppress the virus prevents certain modes of HIV transmission, it is reasonable to assume that it provides some risk reduction.
HIV Transmission Lessens
It may reduce the risk of HIV transmission among injecting drug users. Scientists do not yet know whether suppressing or undetectable viral load can prevent the transmission of HIV through sharing needles or other injectable drug equipment, but it is reasonable to assume that it can reduce some risks. Even if you are taking HIV drugs and cannot be detected, use new equipment for each injection and not share needles and syringes with others.
PrEP
Pre-exposure Prophylaxis, is a method of HIV prevention in which people who are not infected with HIV take HIV drugs to reduce their risk of contracting HIV when exposed to the virus.
Pre-Exposure Prophylaxis Limitations
PrEP can prevent HIV from spreading throughout your body. Currently, there are only two FDA-approved daily oral medications for PrEP. PrEP is prescribed for HIV-negative adults and adolescents at high risk of contracting HIV through sex or injecting drugs.
Benefits of taking PrEP
PrEP is very effective when taken as directed. Therefore, it should be used in the following way.
- Taking birth control pills once a day can reduce the risk of HIV infection through sex by more than 90%.
- Among people who inject drugs, it reduces the risk by more than 70%.
- If you use PrEP in combination with condoms and other prevention methods, your risk of contracting HIV through sex is reduced.
Is Pre-exposure Prophylaxis right for you?
If you are HIV negative and have had anal or vaginal sex in the past six months, and you,
• Have a sexual partner who is HIV-infected (especially if the partner’s viral load is unknown or detectable)
• Not using condoms all the time
• Diagnosed with STD in the past six months.
To whom is Pre-exposure Prophylaxis (PrEP) recommend?
• People inject drugs and have an HIV injection partner or share needles, syringes, or other injection equipment.
• If you have received PEP (post-exposure prophylaxis) and you have reported persistent risky behavior or used multiple PEP courses, then it may be for you.
• If you are a woman infected with HIV and are considering pregnancy, please discuss PrEP with your doctor. PrEP may be an option to help you, and your baby avoids getting HIV while you are trying to conceive, during pregnancy, or while breastfeeding.
Drugs approved for Pre-exposure Prophylaxis (PrEP)
The following drugs are approved as PrEP for daily use. They are a combination of two anti-HIV medications in one pill:
• It is recommended that all adults and adolescents at risk of HIV infection due to sexual behavior or injecting drug use take emtricitabine (F) 200 mg and tenofovir disoproxil fumarate (TDF) 300 mg (F-TDF; Trade name Truvada ®). The universal version of Truvada® is also available.
• It is recommended to use emtricitabine (F) 200 mg in combination with tenofovir alafenamide (TAF) 25 mg (F-TAF; trade name Descovy ®) for adults who are at risk of HIV infection due to sexual behavior and Adolescents, excluding those who are at risk due to vaginal sex. Descovy® has not conducted HIV prevention studies for receptive vaginal intercourse.
Is Pre-exposure Prophylaxis (PrEP) safe?
PrEP is safe. No significant health effects have been found for people who are HIV-negative and have been taking PrEP for up to 5 years.
Some people taking PrEP may experience side effects, such as nausea, but these side effects are usually not serious and will disappear over time. If you are taking PrEP, tell your healthcare provider if you have any side effects that bother you or will not go away.
Please note: PrEP can protect you from HIV infection, but it cannot protect you from other sexually transmitted infections (STI) or other types of infections. Using PrEP in combination with condoms will reduce your risk of contracting other sexually transmitted infections.
How do you get PrEP?
If you think PrEP may be right for you, please consult your doctor or healthcare provider. PrEP can only be obtained by prescription. Any healthcare provider licensed to prescribe PrEP can prescribe PrEP; no expertise in infectious disease or HIV medicine is required.
If you don't have a doctor, you can use the HIV service locator to find PrEP providers and other HIV services near you. In addition, you can visit many community health centers for PrEP consultation.
More than 190 health centers are providing PrEP services in 57 jurisdictions prioritized by the End AIDS Epidemic Initiative. Many health centers in other jurisdictions also provide PrEP services.
Because PrEP is for people who are HIV negative, you must have an HIV test before starting PrEP, and you may need other tests to make sure it is safe to use PrEP.
If you take PrEP, you will need to see your healthcare provider every three months for repeated HIV testing, refilling, and follow-up.
How can you get help paying for Pre-exposure Prophylaxis (PrEP)?
As of 2021, due to the preventive service provisions covered by the Affordable Care Act, most health plans must cover the total cost of PrEP drugs without charging you a co-payment. To find out if your health plan covers PrEP medications for free,
• If you buy private health insurance through your employer or buy it yourself, check with your health insurance company about the coverage of PrEP drugs.
• If you buy a health plan through HealthCare.gov or a state-based market, this NASTAD flyer can help you verify that the plan covers PrEP drugs.
• If you are enrolled in Medicaid, please consult your benefits counselor. If your health insurance still requires a copayment, but you cannot afford it, you may get copayment assistance from a drug manufacturer, a state plan, or a patient rights protection foundation.
• If you are enrolled in Medicaid, please consult your benefits counselor. If your health insurance still requires a copayment, but you cannot afford it, you may get copayment assistance from a drug manufacturer, a state plan, or a patient rights protection foundation.
To obtain or renew a PrEP prescription, you also need to pay for clinic visits and laboratory tests. If your health plan does not cover these services:
• You can get them at HRSA-funded health centers, where the variable fee depends on your ability to pay. There are more than 12,000 medical centers nationwide.
• PrEP assistance programs in some states cover clinical visits and laboratories.
If you do not have insurance, your healthcare provider can direct you to participate in PrEP's drug assistance program, or a patient navigator or welfare consultant at your clinic or provider’s office can help you sign up for the Marketplace program or Medicaid (if you qualify).
PEP
post-exposure prophylaxis, is a short-term HIV drug treatment taken immediately after possible exposure to HIV to prevent the virus from growing in your body.
Note:
You must start using it within 72 hours (3 days) after being exposed to HIV; otherwise, it will not work. Every hour is important! PEP should only be used in emergencies. It is not suitable for frequent use by people who are frequently exposed to HIV.
How do you know if you need Post-exposure Prophylaxis (PEP)?
If you are HIV negative or do not know your HIV status, and you think you may have been exposed to HIV in the past 72 hours, then PEP may be right for you:
- When having sex (for example, you broke the condom with a partner whose HIV status is unknown or an HIV partner who is not suppressed by the virus)
- By sharing needles, syringes, or other equipment used to inject drugs,
- Through sexual assault
Contact your healthcare provider immediately or go to the emergency room or emergency care clinic directly.
Your healthcare provider or emergency room doctor will evaluate you to help you determine whether PEP is right for you and work with you to decide which drugs to take for PEP.
In addition, if you are a health care worker, you may receive PEP after exposure to HIV at work, such as a needle stick injury.
How long do you need to take Post-exposure Prophylaxis (PEP)?
If you receive PEP, you will need to take HIV medication every day for 28 days. You will also need to return to your healthcare provider at a certain time while you are taking PEP and after completing the HIV test and other tests.
How effective is Post-exposure Prophylaxis (PEP)?
Taking PEP correctly can effectively prevent HIV infection, but it is not 100% effective. The sooner you start PEP after possible exposure to HIV, the better. When taking PEP, it is essential to use other HIV prevention methods, such as using condoms correctly every time you have sex, and using only new, sterile needles, and work when injecting drugs
Can Post-exposure Prophylaxis (PEP) cause side effects?
PEP is safe, but the HIV drugs used for PEP may cause side effects such as nausea in some people. However, in almost all cases, these side effects are treatable and not life-threatening.
If you are taking PEP, if you have any side effects that bother you or will not go away, please consult your healthcare provider. In addition, PEP medications may also interact with other medications a person is taking (called drug interactions). For this reason, it is important to tell your healthcare provider about any other medicines you take.
Can you take PEP every time you may be exposed to HIV?
Not possible. PEP should only be used in emergencies. It is not intended to replace the routine use of other HIV prevention methods. If you feel that you may be exposed to HIV frequently, discuss PrEP (pre-exposure prophylaxis) with your healthcare professional.
Can you get help to pay for Post-Exposure Prophylaxis (PEP)?
If you received a PEP after a sexual assault
You may be eligible for reimbursement for some or all of your medication and clinical care expenses through the Office of Victims of Crime, funded by the U.S. Department of Justice.
If you have been issued a PEP for other reasons and you cannot get insurance (Medicaid, Medicare, private or employer-based)
Your healthcare provider can apply for free PEP medications through the medication assistance program operated by the manufacturer. In many cases, these requests can be processed urgently to avoid delays in obtaining medicines.
If you are a healthcare worker who has been exposed to HIV at work
Your workplace health insurance or workers' compensation will usually pay for PEP.