PrEP (Pre-Exposure Prophylaxis) is a therapy that can be taken BEFORE a possible exposure to the HIV virus to reduce the risk of developing the infection. It involves taking a pill containing two drugs, tenofovir and emtricitabine, which work by preventing HIV from replicating in cells. This way, even if the virus enters the body, it cannot spread and is eliminated.
When is it prescribed?
PrEP can be prescribed to people who have not contracted HIV infection, but who often find themselves in situations where there is a real risk of this occurring. For example:
Sexual intercourse without a condom with a partner of unknown HIV status, or with HIV infection but NOT UNDETECTABLE (link to the U=U Help&Advice page)
sharing of materials for intravenous drug use
How is it taken?
There are two main ways to take PrEP:
Every day, at the same time, for continuous protection.
As needed, when risky intercourse is anticipated a little in advance. In this case, you take two pills at least two hours before intercourse, followed by one pill per day for the next two days.
The choice between the two regimens depends on personal habits and is agreed upon with the doctor.
How effective is it?
When taken correctly, PrEP offers very high protection: up to 95%. Of course, incorrect intake could reduce its effectiveness.
Are there any side effects?
As with any medication, there can be side effects, but in most cases PrEP is well tolerated. With the exception of allergies, which fortunately are rare in severe forms, the most common side effects include stomach ache, diarrhea, nausea, headache, or a feeling of tiredness, especially in the first few days. These effects tend to disappear over time. In a small percentage of cases (about 2%), a slight reduction in kidney function may occur, which is however reversible and returns to normal when therapy is stopped.
PrEP and condoms
do they do the same thing?
No! Condoms protect against all sexually transmitted infections and prevent unwanted pregnancies. PrEP, on the other hand, protects only against HIV. In essence, it is not a valid alternative to condoms, but at least it limits the risks run by those who do not use them.
What checks do I need to do?
During your first visit, you'll be given a comprehensive screening for sexually transmitted infections, and you'll be given a prescription for blood tests at a local health authority (ASL) or affiliated laboratory. This prescription must be brought to the infectious disease specialist's office for review during your second visit. At subsequent check-ups, the complete screening for sexually transmitted infections will be repeated, and renal function will be monitored periodically. Any further tests will be indicated from time to time by the infectious disease specialist.
What tests should I take before starting?
Before starting PrEP, you must:
take an HIV test, because PrEP is not suitable if you are already HIV-positive;
a comprehensive screening for sexually transmitted infections;
kidney, liver and blood parameter checks.
If everything is normal, the doctor can proceed with the prescription.
How much does it cost?
Currently, PrEP is free in Italy. After undergoing a series of initial tests, you will be issued a prescription that you can use to collect the pills from the hospital pharmacy. At CeMuSS, for example, tests are first performed on the kidneys, liver, and possible infections, then a treatment plan is drawn up.
