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In which Lindsey introduces us to a pill that can prevent 90% of HIV transmissions when used properly. Who should use it? Find out.
You know how some people use condoms and take pills to double pregnancy prevention efforts? What if you could do the same thing: wear condoms and take a pill to up the prevention of HIV transmissions?

PrEP. It's a pill that stands for pre exposure prophylaxis, and it prevents HIV. It works to stop any invading HI virus from setting up shop in a new host.

HIV... [covers "virus"] PrEP.

The drugs in PrEP, called [tenoforvir] and [emtricitabine] both inhibit the replication of HIV in the body, if it is in the body.


When I first started doing HIV prevention work in the early 2000s, PrEP wasn't around. We did have PEP, though. Post exposure prophylaxis. So if I were to get stuck by the needle I had just used to test someone's HIV status, I could go to the health department within 72 hours, and get a medication that would prevent HIV from establishing itself in my system.

That was PEP. PrEP is the pre-emptive version, as in "I'm gonna prevent the attack rather than intervene on it." Here's the thing though: PrEP isn't a one-time dose or an 'as needed medication,' like, 'take it Saturday because we're having sex on Sunday.' For it to work, it needs to be built up in the bloodstream, so that if HIV were to enter 'here' [mouth], 'here,' 'here,' 'here,' or 'here' [crotch area], PrEP would be on site to be like, [hits "virus" away]. 

Here's one person's thoughts on it: "As the receptive partner, I had always made my HIV status contingent on the "top" using a condom, making sure it didn't fall off, fall in, or break. With PrEP, I could make rational decisions about my sexual choices and still remain 100 percent in control of my negative HIV status. That has increased my romantic and sexual connections greatly."

[laughs] Well, maybe not 100 percent, but it is 90 percent effective at preventing HIV transmission and that's incredible, especially when paired with other methods like in-and-out condoms. 

Let's do the math. I take PrEP consistently, and use condoms properly and my risk of becoming HIV positive from penetrative sex with someone who is HIV positive is less than two percent. [0.10*0.15=0.015<2%] And with perfect use of these methods, it's less than 0.02 percent. [0.10*0.02=0.02=0.2%(mistake)]

That's, arguably, a game-changer where virus loses and humans win! There are approximately two million new HIV infections per year, with PrEP, that could be a difference between 'this many' people becoming HIV positive and passing the virus to 'this many' people, and then 'this many' becoming positive and passing it to 'this many' people.

There are communities who function in a 'when I get HIV,' not 'if I get HIV' mentality. There are people who fall in love with someone who has HIV and want the intimate experience of sex with that person without such a risk of becoming HIV positive too. Others just wanna have sex, they wanna do it and do it and do it! In these riskier situations, PrEP can decrease sex suck!

We're a problem solving species, we figured out how to control parenthood with the pill in the sixties, how to avoid seventy percent of cervical cancers with Gardasil in 2006, and now, how to impede HIV transmission with PrEP.

Why aren't we all taking it? Well, the start, not everyone needs it. If you're not at risk for HIV infection, there's no sense putting a medication in your body that comes with side effects, a strict regime, and a hefty price tag. Plus, if the person taking the medication is unable to strictly adhere to when and how it needs to be taken, it may reduce the efficacy of the drug.

Another biggie is social stigma, but bleghh! People shame PrEP, like it's a pass to promiscuity. But promiscuity is a term designed to control other sexualities.  Just as access to condoms, birth control, and sex education don't cause people to be sexual, neither does PrEP. People are sexual.

So who should take it? People who are HIV negative, meaning they don't have it, people who have done their research, talked to other health care providers, people who can ask for help, follow directions, and use condoms.

It is the most practical for people who want to partner sexually with people who are HIV positive or HIV uncertain and don't want to become infected.

Take it or leave it, at least stay curious! PrEP is one way to reduce the risk of HIV transmission, here are some others: getting tested, sharing your results, wearing condoms, low or no-risk behaviors like oral sex or dry humping and making out too.