What is Pre-Exposure Prophylaxis (PrEP)? Who is eligible for PrEP?

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What is "Pre-Exposure Prophylaxis" (PrEP)?

You can think of it as birth control pills, but for HIV prevention.

The English term is Pre-Exposure Prophylaxis, abbreviated as PrEP. It might sound technical, but it's easy to understand when broken down:

Pre-Exposure: Meaning before you might be exposed to the HIV virus.
Prophylaxis: Refers to measures taken to prevent disease.

So, the core idea of PrEP is this: By taking specific antiviral medication every day or "on-demand" before engaging in high-risk behaviors (like unprotected sex), you build up sufficient drug levels in your body. If the HIV virus does enter your body, these drugs immediately "kill" the virus, preventing it from establishing an infection.

A simple analogy: It's like putting a "bulletproof vest" on your body's cells. When the virus comes, it can't breach your immune system.

A few important points:

PrEP is not a vaccine: It does not provide permanent immunity; the protective effect requires continuous medication. Once you stop taking it, the protection disappears.
PrEP is not the "morning-after pill" (PEP): PEP (Post-Exposure Prophylaxis) is an emergency treatment taken after a high-risk exposure, within 72 hours. PrEP is a preventative measure taken beforehand. One is "pre-event," the other is "post-event."
PrEP does not treat HIV: It only prevents infection. If you are already living with HIV, taking PrEP is not only ineffective but may also lead to drug resistance, impacting future treatment.

Who is PrEP suitable for?

Put simply, PrEP is suitable for people who are currently HIV-negative but feel they have a higher risk of HIV infection in the foreseeable future. It's a way to take proactive control of your health.

Specifically, PrEP should be seriously considered in these situations:

People with multiple sexual partners, or whose partners have other sexual partners. Because you cannot be certain of all partners' HIV status, PrEP provides an extra layer of protection.
People who don't always use condoms consistently. We all know condoms are important, but various reasons (like getting caught in the moment or accidents) can lead to non-use in real life. If you find yourself in this situation, PrEP is an excellent supplementary protective measure.
Your sexual partner is living with HIV, and their viral load is unknown or detectable. (If your partner is on effective treatment and maintains an undetectable viral load - commonly known as U=U - the risk of transmitting HIV through sex is zero; PrEP may not be needed in this scenario. However, some choose to use it for extra peace of mind.)
Sexually active men who have sex with men (MSM) and transgender women. Due to biological factors and modes of transmission, these groups are statistically at higher risk of HIV infection globally and are the primary populations for whom PrEP is recommended.
People who inject drugs and share needles/syringes. Blood transmission is another major route for HIV, and PrEP is also highly effective in preventing infection in this context.

In short: PrEP isn't for people with a specific "label"; it's for people in specific "risk" situations who want to proactively protect themselves.

Important things to know before using PrEP

If you think you might need PrEP, these points are crucial:

Testing is mandatory: You must test HIV-negative before starting the medication. Your doctor will also screen your kidney and liver function to ensure your body can handle the medication.
It is a prescription medication: PrEP requires a prescription from a doctor. You cannot just buy it online. Please consult at a regular hospital or qualified facility (like CDC clinics or dedicated sexual health clinics).
Regular follow-ups are essential: After starting PrEP, it's usually recommended to check in every 3 months. Tests include your HIV status, other sexually transmitted infections (STIs like syphilis, gonorrhea), and kidney/liver function to ensure your safety and health.
Adherence is key: PrEP has two main dosing regimens: "Daily Dosing" and "On-Demand Dosing (2-1-1 regimen)". With either plan, strict adherence to the schedule is crucial; missing doses reduces protection.
Condoms are still your friend: PrEP only protects against HIV, not other STIs like syphilis, gonorrhea, genital warts, etc., nor does it prevent pregnancy. Therefore, condoms remain the best tool for your comprehensive sexual health. Think of PrEP and condoms as working "hand in hand" for maximum protection, not as "one replacing the other."

PrEP is a powerful self-protection tool, giving us more choices and peace of mind. If you have concerns in this area, don't hesitate to consult a healthcare professional to see if it's right for you.