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1636 S. Glenstone Springfield, MO 65804 417-881-1900

1636 S. Glenstone Springfield, MO 65804 417-881-1900 Bob Holtkamp, Director of Prevention & Outreach Bob.Holtkamp@APO-Ozarks.org. PrEP (Pre-Exposure Prophylaxis). PrEP is a method for people who are HIV -negative and at substantial risk for HIV infection

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1636 S. Glenstone Springfield, MO 65804 417-881-1900

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  1. 1636 S. Glenstone Springfield, MO 65804 417-881-1900 Bob Holtkamp, Director of Prevention & Outreach Bob.Holtkamp@APO-Ozarks.org

  2. PrEP(Pre-Exposure Prophylaxis) PrEP is a method for people who are HIV-negative and at substantial risk for HIV infection Pill contains two anti-retroviral medicines which taken daily reduces risk of HIV infection by 95% . Effective after 7 days use for men and 21 days for women. Side effects such as an upset stomach or headache, but are mild and usually disappear within the first month.

  3. iPrEx study • 2,499 gay, bisexual, and other men who have sex with men in US, Peru, Thailand, Ecuador, and South Africa • Average of 18 sexual partners in the last 3 months • 60% reported condomlesssex in the last 3 months • 77.5% reported condomless sex with a partner of unknown HIV status in the last 6 months • 2.5% reported condomless sex with a HIV-positive partner in the last 6 months

  4. Reported Side Effects 2% Elevated Creatinine (Measure of kidney function) 2% Weight Loss 2% Nausea 4% Headache Monitor Kidney Function and bone mineral density www.healthline.com/health/truvada-prep-preventing-hiv-with-daily-pill-Infographic

  5. IPrExand Safety N Engl J Med 363;27 December 30, 2010

  6. iPrEx Results • 44% reduction in HIV transmission among all participants • 77% reduction among participants who reported that they were taking the drug • 92% reduction among participants with detectable levels of drug in the blood • 99% reduction among participants with levels of drug in the blood consistent with daily adherence

  7. PrEP Dosing SciTransl Med. 2012 September 12; 4(15)

  8. IPrEX and Behaviors Reported High risk behavior decreased substantially after enrollment and remained lower Counseling, testing, and dispensing condoms may have contributed to Safer behaviors Taking a pill a day may have served as a daily reminder of imminent risk and promoted planning for sex which has been associated with lower risk N Engl J Med 363;27 December 30, 2010

  9. Uses of PrEP • Serodiscordant couples (1 person with HIV and the other is not) • Men who Sex with Men (MSM) • Transgender persons • Sex Workers/Transactional sex • People who Inject Drugs (PWID) • High-risk individuals-multiple partners/unknown status • Individuals with multiple STIs in the previous year • Mother-to-child prevention

  10. CDC Recommendations • Must be HIV-Negative • Must be retested for HIV and STIs every 3 months • Not intended to be used without condoms • Creatine levels monitored

  11. What PrEP not do? Does not protect a person against diseases like chlamydia, syphilis, herpes, or gonorrhea Does not prevent pregnancy Not a cure for HIV Doesn’t work as treatment for someone already living with HIV Doesn’t work if not taken consistently and correctly myprepexperience.blogspot.com

  12. TRUVADAas PrEP Only Prescription medication approved (July 16, 2012) by the FDA for pre-exposure prophylaxis (PrEP) Fixed-dose anti-retroviral (combination of emtricitabine 200 mg and tenofovirdisoproxil fumarate 300 mg) was originally approved in 2002 for treatment of HIV. Well known side effect profile. www.truvadapreprems.com/

  13. Insurance Coverage for PrEP? ”We have not heard of any insurance company or any medicaid program outright denying coverage of truvada as PrEP. Some companies and programs are requiring prior-authorization, however, which requires paperwork to be filled out. And the type of insurance coverage you have, including prescription drug benefits, will determine the cost to you…” myprepexperience.blogspot.com

  14. How to Pay: Insurance, Medicaid, Medicare Copay assistance from Gilead at 877-505-6986 and/or Patient Access Network at 866-316-PANF If Uninsured, free antiretroviral medicines through the Gilead at 855-330-5479 Resources: CDC.gov/hiv/pdf/prevention_PrEP_factsheet.pdf ProjectInform.org/prep PrEPFacts.org WhatisPrEP.org MyPrEPexperience.blogspot.com PrEPWatch.org Prep-faq.com

  15. COPAY ASSISTANCE FOR TRUVADAif you have insurance Gilead HIV co-pay assistance coupon cardYou may be able to save on the co-pay for your TRUVADA prescription, with a GILEAD HIV co-pay coupon card. Visit www.Gileadcopay.comor call 1-877-505-6986 for more information and to see if you are eligible.* *Enrollees will have to answer a few questions to confirm eligibility, restrictions apply. The program is subject to change at any time.

  16. www.prep-faq.com

  17. WHY PrEP? Personal control to limit risk of HIV infection Once-a-day dose for all-day risk reduction Daily reminder to stay HIV negative

  18. QUESTIONS?

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