Ask the Doc :: PrEP?

Question:
Dear Dr. Jason,

I have a lot of sexual partners, and I'm wondering what to do about PrEP. I mean, I don't have a lot of unsafe sex, but it occasionally has happened (so shoot me). Should I go see my doctor to start a PrEP regimen after every such incident?

Wanting the truth

Doctor Jason's Response:

There are 2 entities to be aware of: PrEP and nPEP. PrEP is "Pre-Exposure Prophylaxis" where you take medication daily in order to try to prevent infection regardless of incidents, as opposed to nPEP which is "non-occupational Post-Exposure Prophylaxis" where you take medication daily for 4 weeks in order to try to prevent infection within 72 hours of an incident.

PrEP has become a hot topic in the past year due to the results of a few international studies which demonstrated up to a 73% reduction in the risk of acquiring HIV for those who took PrEP. At the current time, however, there are no specific guidelines regarding PrEP.

Situations in which it would be reasonable to discuss the possibility of PrEP with your health care provider include having a regular partner who is HIV-infected, utilizing nPEP more than 3 times in a calendar year, or engaging in routine unsafe sexual behavior (e.g., as a commercial sex worker).

Stay healthy,
Doctor Jason

Dr. Faulhaber is a graduate of Tulane University in Psychology and Cellular and Molecular Biology and received his medical degree from the University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School. He performed his residency training in Internal Medicine and Pediatrics at Saint Vincent's Hospital in Manhattan, where he then served as a Chief Resident in Internal Medicine. He completed his fellowship in Infectious Diseases at New York University, where he specialized in HIV/AIDS, Hepatitis, and fungal infections. Since fellowship, he has been working as an Internal Medicine/Infectious Diseases physician at Fenway Community Health in Boston. He is a Clinical Instructor in Medicine at Harvard Medical School, and he is affiliated with Beth Israel Deaconess Medical Center. He has been the lead author or co-author of several journal articles and textbook chapters on infections with HIV, other viruses, bacteria, and fungi. He is also accredited by the American Academy of HIV Medicine.

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