PrEP: what you need is a correct information – Pt.1

There is still a long way to go when it comes to correct information about PrEP: this dark shade on it puts us in the risk of falling into mistakes and harming our-selves even more in the attempt of taking care of us.

We had a chat with Pietro Vinti, responsible manager of the PrEP desk of the Milan Checkpoint – an association which offers medical and psychological support – to whom we asked a series of questions about PrEP we received from our readers.

What does PrEP Mean?

PrEP stands for Pre Exposure Prophylaxis. It means that by taking a specific drug before a risky sexual relationship, for example sex without condom, you can prevent the transmission of the HIV virus. The drug used was born to keep the virus under control in people who already live with HIV, but in many years of observations it has been verified that the two active ingredients it contains – emtricitabine and tenofovir – are also effective for a good prevention. However, this medicine only works if it is taken in specific ways, so it is very important not to ‘do it your way‘ but to rely on specialised centres.

How does it work?

The greatest risk of transmission of HIV during sex with no protection, is through the mucous membranes, such as those of the anus or the glans, which are very permeable tissues. This medicine, once correctly taken, quickly distributes the active ingredients right in the mucous membranes, and essentially prevents the multiplication of the virus. This prevents the HIV virus to penetrate the mucous membranes with which came into contact, and therefore stop it from spreading to the whole body.

What is the PrEP counter?

The PrEP desk in Milano is a service that we offer to those people who want to take PrEP under supervision of doctors. With us users are followed by virologists, psychologists and counselors. This is because we believe that we need to approach to health at 360°,  therefore taking care of both the medical, emotional and motivational aspects for anyone who wants to start PrEP is essential.

Beyond the pharmacological aspect, PrEP is important because it allows each of us to be in control of our sexual health decisions. It means taking responsibility for an important aspect of health, regardless of what others decide or propose, as often it happens with the use of condoms. And, in case of  “incidents”, we can avoid those concerns related to HIV infections. We might say that the main “side effect” of PrEP is a more proactive, responsible and peaceful sex life.

How well known is PrEP actually?

PrEP is well known in the LGBT + community and in particular among gay and bisexual men, but also when it is known it is often accompanied by stereotypes and prejudices that hinder its spread. For example, despite scientific evidence, not everyone is convinced of its effectiveness: some people think it may cause many side effects, others believe that PrEP is only useful for those who have a lot of different sexual partners, while in fact it can be useful in many different situations. Among heterosexuals, however, PrEP is practically unknown.

What is the average age of users?

At the Milano Checkpoint we have users of very different ages: we go from 20 to 65 years of age. However, majority of our users is between 30 and 45 years of age.

Don’t you risk to discourage the use of condoms?

I’ll give you some news (Pietro laughs): many people already don’t  use it. So, if condoms are not already used, then PrEP is an excellent ally in preventing HIV. We have observed that after all the use of PrEP does not affect the habit of using, or not, condoms: those who have not used it before PrEP will continue not to use it, and vice versa. Then, even when you use it, the condom can always break or slip off, if put in a bad way or used with unsuitable lubricants. On the other hand, it has been widely demonstrated that, if a person correctly takes PrEP, the efficacy against the sexual transmission of HIV is very close to 100%.

In which specific cases would it be better to use and avoid it?

PrEP is particularly useful in all those cases where a person has an intense sex life and does not always use a condom.

PrEP has very few medical contraindications. It is not recommended for those who have kidney disease or osteoporosis, because the drug could worsen them. Great caution should also be used in the case of an ongoing Hepatitis B infection because one of the active ingredients of PrEP is also used as a therapy to cure it.

Let’s dispel myths: PrEP applies to everything. What does it cover and what does it not?

PrEP is only for protection against HIV, therefore it does not protect against other sexually transmitted infections such as syphilis, gonorrhoea, papilloma virus (HPV) or chlamydia. It is important to remember that hepatitis can also be sexually transmitted, therefore PrEP does not offer protection against these diseases. For those who like to have unprotected sex encounters, it is therefore recommended to get vaccinated for hepatitis A and B and possibly also for HPV.

In the next post we will try to dispel more myths about PrEP, understand its correct use and other technical and scientific aspects of this mighty pill.

For the next post (available from tomorrow), click here -> PrEP: what you need is a correct information – Pt.2

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