Dr Ismael Maatouk

Prep-Pep


PrEP (short for pre-exposure prophylaxis) is a HIV prevention tool. The United States healthcare authorities approved its use in 2012 after a number of studies had demonstrated its safety and efficacy. Since then, other countries around the world have followed suit to make it available to people at higher risk of infection.

In Europe, the approval of PrEP is under review by the European Medicines Agency (EMA) but some countries have found mechanisms for introducing it without having to wait for authorisation to come through so as not to delay any longer effective HIV prevention in the most vulnerable groups in the population. France has gone even further and via a health measure called recommendation of temporary use (RTU) it became the first European country to make PrEP widely available and at no-expense through its public healthcare system.

At our clinic, we have been frontline advocates of this prevention tool and have for some time now carried out all kinds of education in our community in order to speed up its arrival in our country. 

What does PrEP consist of?

PrEP is a HIV prevention strategy whereby HIV negative people take antiretroviral drugs to reduce their risk of infection. According to the research findings it is NOT 100% effective in preventing HIV transmission in people who use it consistently!

How is it different from PEP?

Post-exposure prophylaxis (PEP) is also a HIV prevention strategy for HIV-negative people who take antiretrovirals but in this case they do so after they may have been exposed to the virus. PEP treatment lasts 28 days and is dispensed from the emergency wards of public hospitals. It must be started as soon as possible, preferably within the first 6 hours after exposure and within 72 hours after exposure at the most.

Who is PrEP recommended for?

Experts and regulating bodies such as the WHO (World Health Organisation) and the European Aids Clinical Society (EACS) recommend PrEP for sexually active people who belong to population groups that are most exposed to HIV, with gay men, bisexuals, other men who have sex with men, and transgender women at the top of the list.

What drug is used?

Although studies are underway with other drugs, for now the only drug that has been approved for PrEP goes under the brand name of Truvada. In actual fact it is a tablet that combines two drugs: Emtriva (emtricitabine, also known as FTC) and Viread (tenofovir also known as disoproxil fumarate or TDF).

Does it have side-effects?

The drugs that are used for PrEP are very safe and have a low toxicity profile. The majority of people who use them have not reported side-effects and when these do appear they tend to be mild. Even so, PrEP needs a prescription and must always be taken under a specialist doctor’s supervision to guarantee safety.

And what if I take it on my own?

In countries where PrEP has not been approved yet (INCLUDING LEBANON), some people decide to follow this prevention strategy by themselves either by obtaining drugs on the black market or legally by importing generic drugs for personal use.

If this is your case, at our clinic we can offer you guidance on how to minimise any possible risks that go along with PrEp under these conditions.

  • PrEP: Short for “pre-exposure prophylaxis,” PrEP is an HIV prevention strategy in which HIV-negative people take an oral pill once a day before coming into contact with HIV to reduce their risk of HIV infection.
  • PEP: Short for “post-exposure prophylaxis,” PEP is an HIV prevention strategy in which HIV-negative people take anti-HIV medications after coming into contact with HIV to reduce their risk of HIV infection.
  • Only your doctor will know when should you follow these strategies!

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