PReP

The Happy Trail

By Emma Holmes

While it’s easy to think of AIDS as a terror of the past, new cases are emerging to indicate a mutation of the virus that is not yet treatable. PEP and PrEP have been used for several years to allow partners of HIV-positive people to safely engage in sexual activity with minimized risk of infection. However, several new cases of “drug-resistant” HIV have doctors scrambling for a solution.

   PEP stands for post-exposure prophylaxis, and is taken orally for 28 days after a patient has been exposed to HIV. This can occur through unprotected sex, unsanitary injections or sexual assault. The active ingredients multiply within the infected cells and wipe them out before they are able to multiply. Treatment is most effective when started within 72 hours of initial exposure.

   PrEP, conversely, is a preventative pill used by those with frequent exposure to the virus. If taken once daily, it limits HIV’s ability to replicate and infect the body. Though the pills were approved by the FDA in 2012, by 2014 they were also prescribed for mothers hoping to conceive, as the treatment also blocked infection of a child.  

   Since 2016, about 100,000 people have chosen to take PrEP as a preventative tool (Jacobs, 2016). As of Oct. 28, 2016, there are three reported cases of ineffective treatment: one in Jan. and two in Oct. The mutated form of the virus has been deemed “drug-resistant” to Truvada, the primary drug in PrEP.

   All patients were tested for appropriate levels of Truvada in hair and blood samples, and results indicated long-term, dependable usage, with what should be defensible levels. There is no consistency of position (insertive or receptive) in the patients who have contracted the virus through anal sex.

   A new drug, called Ibalizumab, is currently in the final stages of testing and approval, and has thus far helped 83 percent of drug-resistant HIV cases that it’s been administered to. The drug would ideally prevent against further infection and bar exposure to other people. It’s administered every other week intravenously, and is the only drug of this type that may soon be available.

   Because current prevention of HIV is limited to abstinence, condoms and PrEP, choosing to take the medication is still the best way to guard against infection, especially when used with condoms. Three cases out of approximately 100,000 is only a .003% failure rate, with countless other cases proving perfectly effective. Further information about PrEP, PEP and HIV can be found on www.aids.gov, or with your healthcare provider.

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