Is PrEP effective if my partner is HIV positive?

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

PrEP stands for pre-exposure prophylaxis. The word “prophylaxis” means to prevent or control the spread of an infection or disease. Three HIV (human immunodeficiency virus) medicines are approved by the U.S. (United States) Food and Drug Administration (FDA) to use as PrEP: Truvada (Emtricitabine and tenofovir), Descovy (Emtricitabine and Tenofovir), and Apretude (Cabotegravir). Which medicine to use for PrEP depends on a person’s situation. If a person is exposed to HIV through sex, injection, or drug use, having the PrEP medicine in the bloodstream can stop HIV from taking hold and spreading throughout the body. However, if PrEP is not taken as prescribed, there may not be enough medicine in the bloodstream to block the virus.

Who should consider taking pre-exposure prophylaxis:

PrEP should be used by people who are HIV (human immunodeficiency virus) negative and are at high risk of being exposed to HIV through sex, injection, or drug use. If you have HIV, PrEP medicine is not for you. Specifically, the Centers for disease control and Prevention (CDC) recommends that you should consider PrEP if you are HIV-negative, have had anal or vaginal sex in the past six months, and have a sexual partner with HIV (especially if the partner has an unknown or detectable viral load), or have not consistently used a condom, or have been diagnosed with an STD (sexually transmitted disease) in the past six months. PrEP is also recommended if you inject drugs and you have an injection with a partner with HIV or share needles, syringes, or other equipment to inject drugs. PrEP should also be considered for people without HIV who have been prescribed non-occupational post-exposure prophylaxis (NPEP).

HIV stands for human immunodeficiency virus. HIV infects and destroys cells of the immune system, making it hard to fight off other diseases. When HIV has severely weakened your immune system, it can lead to acquired immunodeficiency syndrome (AIDS).

AIDS is the final and most serious stage of an HIV infection. People with AIDS have very low counts of certain white blood cells and severely damaged immune systems. They may have additional illnesses that indicate that they have progressed to AIDS. Without treatment, HIV infections progress to AIDS in about ten years. HIV infects white blood cells of the immune system called CD4 cells, or helper T cells. It destroys CD4 cells, causing the white blood cell counts to drop. This leaves you with an immune system that cannot fight off infections, even those that would not normally make you sick. HIV initially makes you feel sick with flu-like symptoms. Then it can hide in your body for a long time without causing noticeable symptoms. During that time, it slowly destroys your T-cells. When your T-cells get very low or you begin to get certain illnesses that people with healthy immune systems do not get, this indicates that HIV has progressed to AIDS.

I suggest you undergo some investigations, including viral markers, HBsAg (hepatitis B surface antigen), anti-HCV (hepatitis C antibody test), and an HIV test by PCR (polymerase chain reaction).

The management of HIV involves a multidisciplinary team (MDT) approach. This includes consultation with an HIV expert, a physician, a psychologist, and a psychotherapist. Medications include:

1. NRTIs (nucleoside reverse transcriptase inhibitors): These are faulty versions of the building blocks that HIV needs to replicate itself. Examples include Abacavir (Ziagen), Tenofovir disoproxil fumarate (Viread), Emtricitabine (Emtriva), Lamivudine (Epivir), and Zidovudine (Retrovir). Note that Retrovir is no longer recommended for routine use in the United States due to its high toxicity rates. Combination medications, such as Emtricitabine-Tenofovir disoproxil fumarate (Truvada) and Emtricitabine-Tenofovir alafenamide fumarate (Descovy), are also available.

2. Protease inhibitors (PIs): These medications inactivate HIV protease, a protein that the virus needs to replicate. Examples include Atazanavir (Reyataz), Darunavir (Prezista), and Lopinavir-ritonavir (Kaletra).

Prevention tips include:

1. Practice safe sexual intercourse.

2. Conduct an ELISA (enzyme-linked immunosorbent assay) test for your spouse to check her HIV status.

3. Ensure proper education and awareness about preventing HIV transmission.

I hope this helps.

Thank you and take care.