TasP, PEP and PrEP: what does it mean in HIV prevention?

TasP: Therapy as Prevention
If you have HIV, it is important to start treatment with HIV medication (called antiretroviral therapy or ART) as soon as possible after diagnosis. If you take it every day, exactly as prescribed, your viral load will become and remain undetectable. Almost anyone can reach an undetectable viral load, usually within 6 months of starting treatment. Regular follow-up care and viral load testing will ensure that this viral load remains undetectable. You then effectively have no risk of sexual transmission of HIV to your HIV-negative sexual partners. There is less certainty of HIV transmission with slamming.

There are important health benefits to getting the viral load as low as possible. People with HIV who take HIV medication daily as prescribed, and get and keep an undetectable viral load, can live long and healthy lives.

PrEP: blocking an HIV infection BEFORE you are exposed to HIV
PrEP, or pre-exposure prophylaxis, is an HIV prevention method in which people who do not have HIV take HIV medications daily to reduce their risk of getting HIV. PrEP can prevent HIV from settling and spreading in your body. 

PrEP is prescribed to HIV-negative adults and adolescents who are at high risk of contracting HIV through sex or injection drug use. It is highly effective when taken as directed. The once-daily pill reduces the risk of contracting HIV through sex by more than 90%. In people who inject drugs, the pill reduces the risk by more than 70%. Your risk of contracting HIV through sex may be even lower if you combine PrEP with condoms and other prevention methods.

PrEP may benefit you if you are HIV-negative and ONE or more of the following apply to you:

  • sharing needles or equipment to inject drugs 
  • being at risk of contracting HIV through sex.

Long chemsex sessions can make you forget about time. This can cause you to forget to take your pills on time, whether it’s PrEP or HIV medication. Set an alarm on your cell phone for the exact time you take your pills. Carry an extra dose in case your chemsex sessions take longer than planned.

PEP: blocking an HIV infection AFTER you’ve been exposed to HIV
PEP, or post-exposure prophylaxis, is a short course of HIV medications taken very soon after a possible exposure to HIV to prevent the virus from taking hold in your body. You must start it within 72 hours of your exposure to HIV or it will not work. In other words, every hour counts. It should only be used in emergency situations, and is not intended for regular use by people who may be frequently exposed to HIV.

You can be prescribed PEP if you are HIV-negative or don’t know your HIV status, and you have taken PEP in the past 72 hours:

  • Think you may have been exposed to HIV during sex (for example, a condom broke)
  • Have shared needles 
  • Been sexually abused

If any of these apply to you, contact your health care provider immediately or go to the emergency room right away. Your health care provider or doctor in the emergency room will assess you and help you decide if PEP is right for you.

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