PrEP: The key to preventing HIV spread

If you take anything away from reading this, Veronica Navarro, ARNP, FNP, hopes it’s that you know PrEP exists.

Pre-exposure prophylaxis, or PrEP, is used to prevent the transmission of HIV. When taken as prescribed, it can be up to 99 percent effective — meaning it will be key in ending the HIV epidemic.

“With PrEP use, the whole community has an extra layer of protection by up to 60 percent reduction in HIV transmission,” says Navarro, an internal medicine provider for MultiCare Rockwood Clinic.

Navarro is one of four clinic-based HIV specialists in the Inland Northwest. She works closely with her colleague, Rachel Safran, MD, and the Spokane Regional Health District, to reduce the spread of HIV through education and prevention.

Their key message: The spread of HIV is more than just an individual health concern — it’s a public health issue.

In 2021, 461 new HIV cases were reported in Washington state. For several years prior to the COVID-19 pandemic, there had been a gradual decline in new HIV cases — but in recent years the numbers have either plateaued or increased.

To reverse this trend, the community must know their risks and options.

Who’s at risk of HIV?

Anyone seeking sexually transmitted infection (STI) testing should consider PrEP, or at least have the discussion, Navarro explains.

While men who have sex with men (MSM), as well as women and people of color, are at greatest risk, PrEP consideration should be based on your overall sexual activity and safe sex practices, she says. Being married or in a monogamous heterosexual relationship doesn’t eliminate risk.

It’s also important for those between the ages of 18 and 22 to recognize the risk that runs within their peer groups, Navarro adds. Cases in this demographic are commonly caught late, or only sporadically, through urgent care clinics or school-based counselors.

Many STIs are asymptomatic, meaning you may have minimal to no symptoms at all, which is why regular screening is so important, adds HIV specialist Caitlin Camfield, MD, MultiCare Infectious Disease Specialists — Tacoma.

And, of course, engaging in unsafe sex practices will always put you and others at risk of infection.

Do you know the signs of an STI?

Learn more

Know your options for HIV treatment

If you’re at risk for HIV transmission or engage in activities that could put you at risk, know that you have options to protect yourself, Navarro stresses. Current treatments include a pill or shot.

The top recommended oral option is a once-daily pill. If that’s not an option for you, there are oral alternatives you can discuss with your doctor or other health care provider.

For those who would rather receive the shot, it’s becoming more readily available and covered by insurance providers.

Apretude, an approved shot for PrEP, recently received top recommendations from the U.S. Preventive Services Task Force, which means more insurance providers will cover the cost. The shot is given every other month, after the initial two monthly dosages.

Your other injectable option is Yeztugo, which is administered every six months, but it can be more expensive than Apretude.

Injectable PrEP can be more effective than pill forms of PrEP since it does not rely on patients remembering to take a pill every day, Dr. Camfield explains. But all options include additional requirements and regular lab testing your provider will review before prescribing.

“PrEP can really be tailored to meet the needs of every patient, so it’s important that you ask your doctor about all the options,” Dr. Camfield says. “This can include options for individuals who don’t have sex frequently or don’t want to take a pill daily.”

Additionally, stay educated about all STI prevention options — not just HIV, she adds. There are a range of as-needed prescriptions that can help protect you against chlamydia, gonorrhea and syphilis.

Talk to your doctor

If you have any questions or concerns about your risk or current status, schedule an appointment with your provider.

It’s time to change the mindset on sexual health. Don’t assume your risk is low and don’t let feelings of awkwardness stop you from discussing your sexual history with your provider, Dr. Camfield adds.

“When individuals feel comfortable being honest with their doctors about their sexual practices, they’re more likely to get good recommendations about how to protect themselves effectively,” she says.