PrEP is changing how we treat HIV and AIDS

According to the County of San Diego, more than 18,700 people in the region are living with HIV, but 1 in 10 are unaware that they carry the transmittable disease. This puts their partners at high risk of infection.

A daily medication available to those at high risk is quietly changing the way doctors treat HIV and AIDS, as well as how patients live with and society thinks about HIV and AIDS. Pre-exposure prophylaxis, or PrEP, has a more than 92 percent success rate in preventing HIV among those at high risk who take it daily, according to Dr. Aimee Lopes, an HIV specialist with Sharp Rees-Stealy Medical Group.

“With PrEP, we can help stop new HIV diagnoses and put an end to the HIV epidemic,” she says.

Who should consider taking PrEP?
This daily two-drug cocktail is designed for people who are at high risk of acquiring HIV. This includes:

• Individuals in an ongoing relationship with someone who has HIV

• People not in a mutually monogamous relationship with a partner who recently tested HIV-negative

• Individuals who have unprotected sex with people at high risk of HIV infection

• A man who has sex with both men and women

• A man who has unprotected anal sex or has been diagnosed with a sexually transmitted infection (STI) in the past six months

Patients who meet these criteria should talk with their doctor about whether PrEP is an appropriate treatment. A preliminary screening includes tests for HIV, hepatitis B, STIs and kidney function. These tests are repeated on a quarterly basis during routine doctor visits, which has a real benefit for patients, according to Dr. Lopes.

“What I see in my clinic, and other providers do as well, is that when we engage with these patients at high risk, they come in more frequently and get more routine screenings for other STIs, including syphilis, gonorrhea and chlamydia,” she says. “We are able to treat these diseases earlier. This in turn reduces the risk of transmission and acquisition of these diseases and HIV.”

Unfortunately, not all patients feel comfortable talking with their doctors about same-sex relationships or risky behaviors, she says, and sometimes doctors aren’t comfortable either. “If both sides increase their comfort levels with this topic, we would improve our chances of providing this treatment to at-risk patients,” says Dr. Lopes.

How PrEP is changing HIV and AIDS
The availability of PrEP is part of a larger change in the way doctors and health officials view and treat HIV and AIDS.

“We are no longer dealing with an AIDS epidemic,” says Dr. Lopes, noting that the increase in screenings and preventive treatments allow doctors to help patients with HIV maintain their immune systems so the disease never progresses to AIDS.

“We can now treat HIV like a chronic disease,” says Dr. Lopes. “If patients are compliant and take their medication, they can manage their disease and it will not progress.”

“Don’t be afraid to reach out to your doctor,” she says. Information about PrEP and HIV prevention is also available through PreP San Diego or the Centers for Disease Control and Prevention (CDC).

For the news media: To talk with Dr. Lopes about PrEP and HIV for an upcoming story, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.