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A step-by-step guide to accessing PrEP & Tips for Taking PrEP
A Step-by-Step Guide to Accessing PrEP
Access to PrEP is becoming more widely available, particularly for individuals at high risk of HIV exposure. This guide will walk you through the step-by-step process to access PrEP in Jamaica, including initial consultation, testing, and prescription.
The first step in accessing PrEP is a consultation with a healthcare provider who is knowledgeable about HIV prevention. This could be at a public health clinic, private doctor’s office, or a specialized HIV clinic.
What to expect during your consultation:
- Risk Assessment: The healthcare provider will ask about your sexual practices, potential HIV exposure risks, and other factors like whether you have a partner who is HIV-positive or if you engage in unprotected sex. This helps determine whether PrEP is suitable for you.
- Medical History: You will be asked about your medical history, including any existing health conditions, current medications, and any history of kidney problems. This is important because PrEP may not be recommended for individuals with certain pre-existing conditions.
- Discussion of Benefits and Risks: The healthcare provider will explain the benefits of PrEP in preventing HIV transmission and the potential side effects. They will also discuss the importance of adherence to the medication regimen for it to be effective.
Before starting PrEP, you must undergo several tests to ensure you are HIV-negative and that you are healthy enough to take the medication. These tests are typically done at the clinic and are crucial in ensuring your safety while on PrEP.
Tests you will undergo:
- HIV Test: The most important test, to confirm that you are HIV-negative. PrEP should only be used by individuals who are HIV-negative.
- Kidney Function Test: Since PrEP (specifically the medication Truvada) can have an impact on kidney function, your healthcare provider will monitor your kidney health through blood tests.
- STI Screening: You may be screened for sexually transmitted infections (STIs) as part of a comprehensive sexual health assessment. Treating STIs can reduce the risk of acquiring HIV.
- Hepatitis B Test: If you have a history of Hepatitis B, additional considerations may be necessary, as Truvada can be associated with an increased risk of Hepatitis B reactivation.
- Pregnancy Test (for individuals who could become pregnant): It is essential for women to confirm they are not pregnant before starting PrEP, as the safety of PrEP during pregnancy needs to be assessed by a healthcare professional.
What happens after the tests:
- If all tests return negative (HIV-negative, healthy kidney function, no active STIs), you will be eligible to start PrEP.
- If you test positive for HIV, PrEP is not recommended, and you will be referred for HIV care and treatment.
- If kidney function or other conditions are a concern, the healthcare provider will discuss alternative options or treatments.
Once you have passed all necessary tests, your healthcare provider will prescribe PrEP. The most common medication used for PrEP in Jamaica is Truvada, a combination of emtricitabine and tenofovir disoproxil fumarate, taken as a daily pill.
What to expect after receiving your prescription:
- Dosage and Instructions: You will be prescribed one pill of Truvada to take daily. Consistency is key to PrEP’s effectiveness, so it is important to take the pill at the same time every day. Your healthcare provider will explain how to take the medication and answer any questions you have.
- Follow-up Appointments: After starting PrEP, regular follow-up visits are necessary. You will be asked to return every 3 months for routine testing, including HIV testing, kidney function checks, and STI screenings. This is to monitor your health while on PrEP and ensure that it is still the right option for you.
PrEP is highly effective at preventing HIV when taken correctly, but it is not a one-time treatment. You will need to continue to take the medication daily and attend follow-up appointments for as long as you are at risk of HIV.
Ongoing care includes:
- Quarterly Visits: Every 3 months, you will need to see your healthcare provider for check-ups. This includes an HIV test to ensure you are still HIV-negative and kidney function tests to ensure that your body is tolerating the medication.
- Refills: You will be given refills of your prescription every 3 months. Your healthcare provider will also check in with you about any side effects, adherence to the medication regimen, and any changes to your sexual health or lifestyle.
- Counseling: During follow-up visits, you may receive counseling on safer sex practices, the importance of condom use, and the role of PrEP in a comprehensive HIV prevention strategy. This may also include guidance on managing side effects and addressing any concerns you may have about the medication.
In some cases, individuals may choose to discontinue PrEP if they no longer face significant HIV risk or if they encounter side effects that make the medication intolerable.
Considerations when stopping PrEP:
- You should not stop taking PrEP without consulting your healthcare provider. They will discuss with you the best course of action.
- If you are considering stopping because you no longer engage in high-risk behavior, your healthcare provider may help you transition to a new prevention plan.
- If you stop PrEP, you should continue to use other HIV prevention methods (like condoms) to reduce the risk of transmission.
PrEP is available at various healthcare facilities across Jamaica; see the list here.
Cost of PrEP in Jamaica
The cost of PrEP may vary depending on where you access it. In public health settings, PrEP may be available at no cost or at a subsidized rate. In private settings, the cost can range from JM$5,000 to JM$10,000 or more per month for the medication.
Insurance may also cover the cost of PrEP, so it’s important to check with your provider.
Tips on How to Take PrEP
When taken consistently and correctly, PrEP can reduce the risk of HIV by more than 90%. Here’s a step-by-step guide on how to take PrEP:
- Dosage: The most commonly prescribed PrEP medication is Truvada (a combination of emtricitabine and tenofovir disoproxil fumarate), which is taken as one pill per day. Another option is Descovy (emtricitabine and tenofovir alafenamide), which is also taken once daily.
- Time of Day: It’s important to take PrEP at the same time every day to help you remember and maintain a consistent level of the drug in your bloodstream. Whether you take it in the morning, at night, or with meals, the key is consistency.
- Food: You can take PrEP with or without food, depending on your preference. Some people find that taking it with food helps reduce stomach upset, but it’s not necessary.
- Water: Swallow the pill with a full glass of water.
- Adherence is Key: For PrEP to be most effective, you must take it every day, even if you don’t engage in high-risk activities every day. Missing doses reduces its effectiveness and can increase your risk of HIV.
- What If You Miss a Dose?: If you miss a dose of PrEP, take it as soon as you remember, unless it’s almost time for your next dose. Do not take two doses at once to make up for a missed dose. If you miss multiple doses or are unsure about what to do, consult your healthcare provider.
While on PrEP, you will need to visit your healthcare provider every 3 months for the following:
- HIV Test: To ensure you are still HIV-negative, as PrEP should only be taken by individuals who are not already infected with HIV.
- Kidney Function Tests: PrEP can affect kidney function, so your provider will monitor your kidney health with blood tests.
- STI Screenings: It’s important to get tested for other sexually transmitted infections (STIs) regularly.
- Prescription Refills: You will receive a 3-month supply of PrEP at each visit.
PrEP is most effective when combined with other methods of HIV prevention, including:
- Condom Use: Use condoms for additional protection, especially if you have multiple sexual partners or engage in sex with people whose HIV status is unknown.
- Regular HIV Testing: Even while taking PrEP, regular testing for HIV and other STIs is important to monitor your sexual health.
- Safer Sex Practices: Discuss other safer sex practices with your healthcare provider, such as reducing the number of partners or practicing mutual monogamy, if appropriate.
- You may choose to stop taking PrEP if your risk of HIV exposure decreases. However, always consult with your healthcare provider before stopping, as they can guide you on the best course of action.
- If you decide to stop taking PrEP, make sure you continue using other HIV prevention methods (like condoms) to reduce your risk of infection.
Important Things to Remember:
- Take your pill every day without skipping doses to maintain maximum protection.
- Stay in touch with your healthcare provider for regular check-ups and to renew your prescription.
- PrEP is highly effective, but it doesn’t protect against other STIs. Always consider using condoms and getting regular STI screenings.
- If you have concerns or experience side effects such as nausea, headaches, or kidney issues, speak with your healthcare provider immediately.
By following these guidelines, you can ensure that PrEP works effectively to reduce your risk of HIV and protect your sexual health.
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