Let's talk about an important part of our sexual health: preventing HIV and other STIs. We're living in a time of incredible advancements in prevention, and we have more tools than ever. As clinicians, we're excited to empower you to make informed decisions about your well-being and keep your sex life safe, smart, but most of all—fun!
Why HIV and STI prevention matters
HIV (Human Immunodeficiency Virus) and bacterial STIs (Sexually Transmitted Infections) are out there, and while treatments have come a long way, prevention is always the best strategy. The good news is that we have powerful ways to protect ourselves and our partners.
For many in the LGBTQ+ community, discussions around sexual health are particularly vital. We know that certain communities face higher rates of HIV and other STIs due to a complex interplay of factors. That's why being proactive and knowledgeable is key.
Understanding your risk for HIV and STI
Knowing your risk for HIV and STIs is the first step. Factors that can increase risk include having multiple partners, engaging in unprotected sex (vaginal, anal, and yes—oral!), and sharing needles. Open and honest communication with your partners about sexual health history is crucial. Regular STI testing, even if you're not experiencing symptoms, is also a must.
PrEP: Your proactive shield against HIV
HIV PrEP (Pre-Exposure Prophylaxis) has been the biggest game changer in prevention. PrEP is a highly effective medication used to prevent HIV acquisition. When used correctly, PrEP reduces the risk of getting HIV from sex by about 99 percent.
PrEP options come in two main forms—daily oral pills or injectables. The pill options include:
- Truvada (emtricitabine/tenofovir disoproxil fumarate): think of this as the “OG” of HIV PrEP. This was the first PrEP medication approved; it’s a tried-and-true option for folks. It's a once-a-day pill, taken every day, and can be accessed very affordably without insurance and often for free if you have insurance.
- Descovy (emtricitabine/tenofovir alafenamide): Descovy is also a daily oral pill. Some studies suggest it may have fewer side effects compared to Truvada, making it a good alternative for certain people. It can be pricey if your insurance doesn’t cover it but can be accessed for those without insurance through special programs.
Injectable PrEP medications: protection with minimal effort
For those who want protection with minimal effort, the landscape is evolving rapidly. We now have two injectable PrEP medications, including one that offers protection for a half-year.
- Apretude (cabotegravir extended-release injectable suspension): This is a newer and very exciting option! Apretude is an injectable PrEP that you receive every two months after an initial loading dose in the office. This is a great choice for folks who prefer not to take a daily pill or might struggle with remembering to take medication.
- Yeztugo (lenacapavir): This is the newest option in HIV prevention and the first-and-only FDA-approved twice-yearly (every six months) injectable PrEP option. After a short starter phase that includes your injections and a few oral pills, you receive an injection from your healthcare provider every six months. This makes prevention even easier with convenience and privacy. Routine STI testing is still important though!
What side effects to expect with PrEP
Most people tolerate PrEP well, but like any medication, it can cause mild short-term side effects and, in rare cases, longer-term changes affecting the kidneys or bones depending on the medication you choose.
During the first few weeks of starting PrEP—sometimes called the “start-up phase”—you may experience mild symptoms such as nausea, headache, stomach upset or fatigue with some of the oral options, and injection site tenderness at the site of the injection you receive. If you do have side effects from one of the PrEP medications there is usually another option that will work well for you.
Your medical provider will review your health history, other medications you take, and other factors to find the right fit for you.
A game changer for STIs: DOXY PEP
While the PrEP options are highly effective in preventing HIV, they do not protect against other STIs like syphilis, chlamydia, or gonorrhea. This is where another recent innovation, DOXY PEP, comes in.
DOXY PEP stands for Doxycycline Post-Exposure Prophylaxis—think of it like the morning-after-pill for STI. This is a single dose of a common antibiotic, Doxycycline (200 mg), taken after a potential exposure. It is effective at reducing the risk of acquiring bacterial STIs—specifically syphilis, chlamydia, and to a lesser degree, gonorrhea.
Studies have shown DOXY PEP reduces syphilis and chlamydia infections by over 70 percent and gonorrhea infections by about 30 to 50 percent.
Making your choice to protect yourself
With all these options—two forms of daily pills, two types of long-acting injections for HIV prevention, and a post-exposure pill for bacterial STI prevention, how do you choose what’s right for you?
These medications are transforming HIV and STI prevention, giving us more control over our well-being than ever before. These are powerful tools and should be used along with condoms, regular STI screening, and the most powerful tool in your sexual health toolkit: knowledge and open communication.
Think of HIV PrEP and DOXY PEP as a layer of defense in addition to your existing prevention strategies. It is important to discuss its use and potential side effects with your provider. We can help you make the right choice based on your risk and overall health history.
Get PrEP’ed!
The healthcare providers at the Corliss Clinic are happy to discuss options for PrEP or DOXY PEP, as well as a range of other sexual health services, including:
- STI screening
- HIV Pre- and Post-exposure prophylaxis (PrEP/PEP)
- Reproductive healthcare
- Contraception, including long-acting contraception (IUD/Nexplanon)
- Gender affirming care
- Hepatitis C treatment
- Cervical cancer screenings
Visit us online to learn more or call 401-793-4715 to schedule an appointment.
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