HIV and PrEP
HEALTH
by Adrian Martinez
HIV is a virus that is spread through body fluids, most often via sexual contact or intravenous drug use. Once infected, a person undergoes an illness that is similar to the flu–fever, fatigue, rash, aches, nausea, vomiting, and diarrhea. This sickness eventually goes away, but the virus remains in the body and attacks the immune system, eventually causing AIDS if the infected person is untreated. AIDS involves many diseases that are difficult to treat; these include fungal infections, pneumonia, and various cancers. Treatment for HIV infection is expensive and lifelong. In 2012, a new type of drug called PrEP (pre-exposure prophylaxis) was approved in the United States to prevent HIV infection in people who are at risk. Studies have shown that PrEP can reduce HIV infection rates by over 90% if taken daily (1).
The Centers for Disease Control and Prevention (CDC) reports that in 2016, there were around 40,000 new cases of HIV infection in the American population. Of those people infected, around 25% were Latino (2). The CDC later estimated that approximately 1.1 million Americans are at risk for HIV infection, but only 90,000 prescriptions for PrEP are filled in a year. Looking specifically at the Latino population, approximately 300,000 Latino people are considered at risk, but only 7,600 of the prescriptions are filled by Latino people. This is all especially alarming given the estimate that 1 in 6 Latino people have HIV and are unaware of it (3). With such high infection rates and such low PrEP prescription rates, it is very important for Latino people to start talking to their doctors about HIV testing and PrEP and to talk to their family and friends about this as well.
Who should be on PrEP? Remember, you can only use the drug if you do not have HIV; PrEP does not treat an HIV infection. Anyone at high risk for HIV infection should be on PrEP; this includes people who, in the last six months, have injected non-prescription drugs or have had anal or vaginal sex without a condom, multiple sexual partners, sex while intoxicated or in exchange for money or gifts, a sexually transmitted infection, or sex with a person who is HIV-positive. In order to be on the medication, you have to get blood and urine tests every few months to check for rare side effects of the medication. Once you start the medication, you need to take it every day until you and your doctor agree that you do not need it anymore. Call 1-800-232-4636 for more information on HIV testing and PrEP, or go to www.cdc.gov/hiv/library/hiv-service-locators.html to find PrEP providers near you.
References
1. https://www.cdc.gov/hiv/risk/prep/index.html
2. https://www.cdc.gov/hiv/group/racialethnic/hispaniclatinos/index.html
3. https://www.cdc.gov/nchhstp/newsroom/2018/croi-2018-PrEP-press-release.html
Adrian Martinez is a Puerto Rican born in California and raised in Vermont, New Hampshire, and Florida. He graduated in 2014 from the University of Florida with a degree in biology and is currently a fourth-year medical student attending the University of Rochester School of Medicine and Dentistry. He is on the executive board of the school’s chapter of the Latino Medical Student Association (LMSA) and is pursuing a career in psychiatry.