Preventing HIV With Medication

Human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS).

HIV is passed through contact with an infected person’s body fluids, such as semen, vaginal fluid, or blood. This can happen during sex or by sharing needles used to inject illegal drugs.

If you're pregnant and have HIV, you can pass the virus to your fetus during labor. If you’re breastfeeding and have HIV, you can pass the virus to your baby.

Once HIV is in your body, it attacks the immune system. As the immune system weakens, it is less able to resist disease and infections.

AIDS is diagnosed when a person infected with HIV develops diseases that the immune system would normally fight off. These diseases include pneumonia, certain types of cancer, and harmful infections.

There is no cure for HIV infection, but it can be treated. Medications are available that can help people with HIV stay healthy for a long time. The earlier treatment is started, the better for your long-term health. Early treatment also reduces your risk of giving the virus to uninfected sex partners.

It's important to be tested for HIV at least once during your lifetime. HIV testing is also recommended if you are pregnant or thinking about getting pregnant.

Pre-exposure prophylaxis (PrEP) is a pill that you take once a day. This pill contains two medications: 1) tenofovir and 2) emtricitabine. If you are exposed to HIV, these medications prevent HIV from causing infection.

If you are sexually active and do not have HIV, talk with a health care professional about whether PrEP is right for you. PrEP may be recommended if one or more of the following apply to you:

• You have had anal or vaginal sex in the past 6 months and you

  • have a sex partner who has HIV

  • do not use condoms at all or do not use them each time you have sex

  • have had a sexually transmitted infection (STI) in the past 6 months

• You inject illegal drugs and you

  • have an injection partner with HIV

  • share needles, syringes, or other drug injection equipment

• You have been prescribed post-exposure prophylaxis (PEP, an HIV medication) and

  • any of the above situations apply to you

  • have used multiple courses of PEP

If you are thinking about taking PrEP, you will be tested for HIV. If you have HIV, you will need HIV treatment. If you do not have HIV, your health care professional may prescribe PrEP.

You must take a pill once a day. Missing doses can lower the medication's effectiveness and put you at risk of HIV infection.

The most common side effects of PrEP include

• stomach pain

• headache

• weight loss

• nausea and diarrhea

These side effects usually go away on their own after a few weeks. Serious side effects of PrEP include liver problems and a condition called lactic acidosis, which happens when there is too much acid in the blood.

PrEP by itself is not guaranteed to prevent HIV infection. You should also follow safe sex practices while taking PrEP:

• Know your sexual partners—Your partner's sexual history is as important as your own. The more partners you or your partners have, the higher your risk of getting HIV or other STIs.

• Use condoms—Using a latex or polyurethane condom every time you have vaginal, oral, or anal sex decreases the chances of HIV infection.

Read How to Prevent STIs to learn more.

While you are taking PrEP, you will need to be tested for HIV every 2 to 3 months. This is to make sure that you have not become infected. You may also be tested for certain STIs if you have risk factors for them. Some STIs increase your risk of getting infected with HIV. Treating these STIs can lower your HIV risk.

PrEP can be expensive. Most health insurance companies and state Medicaid programs cover the cost of PrEP. If PrEP is not covered by your insurance, or if you do not have health insurance, you may be able to get help with the cost. Find more information on paying for PrEP from the Centers for Disease Control and Prevention (CDC).

Talk with your obstetrician–gynecologist (ob-gyn) about how to prevent infection. Steps to prevent HIV infection include the following:

• Your partner should have treatment for HIV infection (if he has not already).

• Have unprotected sex only when your partner has a low or undetectable viral load. Viral load is the amount of HIV in the body. Treatment often causes a person's viral load to become very low or "undetectable" (meaning that HIV cannot be found with a laboratory test). Waiting until your partner has a low or undetectable viral load decreases the risk that you will become infected with HIV during unprotected sex.

• Have unprotected sex only on the days that you are most likely to get pregnant. You can track these days with home ovulation kits purchased from a pharmacy. You should use condoms at all other times.

If you do not have HIV, you can use PrEP when trying to get pregnant. You should start taking PrEP 1 month before you start trying to get pregnant and continue for 1 month after you have gotten pregnant. PrEP is especially recommended if your partner’s viral load is detectable or unknown.

Once you are pregnant, it's important to prevent HIV infection by always using condoms. You can also consider taking PrEP while pregnant.

Most experts agree that PrEP is safe during pregnancy. The medications in PrEP are used to safely treat HIV during pregnancy. There are no reports of birth defects caused by PrEP.

If you do not have HIV and are at high risk of HIV infection, you can take PrEP while you are breastfeeding. Although the medications in PrEP can be found in breast milk, the amount is small and not likely to harm the baby. You should also continue to use condoms during sex while you are breastfeeding and taking PrEP.

If you do not have HIV, you can use sperm from an HIV-negative donor. This may involve the use of intrauterine insemination (IUI) or in vitro fertilization (IVF).

Your partner's sperm can also be treated in a laboratory to remove the virus. Then you can have IUI or IVF done with your partner's sperm.

These options may be costly and may not be covered by insurance.

Acquired Immunodeficiency Syndrome (AIDS): A group of signs and symptoms, usually of severe infections, occurring in a person who has human immunodeficiency virus (HIV).

Birth Defects: Physical problems that are present at birth.

Fetus: The stage of human development beyond 8 completed weeks after fertilization.

Human Immunodeficiency Virus (HIV): A virus that attacks certain cells of the body's immune system. If left untreated, HIV can cause acquired immunodeficiency syndrome (AIDS).

Immune System: The body's natural defense system against viruses and bacteria that cause disease.

Intrauterine Insemination (IUI): A procedure in which a man's sperm is placed into a woman's uterus.

In Vitro Fertilization (IVF): A procedure in which an egg is removed from a woman's ovary, fertilized in a laboratory with the man's sperm, and then transferred to the woman's uterus to achieve a pregnancy.

Obstetrician–Gynecologist (Ob-Gyn): A doctor with special training and education in women's health.

Ovulation: The time when an ovary releases an egg.

Pneumonia: An infection of the lungs.

Pre-Exposure Prophylaxis (PrEP): Daily medication taken to help prevent infection with human immunodeficiency virus (HIV). Along with other preventive measures, such as using condoms, PrEP may reduce the risk of getting HIV.

Semen: The fluid made by male sex glands that contains sperm.

Sexually Transmitted Infection (STI): An infection that is spread by sexual contact. Infections include chlamydia, gonorrhea, human papillomavirus (HPV), herpes, syphilis, and human immunodeficiency virus (HIV, the cause of acquired immunodeficiency syndrome [AIDS]).

Sperm: A cell made in the male testicles that can fertilize a female egg.