Pre-exposure prophylaxis, commonly known as PrEP, is a drug that is used to prevent HIV. If your partner is living with HIV, this is a method of prevention that might work for you, as an HIV-negative person.
If you are not aware of your partner’s HIV status, and have a reason to worry, PrEP could lessen the worry. PrEP could help you take charge of your health. It is also good to get tested together with your partner to be sure of your HIV status.
If you know your partner has HIV, their viral load can help you decide if you need PrEP or not. If your partner has an undetectable viral load, you do not need to use PrEP, as there’s no risk of transmission.
So, what is an undetectable viral load? When a person is living with HIV and is on effective treatment, it lowers the level of HIV (the viral load) in the blood. When the levels are extremely low (below 200 copies/ml of blood measured) it is referred to as an 'undetectable viral load'. This is also medically known as 'virally suppressed'. At this stage, HIV cannot be passed on sexually.
This is widely known as Undetectable = Untransmittable (U=U). It means there is zero chance of HIV being sexually transmitted.
On the other hand, a person living with HIV is considered detectable when the level of HIV in the blood is high and thus can be passed on. In this case, you need to take PrEP or use condoms to protect yourself.
PrEP has three options that you can take: pills, vaginal ring or injection. Depending on where you are in the world, you might find all the options or just the pills.
Pills are usually recommended to be taken every day. There are two types of injectable PrEP, one that lasts for two months and another for six months. The dapivirine ring is inserted in the vagina and used for 30 days. It cannot prevent transmission if you have anal sex.
Before you are given PrEP, the healthcare worker will test you for HIV. It is a good idea to have your kidney function tested, as well as tests for STIs.
To conclude, PrEP is a good HIV prevention method if your partner is living with HIV and has a detectable viral load. However, it does not prevent other STIs or pregnancy – a condom may be a better option if this is a concern.