Yet in much of Europe and North America, the discussion around PrEP has focused almost exclusively on gay and bisexual men, to the exclusion of other people who could benefit from PrEP’s enormous prevention power.
A number of organisations across Europe and the US are working to make sure that women are not left behind. They’re creating campaigns and resources to let women know about PrEP and how it could benefit them.
In the UK, the Sofia Forum, an advocacy group focused on women with HIV, and ClinicQ, who focus on sexual health for trans people, created a website, womenandprep.org.uk, to provide information about PrEP for women. The other leading PrEP information sites in the UK, prepster.info and iwantprepnow.co.uk also include information about PrEP specifically for women.
In the US, cis and trans women are increasingly included in high-profile campaigns, either alongside gay men or in initiatives specifically addressing women. The PrEP4Love campaign, created by the Chicago PrEP Working Group in 2016, featured a range of images including both men and women to promote positive, affirming messages about PrEP, as did the “I’m on the Pill” series of television advertisements from Truvada manufacturer, Gilead Sciences. Both Washington, DC and New York City have created campaigns to promote awareness of PrEP among women.
Here in Ireland, the HSE has promised to roll out a national PrEP programme in the next few months. Although this programme will focus primarily on gay and bisexual men, we think it’s important to make clear that PrEP is an option that anyone concerned about their risk for HIV can consider.
PrEP and women, what’s different?
Although there are some differences, for the most part, the basic PrEP regimen is the same. The medication, a combination of tenofovir and emtricitabine, often abbreviated TD/FTC, is the same, and so is the need for proper medical support.
You need to make sure you’re HIV-negative before you start PrEP, and you need to get tests to check your kidney function, for hepatitis B, and, if you’re someone who can become pregnant, a pregnancy test. You’ll need to continue to get HIV, kidney, STI, and pregnancy tests every three months for as long as you continue to use PrEP.
The biggest difference in PrEP for cisgender women is that the only recommended dosing regimen is daily dosing. When you take the tablet is up to you, and it can vary by a few hours each day, but it’s important to take the tablet every day. It’s also recommended that you take PrEP for seven days to achieve full protection, and that you continue taking it for seven days after your last possible risk for HIV when you want to stop.
Event-based dosing (also called PrEP 211) is not a recommended option for women having vaginal sex. This is because of the way the drugs in PrEP accumulate in different tissues. Anal tissues absorb the drugs more quickly than vaginal tissues, meaning it takes less time for PrEP to become effective and requires less frequent dosing to maintain a protective level.
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