HIV/AIDS Prevention

HIV/AIDS Prevention

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HIV/AIDS & Prevention During COVID-19

During the COVID-19 outbreak, many hospitals and clinics need to emphasize the care of patients who are severely ill with COVID-19 or other conditions. We ask providers of sexual health care to take steps to prevent COVID-19 transmission while maintaining key HIV and STI services:

Minimize clinical encounters and provide services by telephone or video conference when possible. For New York State Medicaid, services covered under a comprehensive insurance policy or contract must be covered when delivered via telemedicine.

Submit prescriptions electronically and encourage the use of mail-order pharmacies or pharmacies that offer home delivery, and discourage patients from stockpiling drugs to avoid exacerbating shortages. New York State has approved 90-day prescriptions for patients in Medicaid, Medicare, and the Uninsured Care Programs/ADAP.

Share guidance with patients on enjoying safer sex during the outbreak. People should avoid close contact – including sex – with anyone outside their household or anyone who feels unwell.

HIV/AIDS FAQ

We know sometimes it’s hard to ask questions about HIV / AIDS
and often the search for answers is very long and
the answers are complicated, but we here to help
so you have the information you need.

The human immunodeficiency virus (HIV) infects cells of the immune system and destroys or disrupts their function. This leads to progressive deterioration of the system and ends up producing an immune deficiency. There is talk of immunodeficiency when the immune system can no longer fulfill its role of fighting off infections and other diseases. Infections that accompany severe immunodeficiency are called “opportunistic” because the pathogens causing it to exploit the weakness of the immune system.

AIDS (acquired immunodeficiency syndrome) defines the most advanced stage of HIV infection. It is defined by the appearance of one of more than twenty opportunistic infections or HIV-associated cancers.

HIV can be transmitted through sexual intercourse (vaginal, anal, or oral) without protection with an infected person; by transfusion of contaminated blood; and by sharing needles, syringes, or other sharp objects. A person giving birth can transmit the infection to their child during pregnancy, childbirth, or breastfeeding.

According to UNAIDS in 2018, there were 37.9 million [32.7 million–44.0 million] people living with HIV. 36.2 million [31.3 million–42.0 million] adults. 1.7 million [1.3 million–2.2 million] children (<15 years). 79% [67–92%] of all people living with HIV knew their HIV status. About 8.1 million people did not know that they were living with HIV.

This period can vary greatly from one person to another. If not treated, most HIV-positive people show signs of disease after 5-10 years, although the period can be shorter. The time between infection with HIV and AIDS diagnosis can vary between 10 and 15 years, sometimes more. ARV therapy can slow evolution because it prevents the virus from multiplying and therefore decreases the amount of infected cells present in the individual (called “viral load”) virus.

Every time you have sex, use protective barriers. For example: male or female condoms, dental dams, and latex gloves.

Refrain from unprotected sexual intercourse. Know your STI/STD status if you are active.

People with multiple sexual partners may be at higher risk. It is helpful and important to be aware of the status of all partners, and/or use barriers, as well as limiting other risk behaviors.

If used correctly in each act of intercourse, the condom is a method proven to prevent HIV infection across all genders. However, apart from abstinence, no protective method is totally 100% effective.

The female condom is the only barrier contraceptive specifically made for people with vaginas currently on the market. It is a transparent sheath, resistant, and soft polyurethane that is inserted into the vagina before intercourse. When used correctly during each act of intercourse, it completely coats the vaginal cavity and protects against pregnancy and sexually transmitted infections.

Circumcising a penis removes an HIV entry point – the inner foreskin contains cells that HIV targets to enter the body. Small tears or genital ulcers on the foreskin can increase the risk of HIV infection. It does NOT reduce the risk of sexual transmission of HIV to a partner.

Circumcision, for medical reasons, is an intervention that provides partial protection for life against sexually transmitted infections, especially caused by HIV. Always it has to be considered as part of a comprehensive set of preventive measures and should never replace other known methods, such as using condoms and other barriers and adhering to PrEP as prescribed by your doctor.

Scroll down to see our PrEP and PEP FAQ for more information!

No, there is no cure for HIV infection. But ARV (antiretroviral treatment) therapy, followed exactly as directed, slows the progression of the infection almost to a stop. More and more people infected with HIV, even in countries with less access to medical care, can remain in good condition and continue to live long, fulfilling, healthy lives.

Knowing your status with regard to HIV can have two important effects:
If you find out that you are infected by the virus, you can take steps before symptoms appear for treatment, care, and support, which can prolong life and prevent medical complications for many years.
If it turns out that you are infected, you can take precautions to prevent transmission of HIV to others.

It is recommended in the following situations:

If you are sexually active, the CDC recommends HIV testing every 3 to 6 months.

If you have engaged in higher-risk behavior. The test should be done once past the window period (from 6-8 weeks after high-risk practice).

When a new relationship starts (since it can pose a risk factor).

If you want to have a child or are pregnant, put in the appropriate means to prevent
vertical transmission.

It is mandatory for donating blood, organs, semen, tissue, or eggs.

Yes, the results, positive or negative, should always be confidential. This confidentiality must guarantee the privacy of the person being tested, this person has the right to demand appropriate professional secrecy for all those involved in the process.

ARV stands for Antiretroviral Treatment.

At the end of 2014, 14.9 million people were receiving antiretroviral treatment worldwide. Until 2003, the high cost of medicines, weak or inadequate health infrastructure, and the lack of money prevented the widespread use of treatment with a combination of these drugs in these countries. In recent years, increased political and financial attention has led to a dramatic expansion of access to treatment.

Any prescribed dose of antiretrovirals should be taken continuously, and missing prescribed doses should be avoided. The virus takes advantage of any loophole to increase its replication and can become resistant to treatment. Remember that the success of treatment depends largely on proper compliance.

However, if you miss a dose, taking more than the prescribed dose at one time is not recommended.

The CD4 + lymphocytes are a variety of T4 + lymphocytes. T cells are the basic cells of the body's defense system.

These cells are the primary target of the attack of the virus. The normal number in an uninfected person is between 1000 and 1500, although figures between 500 and 1000 can be seen with relative frequency among uninfected individuals to behave without risk of opportunistic infections CD4 + lymphocytes / mm3 of blood.

Viral load is the amount of virus circulating in the blood. It tells us what is the degree of activity of the virus in the body. Both parameters are used to evaluate the effectiveness of treatment and prognosis of infection.

The What and Why of PrEP and PEP

Pre-Exposure Prophylaxis (PrEP) is a daily pill that can help you stay HIV-negative.
The medicines in PrEP can protect you before you might be exposed to HIV.
To contact us for a referral for PrEP!
 
PEP is the common name for Post-Exposure Prophylaxis.
PEP is an emergency medication for people who are HIV-negative and may have been exposed to HIV.
If you think you were exposed to HIV, go immediately to a clinic or emergency room and ask for PEP.

Prevention: PrEP FAQ

As New Yorkers are required to stay home, fewer will need to initiate pre-exposure prophylaxis (PrEP) to prevent HIV.

  • Consider home self-testing for people who need to start PrEP.
  • Use telephone or video conference to discuss pausing PrEP or switching to PrEP on demandPrEP on demand.
  • Cisgender men who have sex with men can conserve their supply of medicines by taking PrEP on-demand, before and after sex, following NYC and New York State guidance.
  • Delay switching PrEP regimens or scheduled in-person monitoring, with possible exceptions for patients with impaired renal function.
  • In place of scheduled testing, ask patients about symptoms of incident HIV and STIs.

In the US it is anticipated that Gilead, the pharmaceutical company that produces Truvada® and Descovy®, will release the patent for Truvada® in September of 2020, allowing for consumer access to generic options for PrEP.

  • PrEP is for HIV-negative people who are at risk of being exposed to HIV through sex or injecting drugs and who are ready to take a daily pill.
  • Talk to your doctor. Your doctor or nurse can help you decide if PrEP is right for you. 
  • Take PrEP Every Day. Do not skip doses.
  • Keep using protection. Even if you take PrEP daily, condoms give you additional protection against HIV, other sexually transmitted infections, and unintended pregnancy.
  • Know the common side effects. PrEP can have mild side effects, like stomach pain, weight loss and headaches, especially at the beginning of treatment. PrEP may not be right for everyone. Talk to your doctor.
  • Find Out about Paying for PrEP. Many insurance plans including Medicaid cover PrEP. Assistance may be available if you are uninsured.
  • PrEP is not an emergency medication. If you think you were recently exposed to HIV, you may need emergency treatment, see our PEP FAQ below.

According to the CDC, studies have shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily. Among people who inject drugs, PrEP reduces the risk of getting HIV by at least 74% when taken as prescribed.

PrEP is very effective, but it does not provide 100% protection against HIV. Other safe sex practices, like using condoms and barriers, provide additional protection against HIV, even while taking PrEP. Safe sex barriers, like condoms, also prevent unintended pregnancy and protect against other sexually transmitted diseases and infections.

PrEP contains the same medicines that people with HIV use to stay healthy. If you are exposed to HIV, these medicines can stop the virus from multiplying and spreading throughout your body. PrEP only works if you have enough medicine in your body, so you need to take PrEP every day.

PrEP is for people who are HIV-negative, have a high risk of being exposed to HIV through sex or drug injection, and are ready to take a daily pill. Studies have shown that PrEP works for sexually-active cis-gender gay and bisexual men, cis-heterosexual women and men, and injection drug users, and is also likely to benefit transgender people, including transgender women. PrEP can help protect the partners of people living with HIV.

PrEP is prescribed by a doctor or nurse. You should take PrEP exactly as prescribed. With PrEP, you take one pill once a day, even on the days you don’t have sex or inject drugs.

Two medications, sold under the brand names Truvada® and Descovy® are approved for daily use as PrEP to help prevent a person without HIV from getting the virus from sex or injection drug use. Studies have shown that PrEP is highly effective for preventing HIV if it is used as prescribed. PrEP is much less effective when it is not taken consistently.

PrEP is generally regarded as safe to use and side effects are typically mild. The pill used for PrEP, Truvada®, has been used to treat people with HIV since 2004. PrEP can cause mild side effects, including upset stomach, headaches and weight loss, especially at the beginning of treatment. Rare side effects include kidney or bone problems. Your doctor or nurse can help if side effects are bothering you.

PrEP is for HIV prevention, if you have already tested positive for HIV then speak with your doctor about potential treatments.

Before you start PrEP, you take an HIV test to make sure that you do not have HIV. You also have a check-up to make sure your kidneys and liver are healthy. While you are on PrEP, your doctor or nurse will test you regularly for HIV and other sexually transmitted infections. They will also ask you about your HIV risk and whether you are taking PrEP every day.

PrEP can help you stay HIV-negative when your risk of HIV exposure is high. You may decide to stop taking this medication if your risk changes. But do not stop taking PrEP without first talking to your doctor. Also, tell your doctor if you are thinking about becoming pregnant or if you become pregnant while on PrEP.

Knowing your status with regard to HIV can have two important effects:
If you find out that you are infected by the virus, you can take steps before symptoms appear for treatment, care, and support, which can prolong life and prevent medical complications for many years.
If it turns out that you are infected, you can take precautions to prevent transmission of HIV to others.

Prevention: PEP FAQ

HIV Emergency PEP: Patients in need of HIV post-exposure prophylaxis (PEP) should not go to an emergency room, which are now reserved for people with severe illness.

You can initiate PEP without a clinic visit by calling the 24/7 PEP hotline:

  • In NYC, call: (844) 3-PEPNYC (844-373-7692).
  • In New York State, outside of NYC, call: (844) PEP4NOW (844-737-4669)

PEP is the common name for Post-Exposure Prophylaxis. PEP is an emergency medication for people who are HIV-negative and may have been exposed to HIV. If you think you were exposed to HIV, go immediately to a clinic or emergency room and ask for PEP.

  • Know Your Risk. PEP can protect you if you had anal or vaginal sex without a condom or injected drugs with someone who has, or might have, HIV.
  • Act Fast! PEP works best if started right away. Go to an emergency room or clinic as soon as possible and ask about PEP. You should start PEP within 36 hours of possible exposure.
  • Take the PEP pill every day, for 28 days. You need to take PEP each day to keep enough medicine in your body to stop HIV. If you want to stop taking PEP, talk to your doctor first.
  • Know about Common Side Effects. PEP can have mild side effects, like stomach pain and headache.
  • After you finish taking PEP, your doctor will give you an HIV test to determine your HIV status.
  • The Money Part -Many insurance plans, including Medicaid, cover PEP. Assistance may be available if uninsured.
  • PEP is often considered an emergency treatment. If you need it, get it. 
  • Consider PrEP (Pre-Exposure Prophylaxis): 
  • If you often worry about exposure to HIV, ask your doctor about PrEP – a daily pill that helps prevent HIV.

If you are HIV-negative, PEP can protect you if you had anal or vaginal sex without a condom (or your condom broke) with someone who has HIV or may have HIV. PEP can stop HIV if you were the victim of sexual assault. PEP can also stop HIV if you were exposed while injecting drugs. 

You may be at higher risk of HIV infection if you were the receptive (or “bottom”) partner in anal or vaginal sex (if you had a partner’s penis in your anus or vagina). Receptive partners have a greater chance of exposure to HIV through semen or blood.

PEP is NOT usually recommended after sex that has a lower risk of spreading HIV, like oral sex. If you are unsure whether you are at risk of HIV infection, ask a doctor.

PEP is only meant to be used for a one-time exposure to HIV. If you often worry about being exposed to HIV, ask your doctor about PrEP, aka. Pre-Exposure Prophylaxis – a daily pill that helps prevent HIV.

If you are exposed to HIV, it takes a few days for an HIV infection to take hold in your body. PEP contains some of the same medicines that people with HIV take to stay healthy. As soon as you start PEP, these medicines work to stop the virus from multiplying. As you continue taking PEP- for the full 28 days – cells with HIV die and the virus stops spreading to the rest of your body.

PEP is safe. Emergency PEP has been used for many years to stop HIV in people who were accidentally exposed while at work. PEP can cause mild side effects, including upset stomach and headaches, especially at the beginning of treatment. If side effects are bothering you, tell your medical provider right away. There may be ways to help you feel better. Do not stop taking PEP before talking to your provider.

You should begin PEP no more than 36 hours after exposure. 

Go to any clinic or emergency room and ask for PEP. Clinics with experience providing PEP are all over New York City. Visit the NYC Health Map here to find a location.

Before you start PEP, you will be tested for HIV. Your healthcare provider will also check your kidney and liver function and your overall health. During a follow-up appointment or phone call, your provider will ask you about side effects and HIV risk, and make sure you are taking all the pills in PEP. When you finish PEP, you will be tested again to make sure you have not become infected with HIV. After you finish PEP, stay HIV-negative. Use condoms, and ask your doctor about PrEP. If you inject drugs, always use a clean syringe. PEP is prescribed by a doctor or nurse. You should take PEP exactly as prescribed. When you start PEP, you may be given a “starter pack” with a few days’ supply of pills. This gives you time to fill a prescription for the rest of the 28 days. PEP is much more effective at stopping HIV if you take all the pills for the full 28 days. It is very important never to skip a dose. It is best to take your pills at the same time every day.

PEP is not 100% effective. But if you take PEP immediately after an exposure and for the full 28 days, it often prevents HIV infection. In one study of healthcare workers who were accidentally exposed to HIV, PEP reduced the rate of infection by 80%.

PEP does not provide full protection against HIV, and does not protect against other types of sexually transmitted diseases or infections (STDs/STIs). PEP is an emergency medication to help prevent HIV after exposure, and is not meant for long-term use. Condoms, and other barriers like dental dams, give you and your partners protection against unintended pregnancy -and- many STDs/STIs, including HIV.  

PEP is for emergency situations. If you worry about regular exposure to HIV through sex or while injecting drugs, PrEP may be a ­­better option for you. To learn more about PrEP, click here.

In New York State, PEP is covered by Medicaid and many private health insurance and prescription plans. If you have no health insurance, you may receive financial assistance for PEP through these clinics in New York City. There are also patient assistance programs to help uninsured patients pay for PEP. Your medical provider can help you apply. If you are the victim of sexual assault in New York State, financial support for PEP is available. Call 800-247-8035