Gilead has 2 medications available for HIV preexposure prophylaxis. Discussed are the similarities and differences between the two medications and a review of the available literature. Enjoy!
Happy pride everybody hello and welcome my name is jonathan lewis aaron mckinney and in honor of pride month and as part of the lgbtqa+ community today i’d like to talk to you about hiv it is an infection that has plagued the past and the current times of our community but there are steps to take to prevent your risk of getting hiv it’s in the form of pre exposure
Prophylaxis or prep now you’ve probably heard about it before but did you know that there are now two available drugs to take for prep yes there are ciabatta and disco bee these drugs are about 99 percent effective in some studies of preventing hiv when you take them routinely now what do we know about the two drugs what’s the similarities and what’s the differences
The pharmaceutical company gilead has recently released results on their clinical trial called discover it looked at 5500 individuals taking either truvada or disco bee and compared them side by side and we gained a lot of information as to one of the benefits and one of the risks of each drug so let’s talk about it now to summarize the cdc’s recommendations of
Who should be taking prep it’s basically anyone who has more than one sexual partner of any gender of any sexuality or if they use iv drugs they also cite some high-risk groups such as gay men or men who have sex with men okay so first off what are the similarities to start truvada and discovery should only be taken in people who are currently hiv negative your
Provider will test you to make sure that you are hiv negative before they start this drug of note it’s important to tell them of recent sexual exposures or if you felt fever fatigue in the past week or so sometimes these initial hiv screenings can miss the virus altogether so it’s important to disclose that with your health care provider the other thing to know
Is that both medications are taken daily you need to adhere to them on a daily basis also every three months you’ll be retested for hiv and screened for other sexually transmitted infections now from what we’ve seen with the discover trial is that people are at very high risk of getting sexually transmitted infections despite being on pre-exposure prophylaxis i’m
Talking about gonorrhea chlamydia and syphilis these things are still high risk as people are neglecting to use other safe sex practices like condoms in lieu of just using truvada or to scooby so it’s important to always combine those safe sex practices with each other both medications will also require your provider to get some baseline blood levels of your kidney
Function all right so what are the differences what are you telling me here so disco b’s pill is a little bit smaller so those who have trouble taking pills by mouth may benefit from disco b just for that reason however there is something about sivadas dosing that has not been studied in discovery and it’s called on-demand dosing or 2-1-1 dosing essentially what
You’ll do is you will take two pills to trovato’s two to twenty-four hours before sex you’re elected then you’ll take one pill 24 hours after sexual activity and then another one 24 hours later two-one-one it should also be noted that if you continue having sex that you have to follow up with two sexless days of taking this medication now this on-demand dosing has
Not been studied into scobie so it’s only indicated at this time for truvada and in fact it’s been shown to have an 86 percent reduction in the risk of getting hiv another major difference between the two medications is that disco v is currently not indicated for those who are at risk of hiv through vaginal intercourse further studies are ongoing to see if those
Were the fatima will be covered with disco be yet another difference is that disco b has shown to be better for the kidneys measurements of kidney function showed better in this discovered trial also measures of bone health and bone density have shown to be better in disco b now these are two things that sure vada has long been ridiculed for its ability to impair
The kidneys and the bones the bones the bones okay what else so truvada has also shown that there is less weight gain compared to disco be about two and a half pounds less weight gain for truvada nandus kobe and in those taking truvada their cholesterol levels did not raise as much as it did for the disco b group all right so what does all this mean what does
Boil down to it looks like the study shows that the scoby is better for your kidneys and for your bones but truvada has less weight gain and is better for cholesterol the good news is that both of them are equally effective in preventing hiv so for people who are looking for a prep option should you jump right into scobie or should you switch from terada to disco
B what’s the recommendation here to answer that question i’d like to refer to the paper by the announce of internal medicine it states that the modest reduction in adverse effects that are associated with the scoby are not worth the premium price tag and those currently taking truvada should still stay on trovato unless otherwise indicated right now the research
Suggests that those who have trouble taking larger pills would benefit from muskogee those with baseline lower levels of kidney function would also benefit from muskogee or if you’re at risk for a bone mineral density problem disco b might be the medication for you now medical insurance or a price or anything like that might be an influencer for you in choosing a
Medication both of them cost several thousand dollars a month to maintain the prescription but there are plenty of federal programs and coupons offered by chiliad that can help significantly cut those costs if not providing them for free and it’s important to know that truvada the formulation that makes up truvada is scheduled to go generic in september of 2020
Which should cut the costs of this medication significantly now if you want to read more about pre exposure prophylaxis or hiv prevention i’m going to put some links in the description below as well as a link to an article i wrote for options magazine about this topic i’m so upset that there will be no pride fest this year as a result of this pandemic but i guess
It could be worse and it gives me an excuse to show even more pride the rest of the year alright thanks again please like subscribe comment share and i hope to see you next time let me see you bye e you
Transcribed from video
How to choose between Truvada and Descovy – Preexposure Prophylaxis (PrEP) By Out Loud
