Pre-exposure prophylaxis, commonly known as PrEP, is a highly effective medication used to prevent HIV infection in individuals who are HIV-negative but are at risk of exposure. This medication works by stopping the human immunodeficiency virus from taking hold and spreading throughout the body if an exposure occurs. When taken as prescribed, PrEP significantly reduces the risk of acquiring HIV from sexual activity by about 99% and from injection drug use by at least 74%. PrEP is considered safe for long-term use, with no significant adverse health effects observed in people using it for several years. The medication is available in daily pill forms, such as Truvada and Descovy, and also in injectable forms.
Understanding Common Side Effects
Many individuals starting PrEP may experience initial side effects, generally mild and temporary as the body adjusts. These commonly reported issues include nausea, diarrhea, headaches, fatigue, stomach pain or discomfort, and dizziness. Less than 10% of people taking PrEP experience any side effects. The newer formulation, Descovy, has been associated with even fewer reported side effects compared to Truvada.
Typical Duration of Side Effects
For most, common PrEP side effects are transient and resolve quickly. These initial symptoms typically subside within a few days to a few weeks. Many individuals find that their side effects clear up within one to two weeks after starting the medication. Some people may continue to experience symptoms for a few weeks to a month.
While most side effects are mild and temporary, rare but serious issues can occur, including kidney problems, changes in bone mineral density, liver problems, and lactic acidosis. Kidney and bone health are usually monitored by healthcare providers through regular blood and urine tests before and during PrEP use. Kidney issues, such as those associated with Truvada, affect less than 1% of users and are often reversible if identified early. Bone density loss is also uncommon and typically reverses once PrEP is stopped.
Managing Side Effects
Several strategies can help manage mild, temporary PrEP side effects. Taking the medication with food can often alleviate gastrointestinal discomfort like nausea and stomach upset. Some individuals find that taking their daily PrEP dose at night or just before bed can help reduce stomach symptoms or issues with sleep.
Ensuring adequate hydration can also be beneficial, particularly for headaches. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, may help address headaches.
For soft stools, incorporating fiber supplements into the diet can be helpful. Resting sufficiently can also mitigate fatigue. Always consult with a healthcare provider before making any changes to the medication regimen.
When to Seek Medical Advice
Contact a healthcare provider if PrEP side effects become severe, persist, worsen, or if any new, concerning symptoms emerge. Specific symptoms that warrant immediate medical attention include severe abdominal pain, or persistent vomiting and diarrhea that could lead to dehydration.
Signs of potential liver problems, such as yellowing of the skin or eyes (jaundice), dark urine, light-colored stools, or loss of appetite for several days, should be reported promptly. Additionally, changes in urine output, along with fatigue, nausea, or vomiting, could indicate kidney issues.
Symptoms of lactic acidosis, including unusual muscle pain, shortness of breath, cold or blue hands and feet, dizziness, or a fast heartbeat, also require urgent evaluation. Open and consistent communication with a healthcare provider is important throughout the course of PrEP treatment.