Top 10 PrEP Myths Debunked

Since its introduction to the market, there has been a lot of misinformation surrounding PrEP, or Pre-Exposure Prophylaxis. In collaboration with Damon L. Jacobs, Cempa Community Care’s PrEP Navigator, Mario Forte, took a look at the top 10 Myths about PrEP and presented factual data, debunking the most common myths. Together, we want our community to know that PrEP is safe, affordable, and accessible to everyone.

PrEP Myth #1 SIDE EFFECTS ARE TOXIC & INTOLERABLE

DEBUNKED

  1. Most common side effects are often headache, abdominal pain, and diarrhea that subside in the first few weeks.

  2. Daily use of TDF/FTC (Truvada) is considered as safe, just as for most individuals using daily Aspirin is safe.

    1. Oxford Academic 2016, Is Emtricitabine-Tenofovir Disoproxil Fumarate Pre-exposure Prophylaxis for the Prevention of Human Immunodeficiency Virus Infection Safer Than Aspirin?

  3. Descovy patients may experience increased cardiovascular risk and/or weight gain.

PrEP Myth #2 PrEP HARMS THE KIDNEYS

DEBUNKED

  1. There are no known reports of prescribers under age 40 experiencing significant renalchanges due to taking PrEP.

    1. San Francisco AIDS Foundation 2016, New research at CROI 2016:How PrEP changes kidney function

  2. Most reports of people over age 40 with significant renal changes had other medical conditions they were taking medications for such as diabetes and hypertension.

  3. Kidney function goes back to normal when someone stops using PrEP. There are no known reports of irreversible kidney changes.

    1. aidsmap 2014, Tenofovir HIV PrEP causes no long-term harm to kidneys

  4. CDC recommends creatinine screening at least 2x a year to safeguard against potential kidney damage.

PrEP Myth #3 PrEP IS DANGEROUS TO THE LIVER

DEBUNKED

  1. No verified reports of any PrEP consumers experiencing liver complications.

  2. One report to the FDA in July, 2017, has gone unverified.

    1. The Body 2017, PrEP and Lactic Acidosis Warnings: ‘Context Matters’

  3. Neither the CDC nor WHO include liver testing in their PrEP Provider Guidelines.

  4. Social media content currently contains Fake News about liver failure and PrEP.

PrEP Myth #4 PrEP IS INACCESSIBLE

DEBUNKED

  1. Any doctor, nurse practitioner, or physician assistant can prescribe PrEP.

  2. RESOURCES INCLUDE: PrEPlocator.org, getpreptn.com, Plushcare, Nurx, Cempa Community Care

PrEP Myth #5 PrEP IS UNAFFORDABLE

DEBUNKED

  1. There are many avenues for PrEP coverage in the US, and almost all insurance carriers cover PrEP.

  2. Gilead’s Advancing Access Program 1-800-226-2056

  3. Patient Advocacy Foundation copays.org/diseases/hiv-aids-and-prevention

  4. PrEP is available to almost everyone who is uninsured.

  5. State Funded PrEP Programs (New York, Washington. . .)

  6. Ready, Set, PrEP. HIV.gov

PrEP Myth #6 PrEP DOESN’T WORK AS WELL FOR WOMEN / VAGINAL SEX

DEBUNKED

  1. There are ZERO reports of women contracting HIV while taking PrEP as prescribed.

  2. Daily adherence is key for vaginal sex.

PrEP Myth #7 PrEP IS UP TO 99% EFFECTIVE

DEBUNKED

  1. Only 3 known cases of HIV transmission with VERIFIED adherence to PrEP reported in Toronto, Amsterdam and San Francisco (2015).

    1. The Body 2019, Has Anyone Gotten HIV When They Were on PrEP?

  2. Only 5 reported cases of HIV transmission with UNVERIFIED adherence to PrEP.

    1. The Body 2019, Has Anyone Gotten HIV When They Were on PrEP?

  3. Worldwide, at least 450,000 – 455,000 people are currently using PrEP (JAN 2020).

    1. PrEP Watch, 2020 Global PrEP Tracker

  4. “PrEP reduces risk of acquiring HIV by 99% or higher when taken as directed” is more accurate.

PrEP Myth #8 CONDOMS MUST BE USED WITH PrEP

DEBUNKED

  1. The 99% effectiveness of PrEP works REGARDLESS of condom use.

  2. “We found that PrEP provided the greatest benefit for HIV prevention to people who were using condoms the least.” – Robert M. Grant, MD, MPH, Clinical Professor at UCSF Department of Medicine

  3. Correct and consistent condom use can prevent some other STIs.

PrEP Myth #9 PrEP CAUSES UPTAKES IN OTHER STIs

DEBUNKED

  1. STIs started increasing exponentially in 2007.

  2. If you take PrEP, STI screenings are protocol when seeing your provider every 3 months.

  3. STI rates are higher in geographic regions where PrEP uptake is lower.

  4. There are no significant differences in STIs to comparable non-PrEP populations.

  5. Correlation ≠ Causation

  6. CROI 2018, The Intersection of PrEP & Sexually Transmitted Infections

PrEP Myth #10 DESCOVY IS SAFER TO USE FOR PrEP

DEBUNKED

  1. Descovy has different side effects, but not necessarily “safer.”

    1. Annals of Internal Medicine 2020, Tenofovir Alafenamide for HIV Preexposure Prophylaxis: What Can We DISCOVER About Its True Value?

    2. San Francisco AIDS Foundation 2020, What we know about Descovy’s impact on weight & cholesterol

    3. IDWeek 2019, Switching From TDF to TAF Tied to Higher BMI and Cardio Risk

  2. There are NO medical protocols established that offer best practices for monitoring use of Descovy for PrEP.

  3. Descovy is ONLY approved for use by cisgender men and transgender women. Descovy is NOT approved for use in women whose risk is vaginal exposure. Cisgender women and transgender men who ONLY have anal or oral sex are protected.

  4. If providers mislead consumers about Descovy it can reinforce and validate historic mistrust of medical systems.

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