What LGBTQ+ People Should Know About PrEP

What LGBTQ+ People Should Know About PrEP

This article is for LGBTQ+ people who want to learn or learn more about pre-exposure prophylaxis (PrEP) for HIV, or anyone who wants to learn about PrEP. The goal of this activity is to help you talk to and work with your doctor and healthcare team about PrEP.

You will learn about: 

  • What HIV is and ways to help prevent HIV

  • What PrEP is and how it works

  • HIV, PrEP, and the LGBTQ+ and BIPOC communities

  • Talking about PrEP

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About HIV

Human immunodeficiency virus, or HIV, is a virus that attacks and destroys certain cells of your immune system called T cells. T cells normally help protect you. So when they get destroyed and you don't have enough of them, it can make it easier for you to get certain infections and diseases. If not treated properly, the amount of HIV in your body can increase and may lead to AIDS, which can be life-threatening.

HIV is spread when certain body fluids of someone who is living with HIV -- such as their blood, semen, vaginal fluid, or breast milk -- enter your bloodstream. This can happen through your mucous membranes (such as in your mouth, vagina, penis, and rectum), open cuts or sores, or injection.

How to Help Protect Yourself

People of any age, race or ethnicity, gender or gender identity, and sexual orientation or identity can be diagnosed with HIV. For most adults, HIV happens from having anal or vaginal sex without practicing safer sex or by sharing needles or other drug injection equipment.

But there are ways you can help protect yourself that can include:

  • Practicing safer sex, such as using condoms properly, or abstinence (not having sex)

  • Not sharing needles or drug equipment

  • Taking medicine called PrEP

What Is PrEP?

PrEP stands for pre-exposure prophylaxis and is a medicine that's taken to help prevent HIV before you're exposed to it. When taken as directed, PrEP can lower the chances of HIV from sex or injection drug use.

PrEP may be taken by certain adults or adolescents at risk for HIV who weigh at least 75 pounds (35 kg) and have had a negative HIV test result. It's available as a pill taken by mouth or as an injection that's given by your doctor or healthcare team member.

How PrEP Works

In people who are living with HIV, the amount of HIV present in their bloodstream is called their viral load. The higher their viral load, the more likely T cells may be destroyed.

PrEP works by stopping HIV from replicating (making copies of itself) inside your body. This helps prevent HIV from taking hold in your body.

If you're taking PrEP as directed before you're exposed, it's highly effective at preventing HIV. But it's important to take it as directed, otherwise PrEP will not work as well. Skipping a dose or not taking it correctly can result in there not being enough medicine in your body, which lowers PrEP's ability to protect you.

Is PrEP for You?

PrEP may be recommended if you're sexually active and:

  • Don't always practice safer sex

  • Have multiple sex partners

  • Were diagnosed with a sexually transmitted disease or infection (STD or STI) in the past 6 months

  • Have a sex partner who is living with HIV, or don't know the HIV status of your sex partner(s)

PrEP may also be recommended if you have injected drugs, have an injection partner who is living with HIV, or share needles or other drug equipment.

The LBGTQ+ and BIPOC Communities

Protecting yourself against HIV is important and PrEP can help. While anyone can be diagnosed with HIV, the LGBTQ+ and BIPOC communities are among the largest groups affected.

Of people who are newly diagnosed each year:

  • Black or African American people make up the largest number

  • Hispanic or Latino people are the second largest

  • Men who identify as gay or bisexual make up about two-thirds of people newly diagnosed. Of these men, Black or African American and Hispanic or Latino men are among the largest groups

  • People who are transgender or trans are also newly diagnosed every year, and the majority are Black or African American

Talking About PrEP

Taking PrEP is an important decision. But some people find that bringing up PrEP or certain topics, such as sex, with their doctor or healthcare team member can be uncomfortable or embarrassing.

Some people also report facing other challenges. Trouble getting services, discrimination, racism, homophobia or transphobia, and stigma around HIV can make it harder to get care.

But it's your body and your health, so finding a healthcare team member who understands your individual needs and the needs of your community is important. There are also several support groups, organizations, and clinics that can help connect you to care.

Hakeem talks about his personal journey around his decision to take PrEP.

Questions to Ask Your Doctor and Healthcare Team

Working with a healthcare team member you feel comfortable with is important. Together, you can create a plan to help you stay protected.

Questions you can ask about PrEP can include:

  • How can I help protect myself against HIV?

  • Which type of PrEP may be for me, and what are the possible side effects?

  • How do I take PrEP correctly?

  • Are there ways to help me talk to my partner about PrEP?

  • Is there a support group or community group I can join?

  • Where can I find more information and resources?

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You have successfully completed the program What LGBTQ+ People Should Know About PrEP..

View Additional Materials on this topic that you may find useful:

HIV Basics

HIV Prevention

PrEP

HIV and Gay and Bisexual Men

HIV and African American Gay and Bisexual Men: HIV Prevention

HIV and Hispanic/Latino Gay and Bisexual Men

HIV and Transgender People

Positively Aware

Authors and Disclosures

Clinician Reviewer

Karen Badal, MD, MPH

Senior Medical Education Director, Medscape, LLC.Karen Badal, MD, MPH, has no relevant financial relationships.

Editor

Anita A. Galdieri, PharmD, RPh

Associate Director, Content Development, Medscape, LLC.Anita A. Galdieri, PharmD, RPh, has no relevant financial relationships.

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