Apr 5, 2012
regarding use of Truvada as PrEP I was wondering when I should best start taking the pills before, and for how long after the exposure? Does it pay to complement Truvada with Kaletra for PrEP - or is maybe Atripla more appropriate and what are the pre- and post-exposure time periods for taking the pills there?
Response from Dr. Young
Hi and thanks for posting.
This is an important area without complete data or recommendations. All of the pre-exposure research involves the use of Truvada (not with Kaletra or other third drug). The best data was derived from studies of gay men (or men who have sex with men). There's no particular guidance on when to start, but since it takes 2-3 days to reach effective drug levels, it would be reasonable to have at least a couple of days of medications prior to any risky exposure. PrEP was studied not as a strategy to stop after the exposure. In this later case, I'd fall back to the post-exposure prophylaxis guidelines and treat for 28 days. Understand that these are my best guesses for now, but much data will emerge on this subject in months and years to come.
For more information, here's the link to the US Centers for Disease Control and Prevention's Interim Guidance on PrEP
second exposure PEP
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