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PreP and other medications
May 27, 2014

Hello Dr. Young, I am positive and my husband is negative, as such we fall into a recommended category for PreP. My concern is my husband is 64, in on warfin and a statin (not sure what) as well as uses Viagra. About 6 years ago he had prostate cancer surgery and has been clear since then. I know he would like to stop using condoms but I have resisted. I am on Atripla and UD. I have not discussed the new PreP alternatives with him at this point because I worry about his overall health and drug interactions. I have my next appointment with the ID doctor soon but wondered if PreP should discussed. I would be interested in your opinion? I trust and respect the ID doctor, but he is very about the HIV and less about the person.

Thanks

Response from Dr. Young

Hello and thanks for posting your interesting question about PrEP.

I'm with you in that quality of life for people living with HIV is a lot more than just the virus or an undetectable viral load. Among the issues related to quality of life is one's love life, for sure.

Yes, your husband generally falls into a category of people that we'd consider for PrEP. On the other hand, with you on Atripla with an UD viral load, his risk of acquiring HIV from you is very, very low- approaches nil. A recent European study called PARNTER examined this question among magnetic couples, and found no cases of HIV transmission after an estimated 45,000 sex acts (~30% without condoms).

Regarding PrEP, it's widely underutilized and under appreciated. The good news is that there aren't any significant drug interactions between Truvada and your husband's warfarin or Viagra.

I hope that's helpful and please feel free to write me back at this forum. BY



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