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Have you heard the expression, “treatment as prevention?”

Preventing HIV from spreading starts with testing that connects people to treatment with antiretroviral therapy, or ART. Taken correctly, ART can reduce the viral load, or amount of HIV in the body, to a very low level or a level that is undetectable in testing.

Reaching and maintaining an undetectable viral load is the best thing people with HIV can do to stay healthy. It also helps them avoid transmitting the virus to others through sex or syringe sharing, or from mother to child during pregnancy, birth and breastfeeding. If the viral load stays undetectable, there is effectively no risk of transmitting HIV to a partner through sex. Simply put, undetectable equals untransmittable, or "U = U," a catchphrase used in an HIV public education campaign.

Certain behaviors place people at a higher risk for contracting HIV. Men who have sex with men are in the highest risk population. Unprotected anal and vaginal sex are also risk factors for contracting HIV. People who inject drugs are at a higher risk if they share needles or other injection equipment.

Prophylaxis describes a treatment taken to prevent disease. If you are at very high risk for exposure to HIV, a fairly new prevention tool is called Pre-Exposure Prophylaxis, or PrEP. PrEP centers on a dual combination of HIV medications, sold under the brand name Truvada. Several studies show that taking Truvada daily decreases the chance of high-risk individuals getting an HIV infection from sex by more than 90 percent. Among people who inject drugs, it reduces the risk by more than 70 percent.

If you feel your behavior puts you at a higher risk for contracting HIV, please have an honest conversation with your health care provider and an open discussion about PrEP. Health insurance, Medicaid or a patient assistance program may cover the high cost.

People who work in health care may already know about prevention medication taken after an accidental HIV exposure. Post-exposure prophylaxis, or PEP, is for an emergency use. The two or three drug combination must be started within 72 hours after the exposure, and is most effective if taken even sooner. The treatment lasts about a month and decreases the chance of developing HIV by about 80 percent. The same treatment is available to people outside the health care field, but it’s called non-occupational post-exposure prophylaxis, or nPEP. The treatment is meant for emergencies and may not be covered by insurance, but a patient assistance program may help with the cost.

If you are sexually active, knowing your HIV status is important for your health, your relationships and your future. If you are at high-risk, call RiverStone Health HIV Prevention Services at 247-3247 for information on testing and other services.

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Jace Dyckman, a Health Prevention Health Specialist with Public Health at RiverStone Health, can be reached at 651.6416 or jace.dyc@riverstonehealth.org.

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