Using PrEP? Why Condoms Are Still Important

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About a million people in the United States are living with HIV–but one in seven of them don’t know it. While testing and prevention remain important for stopping the spread of the infection, the introduction of the pre-exposure prophylaxis (PrEP) pill for HIV prevention has been groundbreaking.

This pill, when taken daily, can protect you from becoming infected with HIV; however, it’s important to know it’s not 100% effective. Even if you’re taking PrEP, it’s still crucial to use condoms to prevent the spread of HIV as well as other sexually transmitted diseases (STDs). 

How HIV PrEP Works

PrEP combines two antiretroviral medicines, tenofovir and emtricitabine, into a pill called Truvada. The pill blocks enzymes that enable HIV cells to reproduce in the body. It should be taken daily for maximum effectiveness. Before prescribing PrEP, your doctor will order an HIV test, because the pill doesn’t work for those who already have HIV. If you are diagnosed with HIV, your doctor will work with you to find a treatment regimen that works for your lifestyle and needs. However, if your HIV test comes back negative, you can begin taking PrEP daily to significantly lower your risk of contracting the infection.

The most common side effect reported from taking PrEP is nausea, which usually goes away within a few weeks. Some people find relief by changing the time of day they take the pill. Other side effects can include gas or headache, but they are usually mild and fade over time.  

Using Condoms With PrEP: Increase Your Protection

PrEP has been proven to reduce the risk of getting HIV through sex by more than 90% (and through drug needles by more than 70%). That means that even if you take PrEP, you still have about a 10% chance of getting HIV every time you have unprotected sex. Taking PrEP in combination with using condoms significantly reduces your risk much more than just taking on its own. 

Remember to choose latex condoms, because condoms made with natural materials such as lamb skin have microscopic holes that HIV and STDs can pass through. If you’re allergic to latex, options made from plastic (polyurethane) and synthetic rubber (polyisoprene) are available, although plastic tends to break more easily than latex.

Protection from STDs

PrEP only helps prevent HIV. It doesn’t help prevent other STDs, such as chlamydia, gonorrhea, and genital herpes. And you might think STDs won’t happen to you, but in reality, they are far more common than most people expect–even more common than infection from HIV!

Nearly two million people in the United States were diagnosed with chlamydia in 2017. While chlamydia can be cured, most people don’t have symptoms, so they don’t know they have it unless they’re tested. For women, chlamydia can cause complications, including ectopic pregnancy, infertility, and pelvic inflammatory disease. For men, infertility can also occur, but it’s very unlikely.

More than half a million people were diagnosed with gonorrhea in 2017. Like chlamydia, gonorrhea can be cured, but can cause the same complications. New strains of gonorrhea are also emerging that are resistant to current treatments.

It’s estimated that one in six people in the United States is living with genital herpes. Genital herpes cannot be cured, but medications can prevent outbreaks or shorten how long they last. Having genital herpes increases the risk of HIV because it generates more of the cells that the virus targets (CD4 cells) and provides an entry point through open sores.

Condoms are a highly effective defense against HIV and STDs, but their use has been on the decline for more than a decade, especially among young men (aged 18 to 24) who have sex with other men. Whether or not to use condoms is your choice to make, but you owe it to yourself and your partners to make the decision from an informed place.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jul 3
  1. Fast Facts. U.S. Department of Health and Human Services. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics
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    PrEP: Protection from HIV in a pill? Harvard Medical School.
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    Reported STDs in the United States, 2017. https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/std-trends-508.pdf
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  7. Gonorrhea—CDC Fact Sheet. Centers for Disease Control and
    Prevention. https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm
  8. Genital Herpes—CDC Fact
    Sheet. Centers for Disease Control and Prevention. https://www.cdc.gov/std/herpes/stdfact-herpes.htm
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