HIV Pre-Exposure Prophylaxis (PrEP) Consent
Indication for Use:
You are requesting Pre-Exposure Prophylaxis (PrEP) with either tenofovir disoproxil fumarate/emtricitabine (Truvada®) or tenofovir alafenamide/emtricitabine (Descovy®) as part of your prevention plan to reduce your risk of acquiring HIV. These medications work by maintaining drug levels in blood and tissues that block HIV replication when exposure occurs.
Potential Benefits:
- Substantially reduced risk of acquiring HIV infection when taken consistently and when safe sex methods are used.
Potential Side Effects:
Although many people tolerate PrEP well, side effects, rarely leading to emergency care, can occur.
Common Side Effects:
- Nausea
- Headache
- Fatigue
- Weight changes
Serious Side Effects:
- Kidney injury or decreased kidney function
- Bone mineral density loss
- Allergic reactions (rash, itching, swelling)
- Lactic acidosis (rare)
- Liver toxicity (rare)
Risks and Considerations:
- Renal Function: Both Truvada® and Descovy® may affect kidney function. You must inform your provider if you have pre-existing kidney disease; baseline and periodic kidney function testing are required.
- Bone Health: Truvada® has been associated with decreased bone mineral density; if you have osteoporosis or high fracture risk, Descovy® may be preferred.
- Resistance Risk: If you unknowingly start PrEP during acute HIV infection, there is potential for developing drug-resistant virus. Always confirm a negative HIV test before initiating or re-starting PrEP.
- STI Risk Compensation: PrEP does not protect against other sexually transmitted infections; routine screening and barrier methods (e.g., condoms) remain important.
- Hepatitis B: Both agents are active against hepatitis B virus; stopping PrEP without proper medical supervision may cause HBV flare.
Monitoring and Follow-Up:
- HIV test: Every 3 months
- Renal function (creatinine/eGFR): At baseline, then every 3–6 months
- Bone density assessment: If clinically indicated (e.g., history of osteoporosis)
- STI screening: Every 3–6 months
- Hepatitis B/C testing: At baseline; monitor if positive history
- Pregnancy test: Every 3 months if applicable
Consent (Taking Your PrEP Medication & Supporting Your Health)
To get the full protective benefit, take your PrEP pill at the same time every day whether with or without food and set a daily reminder (alarm, app, or pillbox). Missing doses can reduce drug levels in your body and lower HIV protection.
Even while you’re taking PrEP, combining strategies gives you the strongest protection against HIV. Using barrier methods, such as condoms, correctly and consistently adds a physical barrier against both HIV and other STIs. PrEP does not replace the need for continued and consistent barrier methods.
Regular screening every 3–6 months for STIs helps catch and treat infections that can increase HIV risk, and discussing viral load testing with HIV-positive partners can guide safer intimacy.
If you or your partner participate in injection drug use, always use new, sterile needles and never share equipment. Honest communication with partners about HIV status, risk behaviors, and prevention plans, alongside supportive tools like reminder apps, safer-sex supplies, and behavioral counseling—creates layers of protection that work together with PrEP to keep you as safe as possible.
Acknowledgment:
I have read and understand the information above regarding taking my PrEP medication and supporting my health while on PrEP.
