PrEP and our Kidneys

PrEP without doubt is making a significant impact on the lives of people at risk of contracting HIV, with the Terrance Higgins Trust stating that it is as affective as wearing a condom. Indeed, 56 Dean Street have reported a fall in new infections by 40% this last year alone and whilst this is a London statistic, they contribute significantly to new diagnosis in Britain. What fantastic news, however, new research is finding that we need to make sure that we are getting our internal organs checked regularly and particularly our kidneys, if we are using PrEP.

Whilst not protecting us from other STI’s, Truvada, the drug used in PrEP is protecting us against the one STI that the majority of our community is most concerned about. Of course, like any course of medication, it is important to take it on a regular basis, as instructed, in order to make sure that the protection level of the medication, is maintained. This ensures that we are providing ourselves as much protection as possible against HIV. It significantly reduces the risk of being infected with HIV without any serious side effects, providing, of course, that you are HIV negative and that you take the medication and adhere to the prescription as directed. There is no doubt that it has changed how a once worried community group can once again take charge of their own bodies without always being conscious of what the effects of exchanging bodily fluids might mean. It has given people confidence in their own sexual futures to be able to make decision about how they want to have sex, without the constant threat of contracting HIV. How many of us have said, …we can’t do this, …we shouldn’t do this, …its naughty, ….it’s not right, …it’s wrong?

However, whilst the use of PrEP is becoming well documented and the effect that Truvada is having on the gay community, one area for attention that is being over looked, is the side effects that taking PrEP can have on our internal organs and particularly our Kidneys.

Last year at the conference on Retroviruses and Opportunistic Infections in Boston America, a session was put together to discuss the findings of recent studies that had been carried out called, “It’s complicated: renal function and STIs in PrEP users”. The findings from two major studies indicated that modest kidney decline has been experienced by older people who were taking PrEP, and those who have higher levels of Tenofovir in their systems. Tenofovir is an ingredient in Truvada which has long been used in HIV treatment but which has been known to cause Kidney damage and which needs to be monitored. The findings indicated that a percentage of the people taking Truvada had experienced a small decline in their kidneys health.

Reading the conclusions from the talk, it was interesting to note that whilst clinical trials of PrEP, to date, did not show any notable kidney problems, the tests did show a decline in the kidneys health by a percentage of people participating in the trail. Whilst I find it interesting that the word notable was used, no further explanation from the reading available gave an understanding as to what notable meant because the report clearly states that a decline in the kidneys health was found but how and when that decline becomes notable, is unclear.

What I also found interesting in the reading surrounding the trials was that people with pre-existing Kidney problems were excluded from the trials, thus leaving the findings of kidney decline to people with no pre-existing kidney issues, so we cannot glass over and give the excuse that the decline in kidney health is because participants in the trial already had bad kidney health.

I also think what needs highlighting is that whilst the trials only concentrated on a select group of people (uncommon toxicities) the ability for a drug to be toxic or poisonous, only shows up when many more people are using a drug. So, until Truvada or its equivalent is available to a lot more people, we won’t really know the effects it can have on us fully, without regularly getting checked.

The benefits of using PrEP are without doubt significant. Agencies have reported drops in new cases of infection by almost 40%, which cannot be over looked or ignored but something else that cannot be overlooked is the need for regular check-ups of our internal organs and particularly our kidneys, if we are users of PrEP.

It is worth mentioning that not all sexual health clinics may offer the checks that are needed, on a regular basis, to PrEP users in order to monitor internal organs. Often clinics are understaffed and demand often outstrips supply of services but that being said as individuals that use PrEP, it is important to find a clinic that will support our medical needs and gives the necessary checks that are needed to stay healthy.

Whilst we are aware enough to take care of our sexual health and proactive enough to obtain PrEP, we also need to take care of the other areas of our body that need attention as a result of taking medication. We need to take care of our kidneys and other internal organs, so be honest and open about the use of PrEP when we get our regular sexual health checks.

We all have a status, be that positive or negative and that status needs to be taken care of and checked on. So make sure that if you are taking PrEP, you know how well your kidneys are doing.

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