Consent (HIV Pre-Exposure Prophylaxis (PrEP) with Truvada® or Descovy®):

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:
You will require scheduled laboratory monitoring and follow-up to ensure safety and effectiveness:

• 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