Truvada + Isentress as PrEP

Hi Thanks for all interesting answers. I have been on PrEP since a year and I am just fine. I read that Isentress is adding a security since it does stop the viral integration. Why does not a PrEP regim include Isentress since it is recommended as PEP. I have decided to add Isentress for my PrEP regim and I dont feel any side effects.

Response from Dr. Young

Pre-exposure prophylaxis, PrEP is a very highly effective component for prevention of HIV infection. Added to our customary discussion about condoms and safer sex, PrEP adds in excess of 95% additional prevention effectiveness among adherent people.

While three drug therapy is the standard for treatment of HIV infection, pre-exposure prevention of HIV (PrEP) likely only requires 1 or 2 medications.

Large clinical trials among men who have sex with men, transgender women, heterosexuals and injection drug users show us that two drug (and perhaps, even 1 good drug) is enough to prevent HIV infection. That’s good enough data for me.

While raltegravir is an exceptionally well-tolerated HIV medication (and recommended in post-exposure prophylaxis), there’s little data supporting it’s use in PrEP. Adding Isentress to your Truvada adds substantial cost as well as additional pills and an additional dose of medication- perhaps risking the optimal adherence that is so critical to your PrEP success.

So, all that considered, I don’t think that your Isentress is a needed addition to your PrEP regimens.