You might have heard that preexposure prophylaxis (PrEP) protects against HIV. But maybe you’re not sure exactly what PrEP is or whether it’s right for you. Being unsure about a medication you’ll have to take every day is totally understandable.
PrEP is a medication that prevents you from getting HIV through sexual contact or use of injected drugs. It comes as a daily pill or a shot that you get once every 2 months, and it’s very effective when used correctly.
If you have questions about PrEP, a doctor is the best person to answer them. But we know the “HIV talk” can feel pretty awkward. Here are six icebreakers to get the conversation going.
First, find a doctor you trust. It’s much easier to have the PrEP talk when your comfort level is already high.
Research PrEP online before your visit. Look at trustworthy websites like CDC.gov and HIV.gov. Then you’ll know how to respond if your doctor has any concerns about writing you a prescription.
Write down a few questions to bring to your doctor’s office so you’ll be ready when your doctor comes into the room. Also, bring your health history, including a list of any allergies you have, medications you take, and past illnesses.
Even though it can be uncomfortable to talk about your sex life or drug use, having a direct and honest conversation is the best way to make sure you get what you need.
Believe us: Your doctor has heard everything before. There’s nothing to be embarrassed about.
PrEP is for people who may be exposed to HIV when they have anal or vaginal sex or use injected drugs. You could be a good candidate for PrEP if:
- your partner has tested positive for HIV
- you don’t know your partner’s HIV status
- you don’t consistently use condoms during sex
- you’ve tested positive for a sexually transmitted infection like chlamydia, syphilis, or gonorrhea in the last 6 months
- you’ve been on postexposure prophylaxis (PEP) and are still at risk for HIV
- you share needles, syringes, or other drug equipment
Before you can get PrEP, you will need a negative HIV test result. This is important. If you already have HIV when you start taking PrEP, the virus could become resistant to the medication, and PrEP won’t help you.
PrEP prevents HIV from multiplying in your body. It’s very effective at protecting against infection.
If you take PrEP exactly as prescribed, it can reduce your risk of getting HIV through sex by up to 99%. And it can reduce your risk of getting HIV from using injected drugs by 74% or more.
There is a small risk that you could get HIV while taking PrEP. The risk is higher if you don’t take the medication exactly the way your doctor prescribed it.
Another small possibility is that the virus becomes resistant to PrEP. If that happens, the medication will stop working.
It’s more likely to happen if you already have HIV when you start on PrEP or if you get HIV while you’re taking PrEP. That’s why you’ll need to have a negative HIV test result before you start this medication and every 3 months while you’re taking it.
PrEP has a few possible side effects you should know about before you take it. The most common ones are:
- nausea and vomiting
- appetite loss
- belly pain
Most PrEP side effects are mild and go away with time.
Less often, people develop liver or kidney problems from PrEP. Your doctor might monitor your liver and kidneys while you’re taking PrEP.
One type of PrEP medication, Truvada (emtricitabine-tenofovir), can also weaken your bones. It may not be a good option for people who are at risk for osteoporosis.
Any doctor can prescribe PrEP. They don’t need any special training in HIV or infectious diseases. Physician assistants (PAs) can also prescribe this medication.
But just because every doctor can prescribe PrEP doesn’t mean yours will prescribe it. Some doctors still don’t understand how PrEP works or who it can help. If you get any pushback from your doctor, ask them to contact the National Clinician Consultation Center for advice.
If you don’t have a doctor or your doctor says “no” to PrEP, you can visit HIV.gov to find one who will prescribe this medication.
PrEP is pricey. A 1-year supply can cost up to $22,000.
But if you have health insurance, you shouldn’t have to pay anything for these medications. Thanks to the Affordable Care Act, insurance companies must cover the whole cost of PrEP, including lab tests, doctor visits, deductibles, and copays. Medicaid will also pay for PrEP.
If you don’t have insurance or Medicaid, programs like Ready, Set, PrEP and ViiVConnect can help you pay for PrEP. The Patient Advocate Foundation also has a copay relief program that may be able to help.
PrEP can be a great ally to help you avoid contracting HIV through sexual activity or use of injected drugs, but it does come with some risks and side effects. If you’re not sure whether this medication is right for you, make an appointment with a doctor and ask.
Your doctor might throw a lot of new info your way during that visit. Take notes so you can remember what they said.
Ask lots of questions to make sure you understand everything. If you go home and think, “What did my doctor mean by that?”, call the office and ask.
Not every doctor is equally knowledgeable about PrEP. If yours is in the dark about this medication or won’t prescribe it for you, get a second opinion.