PrEP has only been around since 2012, so you’re not alone if you haven’t heard of it or have questions about it.
What is PrEP, is it right for you, and how can you get it if it is? We’ve got you covered.
Think of PrEP like prepping for getting down. Like birth control pills, it’s a med you take once a day, every day, that prevents something. Instead of preventing pregnancy, PrEP helps prevent you from getting HIV.
PrEP stands for “pre-exposure prophylaxis,” meaning you take it preventively before a potential exposure to HIV.
It’s not to be confused with PEP, which is “post-exposure prophylaxis,” a different pill you can take right after a one-time incident that potentially exposed you to HIV (kinda like Plan B in our pregnancy prevention metaphor).
Two specific medications are approved for PrEP: Truvada and Descovy. Those are the brand names for the pills, and “PrEP” is the umbrella term for the type of pill regimen.
Folks who take PrEP are HIV-negative adults and teens of any gender who regularly do things that come with a risk of contracting HIV.
It can be a fabulous option for:
- people with penises who have sex with each other
- couples in which one person has HIV and the other doesn’t
- sex workers
- people who use injection drugs
- people whose partners use injection drugs
- people who don’t regularly use condoms or other barrier methods when they have sex
Trials for the approval of Descovy didn’t include people with vaginas, so while Truvada is FDA-approved for the prevention of HIV through receptive vaginal intercourse, Descovy is not.
PrEP is actually super easy to take once you’re set up with it: Whether you take Truvada or Descovy, it’s just one pill each day.
Keeping up with taking it every day is what makes it most effective, so make it part of your routine — maybe take it right before you settle in for an evening of Insta scrolling.
PrEP is a prescription medication. If you’d like to get on PrEP, you’ll first need to find a healthcare professional who will prescribe it to you.
If you already have a doctor, you can talk with them about starting PrEP. If you need a new doctor, lots of community health centers offer PrEP prescribers — you can use this locator to find someone.
PrEP is only for people who are HIV-negative, so your doc will do an HIV test first. They may do other tests as well in order to get you started. You’ll have to repeat these tests every 3 months to keep taking PrEP.
Some PrEP providers offer a telemedicine option and self-testing to make it even easier for you. Taking care of your health in your bunny slippers, baby!
Yup!
According to the CDC, “PrEP reduces the risk of getting HIV from sex by about 99 percent when taken as prescribed.” It doesn’t get much more effective than that!
If you might get HIV from injecting drugs instead of from sex, PrEP reduces your risk of getting HIV by at least 74 percent in that case (again, when taken as prescribed).
The key here is “when taken as prescribed.” It’s much less effective when you don’t take it daily, though it’ll still help somewhat.
While the CDC doesn’t officially recommend it, there is evidence that a method known as “on-demand PrEP” — where you take a few doses in just the days and hours directly before and after having sex without a condom or other barrier — can be effective for some people.
It takes 1 to 3 weeks of consistent use for PrEP to reach maximum effectiveness, depending on the activity you’re engaging in.
There are many ways to pay for PrEP. The medication itself costs well over $1,000 per month, but don’t worry — there are only a few situations where you’d have to pay all that yourself. In some cases, it’s even totally free.
Just remember that you need to have ongoing medical visits and lab tests to keep getting the prescription, so those have to be paid for as well.
If you have health insurance, there’s a good chance your plan covers the medication, clinic visits, and lab tests. If you have copays for any of these, you can apply for copay assistance through Gilead, the manufacturer of Truvada and Descovy.
The program helps only with copays for private insurance, not for public plans like Medicare and Medicaid, but those don’t usually have copays anyway.
Not covered by health insurance? Apply for free PrEP through Ready, Set, PrEP, a program offered by the U.S. Department of Health and Human Services. Gilead also has a program to help if you’re uninsured.
There are many other options for discounts and help paying for PrEP and the accompanying visits. For a list of state-by-state assistance programs and other options, visit NASTAD’s page on the topic.
Some programs depend on income and some don’t, so check out what’s available for your unique situation. Your prescriber can probably help point you in the right direction too.
A few side effects are associated with PrEP, but they generally go away over time. So if you experience any, remember they’re likely temporary.
Some people taking PrEP experience:
- nausea
- diarrhea
- headaches
- fatigue
- stomach pain
The National Institutes of Health says the side effects are not serious. So, while they’re not fun, they shouldn’t be severe and should fade away. If you do have serious or prolonged side effects, tell your prescriber ASAP.
Some researchers are exploring whether taking PrEP might make a person resistant to HIV medications if they do get HIV. But so far the research shows that this is infrequent and is most likely to happen when the person starts taking PrEP when they’re already HIV-positive.
Since PrEP is only for HIV-negative people, an HIV-positive person would be taking PrEP only if the HIV test given at the beginning of the prescription process showed a false negative (which can happen if the infection is very new) or if they got HIV while taking PrEP.
It’s very rare to get HIV while taking PrEP as prescribed, but it becomes more possible if you don’t take it every day.
If you’re looking for peace of mind while having sex with or sharing needles with folks who might be living with HIV, PrEP is a proactive way to increase your chances of staying HIV-negative.
It’s effective, but you do need to figure out paperwork and keep up with testing every 3 months to take it. It’s worth the effort for many people, especially since taking this medication helps you keep doing you… and others.