Is PrEP Right For Me?
What is PrEP?
PrEP stands for Pre-Exposure Prophylaxis. It is an HIV prevention strategy that currently involves taking a once-daily pill to reduce the likelihood of contracting HIV. The only pill that is FDA-approved for PrEP is a prescription medication sold under the brand name Truvada®.
How does PrEP work?
It takes a few days for HIV to become established in the body following exposure. When taken as PrEP, HIV medications can block HIV from making copies of itself and spreading throughout the body. People who use PrEP must commit to taking the drug every day and seeing their healthcare provider for follow-up appointments and testing.
How effective is PrEP?
When taken as prescribed by a knowledgeable healthcare provider, PrEP has been shown to reduce the likelihood of HIV transmission by more than 90 percent. PrEP is much less effective if it is not taken daily. Some studies suggest that it takes at least seven days of daily use for PrEP to reach full effectiveness. PrEP does not protect against other sexually transmitted infections (STIs) or pregnancy so the Centers for Disease Control and Prevention (CDC) strongly recommends using condoms in addition to PrEP.
When should I take PrEP?
PrEP should be taken once every day – ideally at the same time of day – prior to exposure to HIV. Daily adherence is essential to maintaining PrEP’s effectiveness.
Is PrEP safe? Are there side-effects?
PrEP is safe, and the regimen is generally well-tolerated. The pill used for PrEP, Truvada, has been used to treat people living with HIV since 2004. PrEP can cause mild side effects, including upset stomach, headaches and weight loss, especially at the beginning of the regimen. Rare side effects include kidney or bone problems. Talk to a knowledgeable healthcare provider if the side-effects are bothersome.
If I start PrEP, does this mean I have to take it for the rest of my life?
No. With proper medical guidance, people can safely start and stop taking PrEP at different points in their lives. However, anytime you start PrEP, it is important to remember that it generally takes at least seven days of daily use for it to reach full effectiveness. For some people, including women and transgender men, it may take longer. In any case, be sure to consult a knowledgeable healthcare provider before starting or ending a PrEP regimen.
How can I access PrEP?
Any licensed healthcare provider can prescribe PrEP. Most private insurance plans cover PrEP, as does Medicaid, the state-run health insurance program for low-income individuals. If you are uninsured or underinsured, ask your healthcare provider about pharmaceutical patient assistance programs, which may be able to offset the cost of the medication.
Is PrEP Right for Me?
Only a medical provider can help you answer that question for sure. Generally, PrEP is for people who do not have HIV but who are more likely to encounter it, including anyone who is in an ongoing relationship with a partner living with HIV, anyone who does not consistently use a condom when having sex or anyone who shares injection drug or hormone equipment. Studies have shown that PrEP can be hugely beneficial for people of various gender identities and sexual orientations.
How else can I stay HIV-negative?
Use Condoms. Find the right size and choose a type of condom you like.
Use Lube. Use water-based or silicone-based lubricant, particularly for anal or vaginal sex, to prevent tears in the skin and to keep condoms from breaking.
Get Tested. It’s the only way to know if you or a partner has HIV.
Test and Treat STIs. Having an active STI, or even a history of STIs, can make it easier to acquire or transmit HIV.
Talk to Your Partners. Ask sexual partners about the last time they got tested for HIV and other STIs. Consider getting tested together.
Date Undetectable. Consider dating people living with HIV who are “undetectable.” Research shows that people living with HIV who consistently take their medication can reduce the likelihood of passing on HIV by at least 96 percent. Dating people who don't know their HIV status, or who are not connected to care, can mean a much higher likelihood of contracting HIV.
Be mindful of drug and alcohol use. Substance use can increase your chances of acquiring HIV directly and indirectly, depending on the circumstances.
Change Syringes. If you inject hormones, drugs or steroids, use a new, clean syringe and other injection equipment every time.
Know about PEP. PEP is an HIV prevention strategy that can be used in emergency situations, such as condomless sex with someone whose HIV status you do not know.
Know about PrEP. PrEP is an HIV prevention strategy that can be taken every day to significantly reduce the likelihood of transmission.
Where Can I Learn More about PrEP?
This article is not a substitute for sound medical advice. Talk with a knowledgeable healthcare provider about whether PrEP is a right for you. Visit www.hrc.org/HIV for more resources on HIV prevention, treatment and care -- including HRC’s What Do I Do? A Handbook to Understanding? Health & HIV.