What is PrEP?
PrEP stands for Pre-Exposure Prophylaxis. It is a once-daily pill regimen that can help you stay HIV-negative. The only drug 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 prescribed, PrEP blocks the virus from making copies of itself and spreading throughout the body.
How effective is PrEP?
When taken as prescribed, PrEP has been shown to be more than 90 percent effective against contracting HIV. PrEP is much less effective if it is not taken daily.
How often should I take PrEP?
PrEP should be taken once every day, ideally at the same time of day. Daily adherence is essential to maintaining PrEP’s effectiveness.
How long does it take for PrEP to start working?
For anal sex, it takes at least seven days of daily use for PrEP to reach full effectiveness. For vaginal sex, it takes at least twenty days of daily use.
Is PrEP safe? What are the side-effects?
PrEP is safe and generally well-tolerated. The drug 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 you are concerned about or experience any of these side-effects.
Does PrEP protect against other sexually transmitted infections (STIs)?
While PrEP does not protect against other STIs or unwanted pregnancy, it can be paired with condoms and other prevention strategies for additional protection. It's also important to remember that STIs remain relatively easy to treat or cure in the United States.
How will taking PrEP affect my use of hormones?
While more research is needed, PrEP appears to work for those taking gender-affirming hormones.
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, any time you start PrEP, it is important to remember that it generally takes at least 7-22 days of daily use for it to reach full effectiveness. 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 anyone at increased risk for contracting HIV, including anyone who is in an ongoing relationship with a person living with HIV, anyone who does not consistently use a condom, and anyone who shares injection drug or hormone equipment. Studies have shown that PrEP can be beneficial for people of various gender identities and sexual orientations.
How else can I stay HIV-negative?
There are several steps you can take to reduce the chances of contracting HIV, including:
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 certain 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. By consistently taking their medication, people living with HIV are able to lower the amount of HIV in their bodies to undetectable levels. While undetectable, a person living with HIV remains in good health, and it is virtually impossible for them to transmit the virus to a partner. Prevention options (e.g., condoms, PrEP) exist for those in relationships where one partner is not yet undetectable.
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.
Where Can I Learn More about PrEP?
This resource is not a substitute for sound medical advice — and the examples throughout it don’t cover every situation! We encourage you to seek out additional resources from other community advocates and, most importantly, talk to a knowledgeable healthcare provider before making any medical decisions. Last Updated: February 2017