What is PrEP?
Pre-Exposure Prophylaxis (PrEP) means HIV negative people take anti-HIV drugs to prevent HIV. The concept of a prophylaxis is common in health care. Both birth control and malaria pills are prophylaxis. They require taking a drug to prevent disease.
PrEP to prevent HIV has reduced new infections among cisgender men, cisgender women, transgender women, and people who inject drugs.
There are two pills approved for use as oral PrEP for HIV prevention. Descovy® and Truvada® are both daily pills. However, Truvada® can also be used for on-demand PrEP (2+1+1). Apretude® is the only injectable PrEP available. It’s given every 2 months after 2 initial shots, one month apart.
Current FDA-approved PrEP can be a daily oral pill (Truvada® or Descovy®) or a long-acting injection (Apretude®). Truvada® taken as “2+1+1” or “on-demand” around the time of sex has also been shown to be effective but is not FDA approved.
PrEP to prevent HIV has reduced new infections among cisgender men, cisgender women, transgender women, and people who inject drugs.
There are two pills approved for use as oral PrEP for HIV prevention. Descovy® and Truvada® are both daily pills. However, Truvada® can also be used for on-demand PrEP (2+1+1). Apretude® is the only injectable PrEP available. It’s given every 2 months after 2 initial shots, one month apart.
Current FDA-approved PrEP can be a daily oral pill (Truvada® or Descovy®) or a long-acting injection (Apretude®). Truvada® taken as “2+1+1” or “on-demand” around the time of sex has also been shown to be effective but is not FDA approved.
What is HIV PEP and how is it different than PrEP?
HIV PEP is post-exposure prophylaxis. Unlike PrEP (pre-exposure prophylaxis), PEP is taken after sex. It is a combination of 3-drugs, while PrEP uses only 2 (Truvada®, Descovy®) or 1 (Apretude®) HIV drug. HIV PEP should be taken within 72 hours after unprotected sex or needle exposure. It is best to take it as soon as possible after the exposure. You need to take HIV PEP for 28 days to maximize protection.
What are some misconceptions about PrEP?
PrEP is not an HIV vaccine—you must keep taking it to stay protected. PrEP is also not a cure or treatment for HIV.
PrEP does not protect against other STIs, like gonorrhea and chlamydia. They can increase your risk of getting HIV. Studies have shown that DoxyPEP greatly reduces the risk of bacterial STIs, such as syphilis, chlamydia, and gonorrhea. Condoms can also prevent getting these STIs.
PrEP is sometimes confused with HIV PEP, or post exposure prophylaxis. The main difference is that HIV PEP is only taken after sex to prevent HIV.
PrEP does not protect against other STIs, like gonorrhea and chlamydia. They can increase your risk of getting HIV. Studies have shown that DoxyPEP greatly reduces the risk of bacterial STIs, such as syphilis, chlamydia, and gonorrhea. Condoms can also prevent getting these STIs.
PrEP is sometimes confused with HIV PEP, or post exposure prophylaxis. The main difference is that HIV PEP is only taken after sex to prevent HIV.
What are the advantages of PrEP?
PrEP is highly effective in preventing HIV. People report less worry about getting HIV. They also feel more at peace. Plus, they enjoy better sex and intimacy. Side effects are usually mild and temporary. PrEP is under your own control – no need to negotiate condom use with a partner.
What are some myths about PrEP?
PrEP is only for gay men.
Studies have also shown that PrEP protects cisgender and transgender women against HIV. We expect that PrEP should also protect trans men, whether they are having anal or front-hole sex.
PrEP is only for promiscuous people.
PrEP is a way of taking control of your sex life and providing protection. Some people get HIV with only one partner. This is especially true if the partner is unaware they have HIV and are untreated. So, PrEP is not just for people having lots of partners – it’s for anyone who may be exposed to HIV.
PrEP is hard to get.
PrEP should be fairly easy to get. There are lots of doctors, nurse practitioners, and pharmacists who provide PrEP. There are also online services to get PrEP without even having to go to a doctor’s office or pharmacy to get it.
You need to take PrEP for your entire life.
You can stop PrEP any time you are no longer concerned about being exposed to HIV. People’s lives change. They may only need PrEP when at risk of HIV through sex or drug use.
PrEP is super expensive.
PrEP can be free or low-cost. All insurance should cover PrEP. For the uninsured or underinsured, there are programs to provide PrEP at low or no cost.
With PrEP you don’t have to worry about STIs.
PrEP is very effective against HIV. But, it doesn’t protect against STIs. Condoms do provide protection against STIs. You can take DoxyPEP, an antibiotic, after sex. It protects against some bacterial STIs, like syphilis, chlamydia, and gonorrhea. But, it is not 100% effective.
You need to take daily PrEP every day.
You don’t need to take PrEP every day if you are using 2+1+1 PrEP. If you are taking daily PrEP, it’s best to take the pill every day, although if you miss a pill here or there, it’s not a problem. The latest data suggests that 4 doses a week gives 99% protection for cis-men and trans women. It gives 88% protection for cis-women. We don’t have data for trans men. PrEP can also be given as an injection every 2 months.
Getting labs is too hard.
When taking PrEP, it is best to get HIV and STI testing regularly, usually every 3 months. Some providers moved to testing every 6 months during COVID. You can talk with your provider about what they recommend.
Studies have also shown that PrEP protects cisgender and transgender women against HIV. We expect that PrEP should also protect trans men, whether they are having anal or front-hole sex.
PrEP is only for promiscuous people.
PrEP is a way of taking control of your sex life and providing protection. Some people get HIV with only one partner. This is especially true if the partner is unaware they have HIV and are untreated. So, PrEP is not just for people having lots of partners – it’s for anyone who may be exposed to HIV.
PrEP is hard to get.
PrEP should be fairly easy to get. There are lots of doctors, nurse practitioners, and pharmacists who provide PrEP. There are also online services to get PrEP without even having to go to a doctor’s office or pharmacy to get it.
You need to take PrEP for your entire life.
You can stop PrEP any time you are no longer concerned about being exposed to HIV. People’s lives change. They may only need PrEP when at risk of HIV through sex or drug use.
PrEP is super expensive.
PrEP can be free or low-cost. All insurance should cover PrEP. For the uninsured or underinsured, there are programs to provide PrEP at low or no cost.
With PrEP you don’t have to worry about STIs.
PrEP is very effective against HIV. But, it doesn’t protect against STIs. Condoms do provide protection against STIs. You can take DoxyPEP, an antibiotic, after sex. It protects against some bacterial STIs, like syphilis, chlamydia, and gonorrhea. But, it is not 100% effective.
You need to take daily PrEP every day.
You don’t need to take PrEP every day if you are using 2+1+1 PrEP. If you are taking daily PrEP, it’s best to take the pill every day, although if you miss a pill here or there, it’s not a problem. The latest data suggests that 4 doses a week gives 99% protection for cis-men and trans women. It gives 88% protection for cis-women. We don’t have data for trans men. PrEP can also be given as an injection every 2 months.
Getting labs is too hard.
When taking PrEP, it is best to get HIV and STI testing regularly, usually every 3 months. Some providers moved to testing every 6 months during COVID. You can talk with your provider about what they recommend.
Is it safe to take PrEP if I’m using drugs or alcohol, or taking medications?
Alcohol and other drugs do not affect PrEP, so you can take PrEP if you’re drinking alcohol or using drugs.
PrEP is safe to take with most medications, but some medications cannot be taken with some forms of PrEP. This is uncommon, so it’s important to talk with your provider about any medications you’re taking.
PrEP is safe to take with most medications, but some medications cannot be taken with some forms of PrEP. This is uncommon, so it’s important to talk with your provider about any medications you’re taking.
Will PrEP interfere with my gender-affirming hormone therapy?
All PrEP types in use (Truvada®, Descovy®, Apretude®) have been tested. They do not affect feminizing hormones, such as estradiol. Truvada and Descovy® have been tested and found NOT to interfere with masculinizing hormones (e.g., testosterone). Apretude® has not been tested for its effect on testosterone. But, it should not interfere with it, based on the drug’s chemistry.
In general, how protective is PrEP?
Daily pills (Truvada® or Descovy®), PrEP 2+1+1, and 2-month injections (Apretude®) are all >99% effective, when taken as prescribed.
How does PrEP work to protect against HIV?
PrEP disrupts the replication process of HIV. When a person first gets infected with HIV, the virus makes millions of copies of itself. It eventually becomes part of the person’s immune system. The first few days after HIV exposure are thought to be critical in preventing the virus from taking hold. PrEP can block HIV replication and prevent the virus from establishing itself in the body.
Where can I find more information on PrEP?
The CDC has a lot of information about PrEP.
The San Francisco AIDS Foundation also has a lot of information.
PleasePrEPMe.org also has resources.
The San Francisco AIDS Foundation also has a lot of information.
PleasePrEPMe.org also has resources.
Have researchers studied PrEP in trans people?
Researchers have studied PrEP in transgender women and are beginning to study it in transgender men. Researchers have studied Truvada®, Descovy®, and Apretude® in transgender women. All appear to work in transgender women. They don’t interfere with feminizing hormones. Feminizing hormones also do not seem to interfere with PrEP.
Will PrEP protect me from STIs?
PrEP does not protect against other STIs, like gonorrhea, chlamydia, and syphilis. These can increase your risk of getting HIV. Studies show that DoxyPEP greatly reduces the risk of bacterial STIs, like syphilis, chlamydia, and gonorrhea. Condoms can also prevent getting these STIs. There are other STIs to still be worried about such as Herpes and HPV. Take a deep dive into the world of STIs and their prevention, testing, and treatment on the CDC website.
Does PrEP protect against HIV from injection drug use?
The only drug tested against HIV in people who inject drugs is Viread®. It is one of the two drugs in Truvada®. We believe PrEP should prevent HIV from needle sticks. So, it should be used by people who share needles or injection equipment. Some people who inject drugs are also exposed to HIV through sex. So, PrEP would protect against sexual exposure to HIV. Another way to prevent HIV from needles is to use clean injection equipment.
