If you have unprotected sex or you've got more than one partner, pre-exposure prophylaxis (PrEP) is your best defense against HIV, the virus that causes AIDS. When you take PrEP the right way, it's about 99 percent effective at reducing your risk of HIV.
Even so, only 1 in 4 gay and bisexual men who could benefit from PrEP use it. One reason is that they don't know much about this preventive medicine and how it can protect them.
Want to learn more about PrEP? Here are 10 common myths that are making the rounds on the internet, and the facts behind them.
1. Myth: PrEP is only for gay men
Fact: PrEP is for anyone who doesn't have HIV but is at risk of getting it through sex or IV drug use. The CDC recommends PrEP if you've had anal or vaginal sex in the past 6 months and:
- You and your partner haven't used condoms every time.
- Your partner has HIV.
- You were diagnosed with a sexually transmitted disease (STD) in the past 6 months.
- You're a woman with an HIV-positive partner who is trying to get pregnant.
2. Myth: You don't need to use condoms if you take PrEP
Fact: PrEP prevents HIV from multiplying in your body if you're exposed to the virus during sex. Using condoms every time you have sex will protect you from being exposed to the virus in the first place. Condoms also protect against other STDs, like chlamydia and gonorrhea, which PrEP doesn't prevent.
3. Myth: It's hard to get a prescription for PrEP
Fact: Any licensed health care provider can prescribe PrEP. If you don't have a primary care doctor, you can visit a health clinic. Or you can search for a doctor through the HIV services locator on HIV.gov.
You will need to test negative for HIV before you can get a prescription. And once you're on PrEP, you'll have to see a doctor about once every 3 months for follow-up visits, HIV tests, and refills. But you may be able to test yourself at home and see your doctor virtually with telemedicine.
4. Myth: You only need to take PrEP after having unprotected sex
Fact: You have to take PrEP consistently for it to protect you from HIV if you're ever exposed. Post-exposure prophylaxis, or PEP, is the pill you take after having unprotected sex. When you take PEP within 72 hours of the possible exposure, it's very effective at preventing HIV. But PEP is only for emergencies and it's not a substitute for PrEP.
5. Myth: PrEP Is really expensive
Fact: PrEP drugs can be expensive. They can cost up to several thousand dollars a month. That's on top of lab tests and doctor visits, which can be as much as $15,000 a year. But you probably won't have to pay anywhere near that amount.
Most private health insurance plans and Medicare and Medicaid cover the cost of PrEP. Insurance also pays for doctor visits and lab tests. If you don't have health insurance, programs like Ready, Set, PrEP and ViiVConnect can help you pay for PrEP.
6. Myth: PrEP is only for people who have multiple sexual partners
Fact: Even if you only have sex with one person, it's good to take PrEP if:
- Your partner has HIV with a detectable viral load, or you're not sure of your partner's HIV status.
- Your partner is an IV drug user.
- Your partner has sex with other people.
7. Myth: You don't need PrEP if you're a top
Fact: Your risk of getting HIV is higher if you're a bottom, meaning that you receive anal sex, than if you're a top and give anal sex. But it is possible to get HIV as a top. It's still important to take PrEP to protect yourself.
8. Myth: You have to take PrEP every day
Fact: That depends on what type of PrEP you choose. Daily PrEP with Descovy and Truvada is a pill that you have to take every day. PrEP also comes as a long-acting injection called Apretude that you get from your doctor every 2 months.
If you don't have sex very often, you can use on-demand PrEP pills. For this regimen, you take:
- Two pills two to 24 hours before you have sex
- One pill 24 hours after the first dose
- One pill 24 hours after the second dose
9. Myth: PrEP has bad side effects
Fact: PrEP is safe. Most people don't have any side effects. And most of the side effects PrEP can cause are mild, such as:
- Headache
- Nausea
- Diarrhea
- Tiredness
- Rash
- Belly pain
These should go away after you take the medicine for a while.
Rarely, long-term use of PrEP can cause liver, kidney, or bone problems. These medicines may not be safe for people who have liver or kidney disease.
10. Myth: You'll need to stay on PrEP for the rest of your life
Fact: You may be able to go off PrEP if you're no longer at risk for HIV. Ask your doctor how to safely stop taking these medicines.
The way you stop PrEP is different for each type:
Daily PrEP. You can stop the pills after you've taken2 daily doses, or 28 daily doses after your last exposure to HIV.
On-demand PrEP. Once you take your third dose, you're done.
Injectable PrEP. You can stop after your last dose. Continue to get HIV tests for about 12 months afterward.
Show Sources
Photo Credit: Liia Galimzianova / Getty Images
BMC Public Health: "The relevance of pre-exposure prophylaxis in gay men's lives and their motivations to use it: a qualitative study."
CDC: "About PEP," "About PrEP," "Deciding to Take PrEP," "HIV and African American Gay and Bisexual Men: HIV Prevention," "Paying for PrEP," "PrEP Effectiveness," "Sexually Transmitted Diseases," "Starting and Stopping PrEP."
HIV.gov: "Pre-Exposure Prophylaxis."
KHN: "HIV Preventive Care Is Supposed to Be Free in the US. So, Why Are Some Patients Still Paying?"
New York State: "Preventing HIV by Taking One Pill Once a Day: Pre-Exposure Prophylaxis (PrEP)."
PrEP Daily: "Tops, Bottoms, and PrEP: What You Need to Know About HIV Prevention."
Project Inform: "Is Taking PrEP the Right Choice for You?"
San Francisco AIDS Foundation: "PrEP Facts: Starting and Stopping PrEP Care."
Stanford Medicine: "Pre-Exposure Prophylaxis (PrEP)," "Putting a Number on It: The Risk from an Exposure to HIV."
