PrEP, or pre-exposure prophylaxis, is a medication that prevents you from getting infected by HIV. It comes in two forms: daily pills and bimonthly injections.
You may be a candidate for PrEP if you’re sexually active or inject drugs and you don’t have HIV.
PrEP may be an option if:
- You had anal sex or vaginal sex in the last 6 months and your sexual partner has HIV, you haven’t used a condom regularly, or you’ve had a sexually transmitted disease in the last 6 months.
- You inject drugs and you share needles, syringes, or other equipment to inject drugs, or your injection partner has HIV.
- You’ve taken post-exposure prophylaxis (PEP), a short-term treatment given within 72 hours after being exposed to HIV, and you have high-risk behavior.
If you don’t fit into these categories, you still may be able to take PrEP. Your doctor can help you decide it it’s right for you.
Who Can Take PrEP?
Your doctor may recommend PrEP if:
- You’re an adult or adolescent and you weigh at least 77 pounds.
- You don’t have HIV.
It’s safe to take PrEP when you’re on birth control. This includes the pill, patch, ring, shot, implant, or IUD. But PrEP doesn’t protect you from STDs or pregnancy.
If you’re pregnant, breastfeeding, or thinking about getting pregnant and your partner has HIV, talk to your doctor about starting PrEP to protect yourself and your baby.
If you take hormone therapy, it’s OK to take PrEP at the same time.
If you’re an adolescent with risk of HIV from sex, it’s safe to take PrEP shots.
Gender, Sexual Preference, and Risk
If you’re a man and you’re gay or bisexual, your HIV risk may be higher. About 70% of people living with HIV are gay or bisexual men. PrEP may lower your risk.
You may get HIV by having contact with someone through blood, semen, or vaginal fluids. If you have anal sex, your risk is about 10 times higher than if you have vaginal sex.
Receptive, or bottom, anal sex has a higher risk. But if you’re an insertive partner, or top, you may also get HIV. No matter which position you prefer, PrEP may lower your risk of getting HIV from sex.
Your risk may be slightly higher if you’re uncircumcised because you may be more likely to get bacteria and infections.
You may also have a higher risk if you:
- Have more than one sexual partner
- Have other sexually transmitted diseases, like gonorrhea or herpes
- Have sex with someone infected with HIV
- Share needles, syringes, or other drug equipment with someone who has HIV
Why It’s Important to Talk to Your Doctor
Your doctor will talk to you about your sexual behavior, drug use, and your preferences to decide what type of PrEP may be best for you.
For example, if you’re an adolescent and your risk of infection is mostly through sex, they may recommend a bimonthly injection. If you inject drugs, they may recommend a pill.
If you’re a gay or bisexual man and you have anal sex without a condom, on-demand PrEP may be an option to lower your risk of getting HIV. This is when you only take pills when you’re planning on having sex within the next 24 hours. On-demand PrEP isn’t approved by the FDA.
Where to Get PrEP
You can get PrEP from any health care provider who is licensed to write prescriptions.
PrEP is covered by many private insurance plans. You might have a copay. It may also be covered by Medicare and Medicaid, which is a state-run health insurance program for low-income people.
If you don’t have insurance or you don’t have full insurance coverage, talk to your doctor. They may refer you to a patient assistance program, which is sponsored by pharmaceutical companies and may lower your costs.
Before Taking PrEP
To take PrEP, you’ll need to be sure you don’t have HIV.
Your doctor will test you for HIV before you start. If you take PrEP pills, you’ll get an HIV test every 3 months. If you take injectable PrEP, you’ll get an HIV test every 8 weeks along with your PrEP injection.
What to Expect
You’ll have regular doctor’s appointments and HIV testing when you take PrEP.
First appointment. On your first visit, your doctor will give you information about PrEP, talk about your options, see if it’s right for you, and do an HIV test and other possible bloodwork.
You may start PrEP right after your first appointment.
First follow-up appointment. You’ll go back to your doctor about 2-4 weeks after your first visit. They’ll see how you’re doing, ask about side effects, and may help with payment or support issues.
Regular HIV testing. You’ll have a test every 3 months if you take PrEP pills. You’ll take a test every 8 weeks if you have an injection.
You may get HIV tests at:
- Your doctor’s office
- A local community-based organization
- A health facility
- A lab
If you get your tests at another facility, make sure they send the results to your prescribing doctor.
Follow-Up appointments. Your doctor will decide how often you’ll go in for follow-up visits.
For PrEP to work properly, you have to take it as prescribed. If you don’t take it correctly, your bloodstream may not have enough medicine in it to block the virus. When you start, it takes at least 7 to 22 days of daily use to have enough in your system.
You can start and stop PrEP at different times in your life. Talk to your doctor before you start or stop taking PrEP.
Show Sources
Photo Credit: monkeybusinessimages / Getty Images
SOURCES:
CDC: “Continuing PrEP,” “Deciding to Take On-Demand PrEP,” “On-Demand Prep,” “PrEP Effectiveness.”
Human Rights Campaign: “Is PrEP Right For Me?”
New York State Department of Health AIDS Institute: “HIV Pre-exposure Prophylaxis (PrEP):
Planned Parenthood: “What is PrEP?”
PrEP Daily: “Tops, Bottoms, and PrEP: What You Need to Know about HIV Prevention.”
