Everything You Need to Know About PrEP

In today’s world, information and prevention are some of our most powerful tools against HIV. Whether you’ve recently heard about PrEP from a friend, a healthcare provider, or online, chances are you have questions. What is it? Who is it for? How does it work? And most importantly, can it help protect you or someone you care about?

 

What Is PrEP?

PrEP stands for pre-exposure prophylaxis, a daily or on-demand medication regimen designed to prevent HIV before exposure happens. Think of it as a shield that helps protect people at higher risk of HIV infection.

Currently, there are two FDA-approved oral PrEP medications:

  • Truvada® (emtricitabine + tenofovir disoproxil fumarate)

  • Descovy® (emtricitabine + tenofovir alafenamide)

There’s also a newer long-acting injectable form of PrEP called Apretude® (cabotegravir), which is given every two months.

When taken correctly, PrEP reduces the risk of getting HIV from sexual contact by up to 99% and from injection drug use by at least 74%.

How Does PrEP Work?

HIV infects the body by attacking CD4 cells (a type of immune cell). PrEP works by building up medication in your bloodstream and tissues, creating a barrier that prevents HIV from establishing a permanent infection if exposure occurs.

  • Oral PrEP (pills): Needs to be taken consistently (daily or as prescribed).

  • Injectable PrEP: Provides sustained protection with fewer adherence concerns.

The effectiveness of PrEP largely depends on adherence—meaning taking the medication as directed. Skipping doses can lower its protective effect.

Who Should Consider PrEP?

PrEP is recommended for individuals who are HIV-negative but may be at higher risk of exposure. This includes:

  • People with a sexual partner who is HIV-positive.

  • Gay and bisexual men with multiple partners or who do not consistently use condoms.

  • Heterosexual men and women who have partners at higher risk.

  • People who inject drugs and share needles.

  • Anyone who has recently had a sexually transmitted infection (STI).

The bottom line: if you are worried about your risk, talking to a healthcare provider about PrEP is a smart step.

Different Ways to Take PrEP

  1. Daily PrEP Pills

    • Best for consistent, ongoing protection.

    • Recommended for most people at risk.

  2. On-Demand PrEP (2-1-1 dosing method)

    • Used mainly by gay and bisexual men.

    • Involves taking 2 pills before sex, 1 pill 24 hours later, and 1 pill 48 hours later.

    • Not officially approved by the CDC but supported by some studies in Europe.

  3. Injectable PrEP

    • Administered every 2 months by a healthcare provider.

    • Great option for people who struggle with daily pill-taking.

How Effective Is PrEP?

  • Sexual exposure: Up to 99% effective when taken consistently.

  • Injection drug use: At least 74% effective.

  • Combined with condoms: Offers even greater protection, not only against HIV but also other STIs like gonorrhea, chlamydia, and syphilis.

It’s important to remember: PrEP prevents HIV, but not other STIs or pregnancy.

Side Effects of PrEP

Most people tolerate PrEP well, but some may experience mild side effects, especially in the first few weeks. These can include:

  • Headache

  • Nausea

  • Fatigue

  • Stomach discomfort

These usually resolve on their own. Long-term use may require monitoring of kidney and bone health (especially with Truvada).

Healthcare providers typically order lab tests every 3 months to ensure everything stays on track.

Getting Started With PrEP

Here’s what the process usually looks like:

  1. HIV Test: You must be HIV-negative to start PrEP.

  2. Kidney Function Test: To ensure PrEP is safe for you.

  3. Prescription: Your doctor prescribes daily pills or injectable PrEP.

  4. Regular Follow-ups: Every 3 months for HIV testing and prescription refills.

How Much Does PrEP Cost?

The cost depends on where you live and whether you have insurance. The good news:

  • In the U.S., most insurance plans (including Medicaid) cover PrEP.

  • There are patient assistance programs from Gilead and other organizations that help uninsured people access PrEP for free or at low cost.

  • Community clinics and LGBTQ+ health centers often provide PrEP support services.

No one should have to skip PrEP because of cost—resources exist to help.

Common Myths About PrEP

🔹 Myth 1: PrEP is only for gay men.
Fact: PrEP is for anyone at risk of HIV, regardless of sexual orientation or gender.

🔹 Myth 2: Taking PrEP means you don’t need condoms.
Fact: PrEP protects against HIV, but condoms still prevent other STIs and pregnancy.

🔹 Myth 3: PrEP is dangerous long-term.
Fact: Studies show PrEP is safe, and regular check-ups ensure any issues are detected early.

Why PrEP Matters

HIV is no longer the life-threatening diagnosis it once was, but prevention is still key. PrEP gives people more control over their health, reduces stigma, and helps communities move closer to ending new HIV infections.

For many, starting PrEP means more than just taking a pill—it’s about peace of mind, empowerment, and living with less fear.

Practical Tips for Staying on PrEP

  • Set a daily reminder on your phone for pill-taking.

  • Pair it with a routine (like brushing your teeth).

  • Talk openly with your healthcare provider about concerns.

  • Join support groups (in person or online) to stay motivated.

The Future of PrEP

Scientists are actively developing new forms of PrEP, including:

  • PrEP implants (long-term protection, similar to contraceptive implants).

  • Monthly oral PrEP options.

  • Multipurpose prevention pills that combine HIV protection with contraception.

These innovations aim to make PrEP more accessible and adaptable to different lifestyles.

Final Thoughts

PrEP has changed the conversation around HIV prevention. It’s highly effective, safe, and increasingly accessible. Whether you’re considering it for yourself or supporting a loved one, the key is getting informed and talking to a healthcare professional.

Your health and peace of mind are worth it.