Introduction
In the ongoing fight against HIV, one of the most powerful tools in prevention is PrEP, or Pre-Exposure Prophylaxis. When taken correctly, PrEP can reduce the risk of getting HIV from sex by over 99% and from injection drug use by at least 74%.
Despite its proven effectiveness, PrEP is still underused—largely due to lack of awareness, misconceptions, and stigma. This article breaks down everything you need to know about PrEP: how it works, who should consider taking it, and how to access it safely.
What is PrEP?
PrEP (Pre-Exposure Prophylaxis) is a preventive medication for people who do not have HIV but are at high risk of being exposed to the virus. It involves taking an HIV medicine consistently to prevent infection before exposure occurs.
Currently Approved PrEP Medications:
- Truvada® (tenofovir + emtricitabine) – for all populations
- Descovy® (tenofovir alafenamide + emtricitabine) – for men and transgender women; not approved for people assigned female at birth for receptive vaginal sex
- Apretude® – a long-acting injectable PrEP given every two months (after an initial startup period)
How Does PrEP Work?
PrEP works by building up protective levels of HIV-fighting medication in your bloodstream and tissues. If HIV enters the body, the drug is there to block the virus from taking hold and replicating.
- When taken daily, or as prescribed, it creates a protective barrier.
- For people at risk, it dramatically lowers the chances of HIV infection, even if exposed.
Who Should Consider Taking PrEP?
PrEP is recommended for individuals who are HIV-negative and have a substantial risk of acquiring HIV. You might benefit from PrEP if you:
Sexual Risk Factors:
- Have a sexual partner who is HIV-positive (especially if they are not virally suppressed)
- Don’t consistently use condoms with partners of unknown HIV status
- Have had a recent sexually transmitted infection (STI)
- Are a man who has sex with men (MSM)
- Engage in commercial sex work
Injection Drug Use Risk Factors:
- Share needles, syringes, or drug preparation equipment
- Have injection partners who are HIV-positive or of unknown status
Other Considerations:
- Recently used post-exposure prophylaxis (PEP)
- Want an extra layer of protection during sexual exploration or new relationships
- Are in a serodiscordant couple (one partner is HIV-positive)
Types of PrEP and How to Take It
1. Daily Oral PrEP (Pill Form)
- Truvada: approved for all genders and transmission types
- Descovy: approved for men and transgender women (not for vaginal sex)
- Must be taken once per day to maintain effectiveness
- Protection levels:
- After 7 days of daily use for receptive anal sex
- After 21 days for receptive vaginal sex or injection drug use
2. Event-Based PrEP (“2-1-1” Method)
- Suitable only for men who have sex with men
- Involves taking:
- 2 pills 2–24 hours before sex
- 1 pill 24 hours after the first dose
- 1 more pill 24 hours after the second dose
- Must be used consistently for effective protection
3. Injectable PrEP (Apretude)
- Given as an injection every two months
- Ideal for those who prefer not to take daily pills
- Requires an initial 2-month lead-in with oral medication to assess tolerance
Benefits of PrEP
- Highly effective at preventing HIV when used correctly
- Discreet and flexible options (daily pills or injections)
- Offers peace of mind in relationships with HIV-positive partners
- Helps reduce anxiety around sex and intimacy
Is PrEP Safe?
Yes. PrEP is considered very safe for most people. Like all medications, some side effects may occur, especially in the first few weeks.
Common side effects (usually temporary):
- Nausea
- Headache
- Fatigue
- Mild stomach upset
Monitoring:
- Regular check-ups (every 3 months) for:
- HIV testing
- Kidney function
- STI screening
- Medication refills
If you take PrEP, staying engaged in medical follow-up is essential for safety and continued protection.
Myths About PrEP – Debunked
Myth: PrEP is only for gay men
Fact: PrEP is for anyone—regardless of gender or sexuality—who is at risk of HIV.
Myth: PrEP encourages risky behavior
Fact: Studies show that PrEP users often increase STI testing and engage in safer practices.
Myth: PrEP protects against all STIs
Fact: PrEP protects against HIV only. It does not prevent syphilis, gonorrhea, or other STIs—use condoms for full protection.
Accessing PrEP: How to Get Started
- Talk to a healthcare provider
- Ask for an HIV test and PrEP eligibility screening.
- Find a PrEP clinic or program near you
- Many sexual health clinics, LGBTQ+ health centers, and community organizations offer PrEP.
- Explore payment assistance
- PrEP is covered by most insurance plans.
- Programs like Ready, Set, PrEP (U.S.) and manufacturer assistance may help if you’re uninsured.
- Commit to regular follow-ups
- Check-ins every 3 months for safety and testing
Conclusion
PrEP is a groundbreaking tool in the prevention of HIV. Whether you’re in a high-risk group or simply want added protection, PrEP empowers you to take control of your sexual health with confidence.
By understanding how it works, who it’s for, and how to use it correctly, you can make informed choices to stay safe and support a future without new HIV infections.
FAQs
Is PrEP 100% effective?
No, but it’s over 99% effective at preventing HIV from sex when taken correctly.
Do I have to take PrEP forever?
No. You can stop PrEP when your risk level changes—but do so under medical guidance.
Can women use PrEP?
Yes. Truvada is approved for all people at risk, including cisgender and transgender women.
Does PrEP protect against other STIs?
No. It protects against HIV only. Use condoms to prevent other sexually transmitted infections.
What if I miss a dose?
Missing one dose occasionally may not greatly reduce protection, but consistency is key. Talk to your provider if you miss multiple doses.
