PrEP, an acronym for Pre-Exposure Prophylaxis, represents a significant advancement in HIV prevention strategies. It involves medications taken by individuals who are at risk of HIV to prevent contracting the virus through sex or injection drug use. PrEP works proactively to impede HIV from establishing itself and spreading within the body if exposure occurs.
Currently, the landscape of PrEP includes both daily oral medications and long-acting injectable options, all approved by the Food and Drug Administration (FDA). These options provide effective means for individuals to take control of their health and significantly reduce their risk of HIV acquisition.
Why is PrEP a Crucial Prevention Tool?
The effectiveness of PrEP in preventing HIV is well-documented and substantial when taken as directed.
When adhered to consistently, PrEP demonstrates an impressive efficacy in preventing HIV transmission through sexual activity, reducing the risk by approximately 99%. For individuals who inject drugs, consistent PrEP use lowers the risk of HIV acquisition by at least 74%. It’s crucial to emphasize that the protective benefits of PrEP are significantly diminished if it is not taken regularly and as prescribed.
Individuals committed to prescribed PrEP and regular healthcare provider visits for follow-up.
Alt text: An illustration depicting diverse individuals diligently taking PrEP medication and attending regular check-ups with healthcare providers, emphasizing the commitment required for effective HIV prevention.
Determining if PrEP is Suitable for You
PrEP is a valuable prevention method for individuals who are HIV-negative and meet certain risk criteria. Consider PrEP if you:
- Have engaged in anal or vaginal sex within the past 6 months, and:
- Have a sexual partner known to be HIV-positive, particularly if their viral load is unknown or detectable.
- Have not consistently used condoms during sexual encounters.
- Have been diagnosed with a sexually transmitted infection (STI) within the last six months.
- Inject drugs and:
- Share injection equipment, such as needles or syringes, with others.
- Have an injection partner who is HIV-positive.
Furthermore, even if none of the above risk factors apply directly to your situation, you may still consider PrEP as a proactive health measure. Consulting with your healthcare provider is recommended to discuss your individual circumstances and determine if PrEP aligns with your needs and health goals.
For individuals with an HIV-positive partner who are planning pregnancy, it is especially important to discuss PrEP with a doctor. PrEP can be a vital tool in protecting both the HIV-negative partner and the baby from HIV transmission during attempts to conceive, throughout pregnancy, and while breastfeeding.
Exploring FDA-Approved PrEP Medications
PrEP is available in both pill and injectable forms, offering flexibility to suit different preferences and lifestyles.
Currently, there are two oral medications approved for daily PrEP use. These medications combine two anti-HIV drugs into a single pill, simplifying the daily regimen:
- Descovy® (emtricitabine/tenofovir alafenamide) is indicated for sexually active men and women at risk of HIV, except for women at risk through receptive vaginal sex.
- Truvada® (emtricitabine/tenofovir disoproxil fumarate) is approved for use by at-risk men and women.
In addition to oral PrEP, a long-acting injectable form of PrEP, Apretude® (cabotegravir), has been approved by the FDA. This injectable option offers protection over a longer period, reducing the need for daily pills.
Understanding PrEP Safety and Limitations
PrEP is considered safe for most individuals. Extensive research has not revealed significant adverse health effects in HIV-negative individuals using PrEP for up to five years.
Some individuals may experience mild side effects when starting PrEP, such as nausea, diarrhea, headache, fatigue, or stomach discomfort. These side effects are typically temporary and resolve over time. If you are taking PrEP and experience persistent or bothersome side effects, it’s important to discuss them with your healthcare provider.
It is also crucial to remember that while PrEP is highly effective against HIV, it does not protect against other sexually transmitted infections (STIs). For comprehensive sexual health protection, combining PrEP with condoms is recommended to reduce the risk of other STIs.
Accessing PrEP: How to Get Started
If you believe PrEP could be beneficial for you, the first step is to consult with your doctor or any healthcare provider. PrEP is only available through prescription. Any licensed healthcare provider, not necessarily an HIV specialist, can prescribe PrEP.
Before starting PrEP, it’s essential to undergo an HIV test to confirm you are HIV-negative. Additional tests may be necessary to ensure PrEP is safe for you based on your health profile.
For individuals taking daily oral PrEP, regular follow-up appointments with a healthcare provider are necessary, typically every 3 months. These visits include repeat HIV tests, prescription refills, and ongoing monitoring. If using injectable PrEP, appointments are needed every two months for HIV testing and injections.
Navigating PrEP Access Without a Regular Healthcare Provider
If you currently do not have a healthcare provider, resources are available to help you access PrEP services. Many health clinics and community health organizations offer HIV testing, PrEP consultation, and prescription services.
Alt text: Thumbnail image of a decision tree flowchart titled “How Can I Pay for PrEP?”, designed to guide users in finding resources to afford PrEP medication and related healthcare services.
Exploring Financial Assistance for PrEP
Cost should not be a barrier to accessing PrEP. Numerous programs and initiatives are in place to support individuals in obtaining PrEP medication and related healthcare services. Utilize this decision tree to explore various options for financial assistance to cover the costs of PrEP.
Understanding Insurance Coverage for PrEP
In most instances, the expenses associated with PrEP medication and necessary healthcare services are covered by health insurance.
The Affordable Care Act (ACA) mandates that most health insurance plans cover PrEP without cost-sharing. As a preventive service, PrEP should be accessible without co-payments or co-insurance, even if your annual deductible has not been met. This means that your PrEP medication, clinic visits, and required lab tests should be covered at no out-of-pocket expense to you under most plans. This coverage extends to private health insurance obtained through employers or purchased individually, plans from the HealthCare.gov or state marketplaces, and Medicaid expansion programs. Traditional Medicaid programs in some states also provide PrEP coverage at no cost.[1] However, Medicare Part D prescription drug plans may involve some cost-sharing for PrEP medication.
To confirm the specifics of your health plan’s PrEP coverage, contact your insurance provider directly.
Options for Uninsured Individuals or Those Facing Affordability Challenges
If you lack health insurance or Medicaid coverage, or still face difficulties affording PrEP despite insurance, various resources can provide financial assistance. Patient assistance programs offered by pharmaceutical companies, state and local health department programs, and non-profit organizations can help cover the costs of PrEP medication, clinic visits, and necessary tests.
Expanding Your Knowledge About PrEP
For further information and resources on PrEP, visit the CDC’s PrEP Basics page.
Enhance your understanding by watching and sharing KFF’s Greater Than HIV and CDC’s Let’s Stop HIV Together Ask Me Anything About HIV video series, featuring PrEP basics and PrEP videos designed for healthcare providers. Explore their Powered by PrEP videos to hear personal stories from individuals using PrEP and how it has empowered them to prioritize their health.
Utilize the HIV Services Locator to find PrEP providers and other HIV-related services in your vicinity.
[1] California, Colorado, District of Columbia, Delaware, Hawaii, Iowa, Kentucky, Louisiana, Massachusetts, Montana, Nevada, New Hampshire, New Jersey, Oregon, Washington, and Wisconsin. (NASTAD PrEP Coverage Brief, July 2021 (PDF, 205 KB))
