All About PrEP, The Pill For HIV Prevention

What is PrEP?

PrEP stands for pre-exposure prophylaxis, and it is a pill that is taken by mouth for HIV prevention. For PrEP to work, it must be taken for at least 7 days before HIV exposure for men, and at least 21 days before HIV exposure for women.

Pre-exposure pills are not a new concept: they have been used for other conditions. If you’re traveling to a country where malaria is common, for example, your doctor will prescribe medication that you begin taking before traveling to prevent yourself from contracting malaria. Birth control pills are also a form of pre-exposure medication, as they prevent pregnancy.

How is PrEP prescribed?

It is prescribed as a pill that is taken once a day, with or without food, at the same time every day.

Are there any side effects?

PrEP could potentially contribute to decreased bone density, or the thinning of bones, so it’s important to have it monitored by a doctor. People who have kidney disease must also be carefully monitored by their doctor when taking PrEP, as it could influence kidney function.

How effective is PrEP?

The Centers for Disease Prevention and Control (CDC) says that when taken daily, PrEP is about 99% effective at preventing HIV from sex, and about 74% effective at preventing HIV in people who inject drugs. PrEP is less effective when taken inconsistently.

Who should consider getting a prescription for PrEP?

The CDC has guidelines to determine who is at risk for contracting HIV:

• Men who have sex with men.
• Someone who is in a sexual relationship with someone else who is infected with HIV.
• Male-to-female and female-to-male transgender people who have unprotected anal intercourse.
• People who have sex for money, drugs or housing (or other transactional reasons).
• People who use drugs who share injection equipment.
• People who use stimulant drugs, like methamphetamine.
• People who have had at least one sexually transmitted infection within the last year.
• People who have taken non-occupational post-exposure prophylaxis (nPEP), especially several courses of it. (nPEP is taken after exposure to HIV. It must be taken within 72 hours of exposure in order to be effective.)

Is there a maximum length of time PrEP should be taken?

There is really no length of time PrEP is meant to be taken—it should be taken as long as the person is at high risk for contracting HIV. If someone decides to stop taking PrEP, they should wait until at least four weeks after their last significant exposure to HIV.

How long has PrEP been in use?

PrEP was approved for use by the Food & Drug Administration (FDA) in 2012.

How can I get a prescription?

Find a primary care doctor or HIV specialist you are comfortable with who prescribes PrEP and start a discussion with them, saying you’d like to be on the medication that prevents HIV infection. Be honest with your doctor and let them ask the questions they need to know in order to prescribe it to you.