Locations:
Search IconSearch

PrEP Offers Everyone Protection From HIV

Like the flu shot or the HPV vaccine, PrEP is a preventative medicine designed to protect your health

Hand holding blue PrEP pill

Risk assessment is a huge part of living. Every day, we make decisions to protect ourselves from illness and prolong our health. We get the flu shot to reduce your risk for influenza. We take birth control to prevent unplanned pregnancy. And now we can take pre-exposure prophylaxis, or PrEP, to protect ourselves from HIV infection.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

PrEP is a relatively new medicine, though, so there are a ton of questions people have about who should take it, how it works and how it affects your body. Internal medicine specialist James Hekman, MD, answers those questions and explains why PrEP is really meant for anyone who currently doesn’t have HIV and is at higher risk for infection.

What is PrEP?

PrEP is a preventative medicine that blocks the HIV virus from taking hold within your body. There are currently two forms of daily oral medications for PrEP and one long-acting injectable form of PrEP. These three forms of PrEP are:

  • Truvada® is a daily pill that combines two medications called tenofovir disoproxil and emtricitabine. It’s for anyone who weighs at least 77 pounds and is at risk of contracting HIV. It’s also available in generic form.
  • Descovy® is a daily pill that combines two medications called tenofovir alafenamide and emtricitabine. It’s for sexually active cisgender men and people assigned male at birth (AMAB) who weigh at least 77 pounds. It’s not for people assigned female at birth (AFAB) who are at risk of getting HIV through vaginal sex, as there are currently no studies on the effectiveness of Descovy in these populations. The generic form of Descovy is not currently available in the U.S.
  • Apretude® is the brand name of medication called cabotegravir, which is a prescribed injection you receive every two months from your doctor. The FDA approved it for use in December 2021, and no generic form is currently available. But this form of PrEP is particularly helpful for adolescents 12 and older and adults who weigh at least 77 pounds who have difficulties keeping up with daily medications.

Advertisement

Why should you consider PrEP?

The human immunodeficiency virus, or HIV, is a sexually transmitted infection (STI) that attacks your immune system, which can make it difficult for your body to fight off illness. HIV enters your body through broken skin (like a cut or open wound), your anus, penis or vagina. The infection, itself, is carried by these body fluids:

  • Blood
  • Semen
  • Cervical secretions
  • Rectal fluids
  • Breast milk

Globally, 44% of all new HIV infections in 2023 were among women and girls of all ages. Men who have sex with men, transgender women and people of color continue to be most affected by HIV. But anyone of any gender or sexual orientation can get an HIV infection at any age.

For these reasons, PrEP can be a useful tool to preventing the spread of HIV before anyone is ever even exposed to it.

“PrEP is presently being offered to many people in many individual circumstances,” says Dr. Hekman. “Anyone who has a greater than average chance of acquiring HIV due to sexual contact or IV drug use should consider speaking with their doctor about a prescription for PrEP.”

Who is PrEP for?

Anyone who doesn’t have HIV can be on PrEP. If you’re curious or interested in using PrEP as a preventative medication, talk to your primary care doctor. They can answer any questions you have about the medication.

They may recommend you go on PrEP if you:

“Several new HIV infections have been acquired in relationships that were thought to be monogamous, so being in a relationship does not exclude someone from considering PrEP,” adds Dr. Hekman. “If you think you may be at risk, please contact your provider for additional discussion.”

How to take PrEP

Before you can start taking PrEP, your healthcare provider will have you take an HIV test. If you test negative, that means you likely don’t have HIV and can begin taking PrEP as a preventative medicine.

You should be on PrEP for one, in most cases, in order for it to start working. For receptive vaginal sex and injection drug use, PrEP pills reach maximum protection at about 21 days of use. To maximize your protection from HIV, you have to be sure to take every dose. Simply put, Dr. Hekman says, “PrEP is incredibly effective, but only if you take it as prescribed.”

HIV.gov reports that when taken correctly, the pill forms of PrEP reduce the risk of getting HIV from sex by about 99%, and it reduces the risk of getting HIV from injection substance use by at least 74%. But the medication isn’t nearly as effective if it isn’t taken consistently, so be sure to set those daily reminders.

Advertisement

As part of the requirement for taking PrEP, you’ll need to get tested for HIV:

  • Every 2-3 months if you’re taking oral PrEP
  • Every 8 weeks if you’re taking injectable PrEP

Side effects of taking PrEP

PrEP is considered safe, but you may experience some side effects at first. They should go away on their own, but talk to your healthcare provider if you continue experiencing these symptoms:

  • Nausea
  • Diarrhea
  • Headache
  • Fatigue
  • Stomach pain

If you have kidney disease or a history of hepatitis B, be sure to tell your healthcare provider. It may impact whether you’re able to take PrEP.

Does PrEP prevent STIs?

“PrEP does not prevent the spread of other STIs,” Dr. Hekman says. “It only prevents the spread of HIV.”

You can (and should) pair PrEP with condom use for the best chances of reducing your risk for any STIs. Embracing safer sex practices can also be helpful when preventing STIs, too.

Will PrEP interfere with hormone therapy?

PrEP should not affect gender-affirming hormone therapy. In fact, PrEP is effective for transgender women. And because the transgender population is at high risk for HIV, it’s important to work with a doctor who can ensure you remain on hormone therapy and guard yourself against HIV.

Talk to your doctor about PrEP

PrEP is a pre-exposure medication, which means that in order for it to do its job, you need to be taking it before you’re exposed to HIV. That means PrEP is not the right medication to take if you’ve been exposed to HIV and want to reduce your chance of infection.

Advertisement

If you’ve been exposed to HIV and aren’t already on PrEP, see a doctor — whether your primary care physician or at an emergency room or urgent care facility — within 72 hours. They can prescribe post-exposure prophylaxis (PEP), medication to prevent HIV after exposure. Unlike PrEP, PEP is used in emergency exposure situations.

PrEP is only available by prescription, so if you’re interested in starting it, make an appointment to speak with your healthcare provider. If you’re looking for someone who is trained in health issues specific to the LGBTQIA+ community, there are many nationwide health services and other ways to find an LGBTQIA+ doctor’s office near you.

If you’re concerned about how to pay for PrEP, be sure to ask your doctor about that, too. Most insurance companies and state Medicare plans cover PrEP, and other options are available for those who qualify.

Advertisement

Learn more about our editorial process.

Related Articles

Glass of water on table, with medicine bottle of purple capsules, and capsules on table
November 27, 2024/Infectious Disease
Can Melatonin Help Treat COVID-19?

Studies have shown promising results, but additional research is needed

Older male reclining on couch, blowing nose, with cold medications and products on coffee table
What’s the Difference Between Walking Pneumonia and Pneumonia?

Walking pneumonia is milder and doesn’t always require medication — but it’s also highly contagious

Healthcare provider examining person's throat in office, with oversized germs around
November 21, 2024/Infectious Disease
How Laryngitis and COVID-19 Can Impact Your Voice

Infection and inflammation can cause you to lose your voice and have other voice changes until you’re fully healed

Person lying stomach down on bed, head on crossed arms, staring into the distance
Having COVID-19 May Increase Your Risk of Depression

A COVID-19 infection can bring on depression or anxiety months after physical symptoms go away

Person in mask and medical coveralls handling COVID-19 vials with gloved hands
November 14, 2024/Infectious Disease
COVID-19 Variants: What’s New and Why We’re Still Concerned

Just like the flu, COVID-19 continues to evolve every year with new and smarter variants

Scientist/lab tech in lab wearing mask and white coat working, with test tubes on counter
November 11, 2024/Infectious Disease
FLiRT COVID Variants: What To Know

The latest omicron subvariants carry specific mutations that may allow the SARS-CoV-2 virus to be better at evading immune protection

Female reclining on couch holding laptop, having video appointment with healthcare provider
November 8, 2024/Sex & Relationships
Dealing With Vaginal Rips and Tears After Sex

Most tears down there are mild and heal on their own, but some require medical treatment

Male sitting on edge of bed with head in hands, distressed, with female sitting in bed, with germs floating around
November 7, 2024/Infectious Disease
Can COVID-19 Cause Erectile Dysfunction?

Research shows the virus can affect your ability to get or maintain an erection

Trending Topics

Person sitting on floor at night next to bed in deep thought, with partner sleeping in bed
Understanding Mental Load: What It Is and How It Affects You

When you get bogged down with mental tasks, you can experience mood changes, sleeplessness and more

Hands holding two different kinds of pain medications separated by a white line
Can You Take Acetaminophen and Ibuprofen Together?

You can alternate these OTCs to help with pain management and fever reduction

Smiling person with headphones on, sweeping floor in living room
Understanding Non-Exercise Activity Thermogenesis (NEAT Exercise)

Non-exercise activity thermogenesis is all the activity we do that’s not technically exercise but is still important to your health and well-being

Ad