PrEP to Prevent HIV

Daily PrEP

• Medicines to use: Truvada (available as a generic) or Descovy
• Who can take it: Anyone can take Truvada as daily PrEP. Descovy has not been approved for people who may have receptive vaginal sex.
• When to take it: Every day
• Planning around sex: None
• If you miss a pill or injection: Protects during anal sex even if you occasionally miss a pill. May not protect as well during receptive vaginal sex if you miss pills.

PrEP on Demand

• Medicines to use: Truvada
• Who can take it: Only shown effective for cisgender men who have sex with men. Not for people having receptive vaginal sex.
• When to take it: Before sex and then every day until two days after you last have sex
• Planning around sex: Must take first dose two to 24 hours before sex — closer to 24 hours is better
• If you miss a pill or injection: You must take each pill as prescribed. Use condoms if you are unable to take a pill in time, or emergency PEP if you miss a dose.

Injectable PrEP

• Medicines to use: Apretude
• Who can take it: Anyone who may be exposed to HIV during sex
• When to take it: Every two months
• Planning around sex: None
• If you miss a pill or injection: If you delay a scheduled injection by more than seven days, you must take the medicine in pill form until your next injection.

In New York State, PrEP is covered by Medicaid and most health insurance plans without any co-pays for medicines, lab work or clinic visits.

Ask your clinic about patient assistance programs that help people who are uninsured or undocumented pay for PrEP.

Learn more about your Payment Options for PrEP (PDF).

Consider taking PrEP if you do not have HIV and any of the following apply to you. If you:

• Are worried you may be exposed to HIV
• Do not always use condoms during sex
• Recently had a sexually transmitted infection (STI)
• Recently took emergency PEP to prevent HIV
• Inject drugs and share syringes or other injection equipment
• Have a partner who has HIV and a detectable or unknown viral load
• Have a partner who may have HIV or who refuses to get an HIV test

If you take PrEP and are exposed to HIV, the medicine in PrEP stops the virus from spreading throughout your body.

PrEP only stops HIV if you have enough medicine in your body, so you need to take it as prescribed.

When taken as prescribed, PrEP reduces the risk of getting HIV through sex by about 99%. In rare cases, people have gotten HIV despite taking PrEP as prescribed.

To prevent other STIs, get tested regularly and use condoms correctly and consistently.

To prevent pregnancy, use birth control.

The medicines used for PrEP are safe. Truvada has been used to treat people with HIV since 2004 and has been used for PrEP since 2012. Clinical trials have shown that Descovy and Apretude are also safe medicines.

Most people on PrEP do not report any side effects. The most common side effects are nausea, upset stomach, fatigue and headaches. These symptoms often get better or go away within the first month or two of taking PrEP. PrEP injections may cause swelling or redness at the injection site. Rare side effects of PrEP include kidney or bone problems.

Your health care provider can help you manage any side effects.

PrEP protects you against HIV as long as you take it as prescribed. Tell your provider if anything makes it difficult for you to take PrEP.

Talk to your provider before you stop taking PrEP. You will need to use another method to prevent HIV.

In New York State, you can get PrEP or other sexual health services without a parent’s permission, including at NYC Sexual Health Clinics. Learn about your rights and steps you can take (PDF) to keep your PrEP prescription or other sexual health services confidential.

PrEP is a safe and effective HIV prevention option for women.

Truvada pills and injectable Apretude are approved for cisgender women and transgender women, and Descovy is approved for transgender women. Descovy may not be appropriate for cisgender women or transgender men because of a lack of research on how well it prevents HIV during receptive vaginal sex.

People who have receptive vaginal sex need to be especially careful to take PrEP pills every day to maintain enough medicine in their vaginal tissue to prevent HIV.

There is no evidence that PrEP interacts with estrogens or affects the levels of hormones in your body. Research has found that transgender women who take PrEP as prescribed are protected from HIV.

Research shows that PrEP does not interfere with any kind of birth control.

PrEP protects people who are pregnant from getting HIV, which protects their fetus and baby from being exposed to HIV during and after pregnancy.

PrEP is safe to use during and after pregnancy and has not been shown to affect fertility.

If you would like to take PrEP while trying to conceive, talk to your health care provider.