PrEP Care

Whats prep?


PrEP works by maintaining a level of these medications in the bloodstream that is sufficient to prevent HIV from replicating and spreading throughout the body. When taken consistently, PrEP is highly effective at reducing the risk of HIV infection.

Pre-exposure prophylaxis (PrEP) is a preventive treatment for individuals who are at high risk of contracting HIV. PrEP involves taking a daily pill that contains two antiretroviral medications, tenofovir and emtricitabine, which help prevent the virus from establishing a permanent infection if the person is exposed to it.

FAQs About PrEP

  • Are you 18 or older?
  • Are you HIV negative?
  • Are you sexually active?
  • Do you have sex with people whose HIV status you don’t know?
  • Are you in a relationship with an HIV-Positive partner?
  • Do you or your partner inject drugs?
  • If you answered YES to any of the questions above, then PrEP may be for you

It takes a few days for HIV to become established in the body following exposure. When taken as PrEP, HIV medications block the virus from making copies of itself and spreading throughout the body. People who use PrEP must commit to taking the drug every day and seeing their healthcare provider for follow-up appointments and testing.

When taken as prescribed, PrEP has been shown to be more than 90 percent effective against contracting HIV. PrEP is much less effective if it is not taken daily.

PrEP should be taken once every day, ideally at the same time of day. Daily adherence is essential to maintaining PrEP’s effectiveness.

It takes at least seven days of daily use for PrEP to reach full effectiveness during anal sex. For vaginal sex, it takes at least twenty days of daily use.

PrEP is safe, and the regimen is generally well-tolerated. The pill used for PrEP, Truvada, has been used to treat people living with HIV since 2004. PrEP can cause mild side effects, including upset stomach, headaches and weight loss, especially at the beginning of the regimen. Rare side effects include kidney or bone problems. Talk to a knowledgeable healthcare provider if you are especially concerned about side-effects.

While PrEP does not protect against other STIs or unwanted pregnancy, it can be paired with condoms to provide additional protection during sex. It’s also important to remember that STIs remain relatively easy to treat or cure in the United States.

While more research is needed, PrEP appears to work for those taking gender-affirming hormones when taken exactly as prescribed.

No. With proper medical guidance, people can safely start and stop taking PrEP at different points in their lives. However, anytime you start PrEP, it is important to remember that it generally takes at least seven to twenty days of daily use for it to reach full effectiveness. Be sure to consult a knowledgeable healthcare provider before starting or ending a PrEP regimen.

Generally, PrEP is for people who do not have HIV but who are more likely to encounter it, including anyone who is in an ongoing relationship with a partner living with HIV, anyone who does not consistently use a condom when having sex or anyone who shares injection drug or hormone equipment. Studies have shown that PrEP can be hugely beneficial for people of various gender identities and sexual orientations.

There are several steps you can take to reduce the chances of contracting HIV, including:

  • Use Condoms. Find the right size and choose a type of condom you like.
  • Use Lube. Use water-based or silicone-based lubricant – particularly for anal or vaginal sex – to prevent tears in the skin and to keep condoms from breaking.
  • Get Tested. It’s the only way to know if you or a partner has HIV.
  • Test and Treat STIs. Having an active STI, or even a history of certain STIs, can make it easier to acquire or transmit HIV.
  • Talk to Your Partners. Ask sexual partners about the last time they got tested for HIV and other STIs. Consider getting tested together.
  • Be mindful of drug and alcohol use. Substance use can increase your chances of acquiring HIV directly and indirectly, depending on the circumstances.
  • Change Syringes. If you inject hormones, drugs or steroids, use a new, clean syringe and other injection equipment every time.
  • Know about PEP. PEP is an HIV prevention strategy that can be used in emergency situations, such as condomless sex with someone whose HIV status you do not know.

While Truvada® as PrEP is expensive, most private insurance covers it. Medicaid covers PrEP in the District of Columbia. If you don’t have insurance, Gilead, the pharmaceutical company that makes Truvada®, offers a Medication Assistance Program. For more on this program click here. If you don’t have health insurance, MetroHealth can assist you with applying for health insurance and then make a referral for PrEP.