PrEP is about HIV Prevention


PrEP is short for Pre-Exposure Prophylaxis, a medication that when taken consistently is effective at preventing you from contracting HIV through sexual contact, if you are exposed. It’s one of many HIV prevention tools. PrEP does not prevent or treat STIs or any other medical condition.

Although PrEP reduces the risk of getting HIV from sex by more than 90% when taken regularly, people still need to practice safe sex by using condoms consistently.

For one thing, there’s still a limited chance of acquiring HIV even while on PrEP. And the medications do not prevent other sexually transmitted diseases, such as hepatitis B, hepatitis C, human papillomavirus (HPV), gonorrhea and chlamydia.

PrEP certainly works, but it’s not a magic pill against all STIs. We need to make sure they can enjoy sex and also minimize as much as possible the risk of infections.

PrEP provides maximum protection from HIV after seven days of daily use for receptive anal sex. For receptive vaginal sex and risk due to sharing needles, PrEP is most effective after 21 days. “Taking it consistently is the key to success.

Studies have shown that the risk of contracting HIV was 99% lower for those who took PrEP than those who didn’t. When you take PrEP as prescribed, it provides significant protection against HIV. Such protection is much more effective when you use condoms and other preventative methods. PrEP does not prevent you from contracting other STIs.

PrEP is highly effective for preventing HIV.

PrEP reduces the risk of getting HIV from sex by about 99% when taken as prescribed.

Although there is less information about how effective PrEP pills are among people who inject drugs, we know that PrEP pills reduce the risk of getting HIV by at least 74% when taken as prescribed. Currently, PrEP shots are not recommended for people who inject drugs.

PrEP is less effective when not taken as prescribed.

PrEP can help protect you if you don’t have HIV and any of the following apply to you:

  • You have had anal or vaginal sex in the past 6 months and you:
  • have a sexual partner with HIV (especially if the partner has an unknown or detectable viral load),
  • have not consistently used a condom, or
  • have been diagnosed with a sexually transmitted disease in the past 6 months.

You inject drugs and you:

  • have an injection partner with HIV, or
  • share needles, syringes, or other drug injection equipment (for example, cookers).

You have been prescribed PEP (post-exposure prophylaxis) and you:

  • report continued risk behavior, or
  • have used multiple courses of PEP.

You may choose to take PrEP, even if the behaviors listed above don’t apply to you. Talk to your health care provider.

For receptive anal sex (bottoming), PrEP pills reach maximum protection from HIV at about 7 days of daily use.

For receptive vaginal sex and injection drug use, PrEP pills reach maximum protection at about 21 days of daily use.

No data are available for PrEP pill effectiveness for insertive anal sex (topping) or insertive vaginal sex.

We don’t know how long it takes for PrEP shots to reach maximum protection during sex.

PrEP pills are covered by most insurance plans, including Medicaid, but because it’s an expensive medication, some patients may encounter relatively high copays. Apretude is covered by many but not all insurance plans. Financial assistance may be available, though, through the drug manufacturers and patient advocacy organizations for all three options. It’s also recommended for intravenous drug users who share needles. “Even though it is recommended to use clean needles, if there is any chance of IV drug users sharing needles, PrEP should be considered.

PrEP can be pills or shots.

There are two pills approved for use as PrEP: Truvada® and Descovy®.

Truvada® is for people at risk through sex or injection drug use.

Descovy® is for people at risk through sex. Descovy is not for people assigned female at birth who are at risk for HIV through receptive vaginal sex.

Apretude is the only shot approved for use as PrEP. Apretude is for people at risk through sex who weigh at least 77 pounds (35 kg).

Before a doctor prescribes the medication, patients must take an HIV test to confirm they are HIV negative and have basic lab work to check kidney function.

Once on PrEP, you’ll need to see your doctor at least every three months for further monitoring if on Truvada and Descovey. Patients receiving Apretude — the newest PrEP option — begin the therapy with two initiation injections one month apart from a healthcare professional, followed by additional injections every two months. CDC guidelines recommend repeat HIV testing before each monitoring appointment. It is also recommended that patients be up to date with hepatitis B vaccination.

Talk to your health care provider about switching from PrEP pills to shots. PrEP shots may be right for you if you do not have HIV and have no known allergy to the medicines in the shot.

If you decide to switch from PrEP pills to shots, you’ll need to visit your health care provider regularly to receive your shot. You’ll also need to be tested for HIV prior to each PrEP shot.

PrEP is for people who do not have HIV but are at high risk of getting HIV. High risk patients include those who have anal or vaginal sex with multiple partners and don’t use condoms consistently, or people who have sex with a partner who has HIV.

It’s also recommended for intravenous drug users who share needles. “Even though it is recommended to use clean needles, if there is any chance of IV drug users sharing needles, PrEP should be considered.”

If you have a partner with HIV and are considering getting pregnant, talk to your health care provider about PrEP if you’re not already taking it. PrEP may be an option to help protect you and your baby from getting HIV while you try to get pregnant, during pregnancy, or while breastfeeding. It’s also recommended for intravenous drug users who share needles. “Even though it is recommended to use clean needles, if there is any chance of IV drug users sharing needles, PrEP should be considered.”

Yes. PrEP pills are approved for use by adolescents without HIV who weigh at least 77 pounds (35 kg) and at risk for getting HIV from sex or injection drug use. PrEP shots are approved for adolescents at risk for getting HIV from sex.

Talk to your health care provider if you think PrEP may be right for you. PrEP can be prescribed by any health care provider who is licensed to write prescriptions.

Before beginning PrEP, you must take an HIV test to make sure you don’t have HIV.

While taking PrEP, you’ll have to visit your health care provider routinely as recommended for:

  • follow-up visits,
  • HIV tests, and
  • prescription refills or shots.

Ask your health care provider about mail-in HIV tests and telehealth services for follow-up visits.

If you don’t have a health care provider, you can use the HIV prevention services at The McGregor Clinic.org

With telehealth (phone or video consultation with a health care provider) and mail-in HIV tests, it is possible to order a specimen collection kit which contains the supplies to do the testing required to start or continue taking PrEP pills, even if an in-person appointment is not possible. If you are receiving PrEP shots, you’ll need to visit your health care provider for your shot.

There are several reasons why people stop taking PrEP:

• Your risk of getting HIV becomes low because of changes in your life.

• You don’t want to take a pill as prescribed or often forget to take your pills.

• You can’t visit your health care provider to receive your shots routinely as recommended.

• You have side effects from the medicine that are interfering with your life.

• Blood tests show that your body is reacting to PrEP in unsafe ways.

Talk to your health care provider about other HIV prevention methods that may work better for you.

Tell your health care provider that you would like to start taking PrEP again. You will need to take an HIV test before you start PrEP to make sure you don’t have HIV.

PrEP is for people who are at ongoing risk for HIV.

PrEP is not the right choice for people who may have been exposed to HIV in the last 72 hours.

If you may have been exposed to HIV in the last 72 hours, talk to your health care provider, an emergency room doctor, or an urgent care provider about PEP (post-exposure prophylaxis).

  • You must take PrEP as prescribed for it to work.
  • If you do not take PrEP as prescribed, there may not be enough medicine in your bloodstream to block the virus.
  • The right amount of medicine in your bloodstream can stop HIV from taking hold and spreading in your body.

There are no known interactions between PrEP and hormone-based birth control methods, e.g., the pill, patch, ring, shot, implant, or IUD. It is safe to use both at the same time.

There are no known drug conflicts between PrEP and hormone therapy, and there is no reason why the drugs cannot be taken at the same time.

• PrEP provides protection from HIV but does not protect against other sexually transmitted diseases (STDs) or prevent pregnancy.

• Condoms can help prevent other STDs that can be transmitted through genital fluids, such as gonorrhea and chlamydia.

• Condoms are less effective at preventing STDs that can be transmitted through sores or cuts on the skin, like human papillomavirus, genital herpes, and syphilis.

Taking PrEP pills only when you are at risk for getting HIV is known as “on-demand” PrEP.

• It is also known as “intermittent,” “non-daily,” “event-driven,” or “off-label” PrEP use.

• The type of “on-demand” PrEP that has been studied is the “2-1-1” schedule. This means taking 2 pills 2-24 hours before sex, 1 pill 24 hours after the first dose, and 1 pill 24 hours after the second dose.

• There is scientific evidence that the “2-1-1” schedule provides effective protection for gay and bisexual men* when having anal sex without a condom.

• We don’t know how “on-demand” PrEP works for heterosexual men and women, people who inject drugs, and transgender persons.

Some health departments in the United States and some health organizations in Europe and Canada are offering guidance for “on-demand” PrEP as an alternative to daily PrEP for gay and bisexual men at risk for HIV.

Although the updated PrEP guideline provides information on how to correctly use the “2-1-1” schedule, this approach is not approved by the U.S. Food and Drug Administration (FDA) and is not recommended by CDC. Taking PrEP as prescribed is currently the only FDA-approved schedule for taking PrEP to prevent HIV. When taken as prescribed, PrEP is highly effective for preventing HIV.

Anyone considering PrEP should discuss the issue with their health care provider.

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The McGregor Clinic, Inc.

3487 Broadway Avenue, Fort Myers, FL 33901

Phone: (239) 334-9555

Fax: (239) 334-2832

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The McGregor Clinic, Inc.

3487 Broadway Avenue, Fort Myers, FL 33901

Phone: (239) 334-9555

Fax: (239) 334-2832

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Disclaimer: Messages are not encrypted and should not contain medically protected health information. This option is NOT for rendering URGENT medical advice or professional services. Most often, a reply via phone call would take 1-2 business days. If you need a reply sooner, please call our office at 239-334-9555. If you have a medical emergency, please call 911.

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