PrEP Resource

What is PrEP?

PrEP, or pre-exposure prophylaxis, is a medicine you can take to prevent getting HIV from sex or injection drug use. It contains medicines that stop HIV before it can spread in your body.

There are now four different options for PrEP, including pills and injectable medications. PrEP, when paired with other harm-reduction measures, is one of several effective ways to reduce your risk of getting HIV.

Who Should Take PrEP?

Studies have shown that PrEP effectively prevents HIV in many different groups of people, including those at risk from sexual activity or injection drug use.

While PrEP is often discussed as part of gay men’s healthcare, it’s not just for this population. PrEP is currently recommended for people who:

  • Have had anal or vaginal sex in the past 6 months, and:
    • have a sexual partner living with HIV (especially if it is not controlled or you do not know if it is), or
    • do not consistently use condoms, or
    • have been diagnosed with an STI in the past 6 months.
  • Inject drugs and
    • have an injection partner living with HIV, or
    • share needles, syringes, or other injection equipment.

PrEP could also be considered after taking a regimen for post-exposure prophylaxis (a month-long treatment started after being exposed to HIV), as a part of pregnancy planning if your partner has HIV, and even just based on your own preferences in consultation with your healthcare provider.

Does PrEP Work?

PrEP is very effective at reducing HIV infection. In clinical trials, PrEP has been shown to reduce the risk by 99% in those who take it for sexual exposure and by 74% in those who take it for risk due to injection drugs. It is important to note that taking it as prescribed is very important, as the effectiveness decreases significantly if not taken consistently. This is particularly true if you receive vaginal sex. 

Please note that PrEP is only effective in reducing HIV transmission and has no activity against any other STIs. PrEP is recommended as part of a strategy that still includes safe sexual practices like wearing condoms. You may want to talk with your doctor about other strategies to decrease your risk of getting any other STIs (such as DoxyPEP).

What Options Are Available for PrEP?

There are currently two different pills and two different injectable medications available for PrEP. Which option is right for you depends on your preferences as well as your specific risk.

The two pills approved for PrEP are Truvada and Descovy. They contain two medications that are active against HIV. This is not a full treatment regimen, as most people living with HIV will require three active medications. 

  • Truvada® (emtricitabine/tenofovir disoproxil fumarate) is for all people at risk for HIV through sex or injection drug use. Generic versions are also available.
  • Descovy® (emtricitabine/tenofovir alafenamide) is for sexually active cisgender men and transgender women at risk of getting HIV. Descovy® is not approved for cisgender women or transgender men who are at risk for HIV through receptive vaginal sex.

There have been other regimens for PrEP that have been studied for people who infrequently have sex, such as “On-Demand PrEP.” Please discuss this with your healthcare provider if you think this might be right for you.

Two long-acting injectable forms of PrEP have also been approved by the FDA. These medications need to be given by your healthcare provider in the office.

  • Apretude® (cabotegravir) is for all people at risk for HIV through sex. It is administered every other month.
  • Yeztugo® (lenacapavir) is for all people at risk of HIV through sex. It is administered every six months with a starter dose of pills for the first two days of the regimen.

Is PrEP Safe? Are There Any Side Effects?

Yes, PrEP is safe. Long-term studies of PrEP users have shown that there are no major safety issues, even after 5 years. Some people taking PrEP may initially have side effects such as nausea, diarrhea, headache, fatigue, and stomach pain, but these are usually not intense and go away over time. People using injectable PrEP can have injection-site reactions that will also resolve over time. It is important that you follow up with your healthcare provider for monitoring. 

If you have any side effects that are serious or not getting better, be sure to contact your provider. It is also important that if you decide to stop taking PrEP for any reason that you talk with your provider, as there may be considerations to discuss before going off of it.

How Do You Get PrEP?

If you think PrEP may be right for you, the best first step would be to talk to your healthcare provider. PrEP is only available with a prescription, but any health care provider licensed to write prescriptions can prescribe PrEP (including pharmacists in some states). You do not need to see an HIV specialist or infectious disease physician to get on PrEP. With the increasing access to telehealth, you might even be able to get started on PrEP using a web-based portal or app.

A great first place to start is with the LGBTQ+ Healthcare Directory, where you can find providers who care about LGBTQ+ affirming care and who are also likely informed about PrEP. 

Many insurances will pay for PrEP, as it is recognized by the United States Preventive Services Task Force as an effective and safe way to prevent HIV. But there are also patient assistance programs if you meet income requirements. Federally qualified health centers are also great resources, based on their ability to provide care on a sliding-scale fee service. 

The most important thing you need to do before starting PrEP is to have a validated HIV test to ensure you are HIV-negative. There are other tests that you will need to complete at the beginning of your journey, and you will also need to have repeat HIV testing while on PrEP, based on the recommendations of your healthcare provider and the type of PrEP you are taking.

References:

Centers for Disease Control and Prevention. (2024). Preventing HIV with PrEP. Retrieved from https://www.cdc.gov/hiv/prevention/prep.html

HIV.gov. (2025, September 18). Pre-Exposure Prophylaxis (PrEP). Retrieved from  https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/pre-exposure-prophylaxis

U.S. Preventive Services Task Force. (2023). Prevention of Human Immunodeficiency Virus (HIV) Infection: Pre-Exposure Prophylaxis. Retrieved from https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prevention-of-human-immunodeficiency-virus-hiv-infection-pre-exposure-prophylaxis

freddie. (2025, Nov 19). PrEP Explained. https://www.gofreddie.com/us/prep-explained

HIV.gov. (2024, March 24). Patient Assistance Programs and Co-payment Assistance Programs: Resources for Accessing PrEP. Retrieved from https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/pre-exposure-prophylaxis/accessing

Written in 2025 by HRC Research & Education and peer reviewed by GLMA Education Committee