PrEP (pre-exposure prophylaxis)

PrEP, or pre-exposure prophylaxis, is an HIV prevention method in which people who don’t have HIV take HIV medicine to reduce their risk of getting HIV if they are exposed to the virus. PrEP can stop HIV from taking hold and spreading throughout your body. Currently, there are only two FDA-approved daily oral medications for PrEP.

PrEP is prescribed to HIV-negative adults and adolescents who are at high risk for getting HIV through sex or injection drug use.

Why Take PrEP?

PrEP is highly effective when taken as indicated.

The once-daily pill reduces the risk of getting HIV from sex by more than 90%.Among people who inject drugs, it reduces the risk by more than 70%.

Your risk of getting HIV from sex can be even lower if you combine PrEP with condoms and other prevention methods.

Is PrEP Right for You?

PrEP may benefit you if you are HIV-negative, 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 an STD in the past 6 months.

PrEP is also recommended for people who inject drugs and have an injection partner with HIV, or who share needles, syringes, or other injection equipment.

It may be right for you if you’ve been prescribed PEP (post-exposure prophylaxis) and you report continued risk behavior or have used multiple courses of PEP.

If you are a woman and have a partner with HIV and are considering getting pregnant, talk to your doctor about PrEP.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.

What Drugs Are Approved for PrEP?

The following medications are approved for daily use as PrEP. They are combinations of two anti-HIV drugs in a single pill:

• Emtricitabine (F) 200 mg in combination with tenofovir disoproxil fumarate (TDF) 300 mg (F-TDF; brand name Truvada ®) is recommended for all adults and adolescents at risk for HIV through sex or injection drug use. A generic version of Truvada® is also available.
• Emtricitabine (F) 200 mg in combination with tenofovir alafenamide (TAF) 25 mg (F-TAF; brand name Descovy ®) is recommended for adults and adolescents at risk for HIV through sex, excluding people at risk through vaginal sex. Descovy® has not yet been studied for HIV prevention for receptive vaginal sex.

Is PrEP Safe?

PrEP is safe. No significant health effects have been seen in people who are HIV-negative and have taken PrEP for up to 5 years.

Some people taking PrEP may have side effects, like nausea, but these side effects are usually not serious and go away over time. If you are taking PrEP, tell your health care provider if you have any side effect that bothers you or that does not go away.

And be aware: PrEP protects you against HIV but not against other sexually transmitted infections (STIs) or other types of infections. Combining PrEP with condoms will reduce your risk of getting other STIs.

How Do You Get PrEP?

People who use PrEP must commit to taking it every day and seeing their health care provider every 3 months for follow-up.

If you think PrEP may be right for you, visit your doctor or health care provider. PrEP is only available by prescription. Any health care provider licensed to write prescriptions can prescribe PrEP; specialization in infectious diseases or HIV medicine is not required.

If you don’t have a doctor, you can use the HIV Services Locator to find a PrEP provider and other HIV services near you. You can visit many community health centers for a PrEP consultation. More than 190 health centers in the 57 jurisdictions prioritized in the Ending the HIV Epidemic initiative are providing PrEP services. Many health centers in other jurisdictions also providePrEP services.

Because PrEP is for people who are HIV-negative, you’ll have to get an HIV test before starting PrEP and you may need to get other tests to make sure it’s safe for you to use PrEP.
If you take PrEP, you’ll need to see your healthcare provider every 3 months for repeat HIV tests, prescription refills, and follow-up.

Is PrEP Covered by My Insurance?

In most cases, yes! Under the Affordable Care Act, PrEP must be free under almost all health insurance plans. That means you can’t be charged for your PrEP medication or the clinic visits and lab tests you need to maintain your prescription. There are no out-of-pocket costs for you.

This applies to most private health insurance plans you get through your employer or purchase yourself, individual plans you purchase through HealthCare.gov or state-based Marketplaces, and state Medicaid expansion coverage plans. In some states, the traditional Medicaid program also covers PrEP at no charge.1 This does not automatically apply to Medicare. (Medicare Part D prescription drug plans cover PrEP medication, but there will still be cost-sharing.)

To find out whether your health plan covers PrEP medications without charge:

• If you have private health insurance through your employer or have purchased it yourself: Check with your health insurance company about coverage for PrEP medications or look on their drug formulary (drug list) online to find information about coverage for the drugs approved for PrEP.
• If you purchased your health plan through HealthCare.gov or a state-based Marketplace: This NASTAD tip sheet can help you verify whether your plan covers PrEP medications.
• If you are on Medicaid: Check with your benefits counselor.
• If you are on Medicare: Find which plans cover your drugs.

What If I Don’t Have Health Coverage or Still Can’t Afford PrEP?

Don’t have insurance or Medicaid coverage? There are resources that may be able to help you pay for PrEP and your necessary clinic visits and tests.

One source is the U.S. Department of Health and Human Services’ Ready, Set, PrEP program that provides PrEP at no cost for people without prescription drug coverage. For more information, and to find out if you qualify, see the blue box below.

Another source is Gilead’s Medication Assistance Program for PrEP (Gilead is the company that makes two of the drugs currently approved by the FDA drugs for PrEP). You can apply for this program to see if you can get PrEP at no cost, based on your income. For more information call (877) 505-6986.

If you do have health insurance that still requires a co-pay but you can’t afford it, you may receive co-pay assistance from drug manufacturers, state programs, or patient advocacy foundation.

Need help paying for your clinic visits and lab tests?

You can get them at HRSA-funded Health Centers, where the sliding scale fees are based on your ability to pay. There are more than 12,000 health centers nationwide.

Some state PrEP assistance programs also cover clinical visits and labs.

Source: https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/pre-exposure-prophylaxis