What is PrEP?
PrEP (Pre-Exposure Prophylaxis) is an FDA-approved, Centers for Disease Control and Prevention-recommended daily prevention pill for HIV-negative people who are especially vulnerable to getting HIV. Taken daily, PrEP is up to 99% effective at preventing HIV. PrEP can also be an important prevention option for people who inject drugs. Men who have anal sex may also choose a non-daily dosing regimen in which you take pills before and after sex — known as 2+1+1.
PrEP users also report feeling safer in their relationships and more in control regarding their sexual health and wellness. What’s sexier than that?
Is PrEP for me?
PrEP is a tool you can choose to make your sex life safer and take control of your sexual health and wellness. PrEP is designed for people who are HIV-negative and vulnerable to getting HIV. PrEP can be prescribed for gay and bisexual men, for heterosexual men and women, for transgender individuals, and for genderqueer or nonbinary people. PrEP can also help people who inject drugs stay HIV-negative.
You might consider PrEP if:
- You don’t always use condoms (external or internal) when you have anal or vaginal intercourse. “Always” means every time, not sometimes.
- You don’t always ask your partner(s) to wear a condom.
- You have been diagnosed with a sexually transmitted infection in the last six months.
- You’re unsure of the HIV status of your sexual partners.
- You're in a relationship with an HIV-positive partner who may or may not be on HIV treatment.
- You are a person who injects drugs, or you’re in a sexual relationship with an injection drug user.
- You’re HIV-negative and interested in PrEP.
Considerations For Taking PrEP from the Centers for Disease Control and Prevention
Are there side effects?
Many people who take PrEP say they haven’t had any side effects, but like with any drug, there are some reported side effects to consider.
Short term: Approximately 10% of people taking PrEP initially experience mild side effects, such as nausea, diarrhea and headaches. These tend to go away quickly.
Long Term: A small number of people taking PrEP may experience changes in their kidney function and in their bone density. These side effects are not common.
It is important to see your health care provider regularly so they can monitor you for all potential side effects and help you stay healthy.
Is PrEP safe?
What about condoms?
You may be drawn to PrEP because of a desire for intimacy and connection you may not feel when wearing condoms. For the prevention of HIV, PrEP taken consistently and correctly is actually more effective than condom use.
That said, PrEP protects against HIV, but it does not protect against other sexually transmitted infections (STIs) such as syphilis, gonorrhea and chlamydia. PrEP does not prevent pregnancy. If you have concerns about sexually transmitted infections or unintended pregnancy, the consistent and correct use of condoms (external and internal) is still a great idea.
If you have more questions, check out the CDC's STI info page.
Where do I get PrEP?
When you take PrEP, you are taking control of your sexual health, but you aren’t in it alone. PrEP is more than just a daily prescription pill; it’s a partnership with your health care provider, who is a judgment-free champion for your health. Your health care provider will act as your advocate and be there to help you navigate your health. They can help you develop daily dosing habits and counsel you on sexual health. And they are there for regular HIV testing, screening for sexually transmitted infections, and ensuring you stay healthy while on PrEP. There are many health care providers and clinics in New Hampshire and surrounding areas that provide high-quality, judgment-free PrEP services for all types of people.
Check out this PrEP provider locator (New Hampshire and beyond!)
How will I pay for PrEP?
PrEP is covered by most insurance programs and Medicaid. The level of your coverage will vary by the type of health insurance plan you have. There are also assistance programs that can help you pay for PrEP, regardless of your citizenship status. Your health care provider and their staff are important resources for helping you navigate your insurance coverage and assistance programs, and they will act as your advocate. Additionally, we can help get you linked into these programs!
Ready, Set, PrEP is a new nationwide program led by HHS. The program provides PrEP medications at no cost to thousands of individuals who qualify.
Gilead Advancing Access® co-pay coupon card may help you save on your co-pays for the two medications that may be used for PrEP.
Are PEP and PrEP the same?
You may have heard about taking a pill for 28 days after you’ve been exposed to HIV (“PEP” or post-exposure prophylaxis). PEP is medication taken immediately after exposure to HIV (within 72 hours) and continued for 28 days.
PrEP, pre-exposure prophylaxis, is taken before exposure to HIV and continued for your “season” of HIV risk.
More information on PEP from the CDC
What medications are used for PrEP?
Two medications may be prescribed for PrEP. Truvada and Descovy are both extremely effective and well-tolerated, though they have slightly different side effect profiles. Each has slightly different pros and cons, and should be discussed with your provider.
Truvada has been shown to be safe and effective for PrEP in cisgender men and women and transgender women. Truvada has not been studied in transgender men. Descovy has been shown to be safe and effective only in cisgender men and transgender women. Descovy has not been studied in cisgender women or transgender men.
More information on the two options used for PrEP
How do I take PrEP 2-1-1?
PrEP 2-1-1 (sometimes referred to as "on-demand" or "event-driven" PrEP) is a way of taking Truvada to protect against HIV when you need it, instead of every day. Essentially, you take it before and after sex — it is a bit more complicated than that, so please read below under "What is the dosing schedule?". This method is regularly prescribed in some European countries and is fully
endorsed by the World Health Organization (WHO), The United States CDC has not officially approved PrEP 2-1-1, but
many US healthcare providers are now recommending it. The evidence from research and clinical practice clearly demonstrates that PrEP 2-1-1 is highly effective.
IMPORTANT! PrEP 2-1-1 has been shown to be effective only with Truvada, not with Descovy. There are good reasons to believe that Descovy would also work, but this has not been proven.