Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 8/12/2021
Science is a pretty incredible thing. Just like infectious disease experts were able to develop vaccines to offer 72 percent to 95 percent protection from COVID-19 infection, scientists developed pre-exposure prophylaxis medicine (also know as PrEP medication), a daily pill that can help lower the chances of getting HIV from sex by more than 90 percent.
More than a million people in the United States could benefit from the protection PrEP provides, but fewer than one in three of these individuals are currently taking daily PrEP.
But recent legislation just made it a lot easier — and more affordable — for more individuals to access PrEP services with little to no PrEP cost. Here’s what you need to know.
PrEP is for people who don’t already have HIV, yet are at increased risk for getting HIV. Talk to your health care provider about PrEP if you:
Are with a partner who has HIV or who is at high-risk for getting it (say, they use injection drugs or have multiple sexual partners).
Have multiple sexual partners yourself.
Have used injection drugs or shared needles in the past six months.
Don’t regularly use condoms.
Recently had another sexually-transmitted infection (STI).
Regularly have anal sex.
As mentioned, using PrEP medication can lower the chance of getting HIV from sex by more than 90 percent, and using PrEP in tandem with condoms can offer additional protection.
However, quick disclaimer: PrEP doesn’t offer protection from other STIs, which is one of the main reasons why condoms remain so crucial.
Daily PrEP is important, as it's ineffective if you skip doses, which means there may not be enough of the medication in your body to effectively block HIV.
Truvada, which includes two antiretroviral medications that are also used to treat HIV, was approved in 2012 for use as an HIV prevention method.
Descovy, which has been shown to perform better in bone density and kidney function tests than Truvada, was given the thumbs up by the FDA in 2019.
No serious issues have been found among people on PrEP, although minor side effects such as headaches, appetite changes or nausea may occur early on while taking daily PrEP.
The vast majority of individuals report zero side effects of PrEP.
Once you’re taking PrEP medication, medical experts recommend meeting with your health care provider or nurse every quarter to receive an HIV test, to talk through any side effects or symptoms and to possibly get tested for other STIs.
If you do happen to get HIV, it’s crucial to stop taking PrEP medication ASAP, as it’s not a treatment for the virus and can actually make treating HIV more difficult.
If you think you could have been exposed to HIV in the previous 72 hours, ask your healthcare provider, an urgent care service or an emergency room doctor or nurse about PEP (post-exposure prophylaxis).
PrEP providers are available from coast to coast for telemedicine or in-person visits. In-person or virtually, you can find a PrEP provider online.
Being open and honest about your sexual history and voicing any questions or concerns is crucial.
So it may be a great fit to seek out a health care provider who specializes in working with LGBTQIA+ communities.
Planned Parenthood sexual health clinics or the Gay Lesbian Medical Association’s provider directory are two excellent resources.
To prepare for the conversation with your healthcare provider, pull together a medical history list that includes any allergies, current medications, past illnesses or health challenges and any family history.
Your healthcare provider can help you decide if PrEP is right for you — as long as you’re forthcoming about your health and sexual habits.
Your provider will likely ask about the frequency and type of sex you have and the protection you use.
They’ll test you for HIV, hepatitis B and C and other STIs, as well as test your kidneys to ensure they’re working well.
Mail-in self-testing for HIV — required to receive a PrEP prescription and to continue taking it — is also possible to get the ball rolling if you prefer the telemedicine route.
As of January 01, 2020, California Governor Gavin Newsom signed Senate Bill 159, making PrEP available without a prescription in the state of California.
Pharmacists can now issue a 30-day or 60-day supply of PrEP without a prescription, but only in California.
In the other 49 U.S. states, a PrEP prescription is still required. You can receive PrEP services and a PrEP prescription from some health clinics or Planned Parenthood locations, local health departments and medical offices.
A July 2021 report from the Centers for Medicare and Medicaid Services, the Department of Labor and the Department of the Treasury informed health insurers that they have 60 days to comply with the mandate to make PrEP prescriptions affordable for all.
This new rule is groundbreaking for those wondering how to get on PrEP but are worried about the cost of PrEP, because it essentially means by well before 2022, insurers cannot charge copays, coinsurance or deductibles for the quarterly visits and lab tests needed to stay on a PrEP prescription.
In terms of paying for the PrEP medication itself, most health insurance providers (including Medicaid) cover PrEP.
Before meeting with your healthcare provider, it’s wise to look at your health insurance plan to make sure PrEP is covered on your plan. If you’re uninsured, Truvada and Descovy can be very expensive.
Some generics can help lower the cost dramatically, so be sure to ask your health care provider if that’s an option.
No health insurance? You can still get assistance covering PrEP costs. Gilead, the manufacturer of Truvada and Descovy, offers payment assistance programs that could make PrEP free for you, depending on your income.
Your health care provider can assist with submitting an application to determine if you qualify for financial support.
Your local Planned Parenthood can also help you find other patient assistance programs to reduce PrEP costs.
Research and government support is mounting about the medicine’s ability to lower HIV rates. And a May 2020 report in the Annals of Epidemiology found that Medicaid programs under the Affordable Care Act that offset PrEP costs makes more at-risk adults more likely to take it.
As a result, daily PrEP continues to get easier and more budget-friendly to receive, if it’s right for you.