PrEP to Prevent HIV

The recommended way to use oral PrEP is to take one pill once a day, even on days when you do not have sex or inject drugs. Research shows that gay and bisexual men and other men who have sex with men can also take Truvada as PrEP only before and after sex, referred to as PrEP on demand. To use PrEP on demand (PDF), take:

• 2 pills 2 to 24 hours before sex
• 1 pill 24 hours after the first dose
• 1 pill 48 hours after the first dose

If you keep having sex, continue taking 1 pill every 24 hours until you have taken two pills after you last had sex.

PrEP on demand prevents HIV during anal sex when taken correctly, but should not be used by people having receptive vaginal sex.

Consider taking PrEP if any of the following apply to you. If you:

• Are worried you may be exposed to HIV
• Do not always use condoms during sex
• Recently had a sexually transmitted infection (STI)
• Recently took emergency PEP to prevent HIV
• Inject drugs and share syringes or other injection equipment
• Have a partner who has HIV and a detectable or unknown viral load
• Have a partner who may have HIV or who refuses to get an HIV test

The medicines in PrEP stop HIV from spreading throughout your body.

PrEP only stops HIV if you have enough medicine in your body, so you need to take it as prescribed.

When taken as prescribed, PrEP reduces the risk of getting HIV through sex by about 99%. In rare cases, people have gotten HIV despite taking PrEP as prescribed.

To prevent other STIs, use condoms correctly and consistently, and get tested regularly.

To prevent pregnancy, use birth control.

PrEP is safe. Truvada has been used to treat people with HIV since 2004 and has been used for PrEP since 2012. Clinical trials have shown that Descovy and Apretude are also safe medicines.

Most people on PrEP do not report any side effects. The most common side effects are nausea, upset stomach, fatigue and headaches. These symptoms often get better or go away within the first month of taking PrEP. PrEP injections may cause a skin reaction at the injection site. Rare side effects include kidney or bone problems.

Your health care provider can help you manage any side effects.

PrEP protects you against HIV as long as you take it as prescribed. Tell your provider if anything makes it difficult for you to take PrEP.

Talk to your provider before you stop taking PrEP. You will need to use another method to prevent HIV.

In New York State, PrEP is covered by Medicaid and most health insurance plans without any co-pays for medicines, lab work or clinic visits.

Ask your clinic about patient assistance programs that help people who are uninsured or undocumented pay for PrEP.

Learn more about your Payment Options for PrEP (PDF).

In New York State, you can get PrEP or other sexual health services without a parent’s permission, including at NYC Sexual Health Clinics. Learn about your rights and steps you can take to keep your PrEP prescription or other sexual health services confidential.

PrEP is a safe and effective HIV prevention option for women.

Truvada and Apretude are approved for cisgender women and transgender women, and Descovy is approved for transgender women. Descovy may not be appropriate for cisgender women or transgender men because of a lack of research on how well it prevents HIV during receptive vaginal sex.

People who have receptive vaginal sex need to be especially careful to take PrEP pills every day to maintain enough medicine in their vaginal tissue to prevent HIV.

There is no evidence that PrEP interacts with estrogens or affects the levels of hormones in your body. Research has found that transgender women who take PrEP as prescribed are protected from HIV.

Research shows that PrEP does not interfere with hormone-based birth control.

PrEP protects people who are pregnant from getting HIV, which protects their fetus and baby from being exposed to HIV during and after pregnancy.

PrEP is safe to use during and after pregnancy, and has not been shown to affect fertility.

If you would like to take PrEP while trying to conceive, talk to your health care provider.