Pre-Exposure Prophylaxis (PrEP)

What is PrEP?

Pre-exposure prophylaxis, or PrEP, is a pill taken daily to prevent HIV. Daily PrEP use reduces the risk of getting HIV through sex by about 99%. Daily PrEP use also reduces the risk of getting HIV through injection drug use by more than 70%. Two medications are approved for daily use as PrEP to help prevent a person without HIV from getting the virus from sex or injection drug use. PrEP is safe and effective for adults and adolescents weighing above 35 kilograms (77 pounds). 

PrEP is intended for use before a possible exposure to HIV. If you think you have been exposed to HIV through needlestick, condomless sex, or by sharing needles or works to prepare drugs within the last 72 hours, you can learn more about non-occupational post-exposure prophylaxis (nPEP).

PrEP works best when taken as prescribed and when it is used with other prevention options. When you combine options, you further reduce the risk of getting HIV from another person. Combination prevention lets you decide which prevention option(s) are best for your lifestyle.

Prevention options include:

Can I take PrEP?

To find out if you can or should take PrEP, you first need to get tested for HIV. If you test negative for HIV, talk to your doctor about starting or restarting PrEP.

PrEP is for people who are at very high risk of getting HIV, including those who:

PrEP is safe for women and does not interfere with hormonal birth control or hormone therapy. PrEP can be used during conception and pregnancy. PrEP only works in preventing HIV. Condom use is recommended to protect against STDs and pregnancy.
 

How much does PrEP cost?

PrEP is free for many people through health insurance and assistance programs. If you do not have insurance, you can get help paying for PrEP from: 

• Manufacturer drug and co-pay assistance
   
• Patient Access Network Foundation
   
• Patient Advocate Foundation
   

Visit Preventative Service Coverage and PrEP Assistance Programs to learn more about the process of paying for PrEP.
 

What are the side effects?

PrEP is safe for adults and adolescents weighing more than 35 kilograms (77 pounds). The drugs in PrEP have been used by people living with HIV for treatment since 2004.

Most people on PrEP do not report any side effects. The most common side effects are nausea, upset stomach, fatigue and headaches during the first month of taking PrEP; these symptoms usually get better or go away. Your healthcare provider can help you manage any side effects.
 

Where can I get PrEP?

You can get PrEP from your physician, nurse practitioner, or physician assistant; you just have to ask for it by name. If your provider is not familiar with PrEP, you can direct them to the CDC PrEP information page.

Visit the Texas DSHS PrEP Directory or the National Prevention Information Network Directory for a listing of clinics and doctors who prescribe PrEP near you. If you do not see any clinics near you or ones that you are comfortable going to, you may be able to get PrEP delivered discreetly to your home or by going to a pharmacy. Options include:

• Tele-PrEP (including NURX and PlushCare)
   
• Walgreens Healthcare Clinics, CVS minute clinics, or other pharmacies
   

What are the steps to getting on PrEP?

At your first healthcare visit, you will be asked questions to help you see if PrEP is a good fit. This includes questions about your sexual behaviors, types of partners, and medical history. In order to get on PrEP, you must take HIV and STD tests, have your kidney function checked, and be assessed for hepatitis B and C infections. Your healthcare provider will help with any STD treatments and work with you to address any health concerns.

PrEP can be accessed at most pharmacies around Texas. Some pharmacies can also mail or deliver the medicine directly to you.

After you start taking PrEP daily, you must see your healthcare provider on a regular basis. Every three to six months, s/he will see how you are doing on the medicines, discuss any side effects, and ask about how often you are taking PrEP. At these visits, you will be re-tested for HIV, STDs, and kidney function.

You can stop and start daily PrEP at different times in your life, but you must notify and consult with your healthcare provider.
 

What if I have more questions?

There are many online resources for people interested in learning more about PrEP or starting or stopping PrEP. You can visit any of the sites below for more information:

• PrEP User’s Guide in English and PrEP User's Guide in Spanish
   
• Greater than AIDS FAQ 
   
• Ask About PrEP
   
• Please PrEP Me 
   
• Or, contact a local community organization or free clinic to ask for more information 
   

Additional Patient Resources

• Let’s Talk About PrEP!
   
• Centers for Disease Control and Prevention 
   
• Daily PrEP to Prevent HIV
   

Pre-exposure Prophylaxis for Providers