Pre-Exposure Prophylaxis (PrEP)

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Pre-Exposure Prophylaxis (PrEP)

What is PrEP?

Find a PrEP Provider in TexasPre-Exposure Prophylaxis, or PrEP, is a highly effective HIV prevention strategy that involves taking medication to prevent HIV. When using PrEP as prescribed, you may reduce the chances of acquiring HIV from sex by 99% and from injection drug use by more than 70%. PrEP is safe and works for adults and adolescents weighing more than 77 pounds (35kg).

IMPORTANT: PrEP works by building protective levels of the medication in your body that stops HIV from establishing PrEP for Healthcare Providersinfection. You need to take PrEP regularly and as prescribed for it to work well. You should only use PrEP before a possible exposure to HIV. If you think you were exposed to HIV through a needlestick, condomless sex or by sharing needles or work to prepare drugs within the last 72 hours, you might be able to take post-exposure prophylaxis, or PEP. PEP prevents HIV after a potential exposure to HIV, you might benefit from non-occupational post-exposure prophylaxis (nPEP).

Types of PrEP

There are two PrEP options to choose from that may best fit into your lifestyle or routine:

  • Daily oral PrEP: Oral PrEP is a pill taken every day with a follow-up to your medical provider once every 3-6 months to renew the prescription.
  • Long-acting injectable PrEP: Long-acting injectable PrEP is an injection of medication every two (2) or six (6) months, given by a physician or nurse.  

Both PrEP options are very effective at preventing HIV and choosing the option that best fits your lifestyle is important. A PrEP provider can help you choose the best medication to fit your particular needs as well as provide you with additional prevention strategies. Using combination prevention allows you to tailor the prevention option(s) that most fit your needs and further reduces your chances of getting HIV. Using more of these prevention options at the same time can increase the barrier against HIV and other STDs.

Prevention options include:

  • Condoms
  • Lube
  • Daily PrEP
  • Emergency PEP
  • Safer drug use
  • HIV and STD testing and treatment
  • Maintain an undetectable* status
  • Talk about sex and drug practices with partners
  • Talk to your doctor about sexual history, drug use, and prevention options

* Undetectable – When a person living with HIV regularly takes their HIV medications, the amount of HIV in their body can drop to a level so low that lab tests can no longer detect the virus. This does not mean the person is cured or no longer has HIV. However, when someone is undetectable, it reduces their chances of getting sick and cannot transmit HIV to their sexual partners. 
 

Can I take PrEP?

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

PrEP is for anyone who is HIV negative, wants extra protection from HIV, and can commit to a regular treatment schedule. It is also a great option for people with higher chances of getting HIV, such as those who:

  • Have condomless sex,
  • Have sex high or while intoxicated,
  • Trade sex for money, drugs, or a place to stay,
  • Want extra protection from HIV,
  • Have had an STD (chlamydia, gonorrhea, syphilis) in the past 12 months,
  • Have sex with people who are living with detectable HIV or whose status you do not know, or
  • Inject drugs or share works.

People of both genders can safely use PrEP even while on hormones or on hormonal birth control. PrEP is also safe for women during conception and pregnancy. 

PrEP only works in preventing HIV but cannot protect against other STDs and cannot prevent pregnancy. To prevent STDs and pregnancy you should use condoms in addition to PrEP.
 

How much does PrEP cost?

PrEP is free for many people who have health insurance. Drug manufacturers and other organizations have assistance programs to help cover PrEP costs for anyone who is uninsured or under insured. Below is a list of some common medication assistance programs that cover PrEP: 

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

Many organizations and health departments throughout Texas have PrEP navigators who can help you discover ways to pay for PrEP. To find local PrEP providers visit PrEP Providers in Texas.
 

What are the side effects?

PrEP is safe for adults and adolescents who weigh more than 35 kilograms (77 pounds). People living with HIV have used the drugs in PrEP for many years with few side effects and research studies have shown that PrEP is effective and safe for most people.

Though most people do not report experiencing any side effects while using PrEP, some report that side effects they experienced usually went away a short while after starting PrEP. The most common side effects for oral PrEP are nausea, upset stomach, fatigue and headaches. The most common side effects for injectable PrEP are swelling or mild pain at the site of the injection and a slight fever afterward. 

These side effects usually get better or go away, but you should let your healthcare provider know if you experience any side effects. Your healthcare provider can help you manage any side effects or other concerns through regular screenings and check-ups. 
 

Where can I get PrEP?

You can get PrEP from your physician, nurse practitioner, or physician assistant; you just have to ask for it. If your provider doesn’t know about PrEP, you can send them to the CDC PrEP information page.

Visit the Texas DSHS PrEP Directory or the GreaterThanHIV Service Locator to find a list of clinics and doctors who prescribe PrEP near you.

If you do not see any clinics near you or you are not comfortable going to any of the ones listed, you can also get PrEP delivered discreetly to your home or by going to a pharmacy. Options include:

What are the steps to getting on PrEP?

Make an appointment to visit your healthcare provider. During your first appointment, your provider will ask questions to see if PrEP is right for you and discuss options for the types of PrEP available to you. Your provider will ask questions about your sexual behaviors, types of partners, and medical history, all necessary to determine what type of medication would be most appropriate for you. To get on PrEP, you must get tested for HIV and STDs. Your physician may also check your kidney function and test you for hepatitis B and C. Should you require treatment for an STD, your healthcare provider will help with any treatments you may need and help to address any health concerns.

You can access oral PrEP at most retail pharmacies around Texas. Some pharmacies can also mail or deliver the medicine directly to you. You will need to visit a clinic for injectable PrEP since it can only be administered by a medical care provider. 

Once you begin taking PrEP, you must see your healthcare provider on a regular basis. For oral PrEP this will mean every three to six months and for injectable PrEP this will mean every two (2) months or six (6) months, depending on the type of injectable medication. Your healthcare provider will monitor you on the medication, discuss any side effects, and check to make sure you are taking the medication as directed. At these visits, you will be re-tested for HIV, STDs and other tests that are needed.

You can stop and start PrEP at different times in your life, but you should talk with your healthcare provider if you plan to stop PrEP, especially if you are taking injectable PrEP. They can help you find ways of staying HIV negative when you are no longer taking PrEP medications.
 

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:

Additional Patient Resources

Pre-exposure Prophylaxis for Providers