Pre-exposure prophylaxis, or PrEP, is a way for people who do not have HIV to help prevent HIV infection by taking a pill every day. When used consistently, PrEP has been shown to greatly reduce the risk of HIV infection in people who are at substantial risk.

PrEP is a powerful HIV prevention tool, and can be combined with condoms and other prevention methods to provide even greater protection than when used alone. People who use PrEP must commit to taking the drug daily and seeing their health care provider every 3 months for HIV testing and other follow-up.

What is PrEP?

PrEP is short for pre-exposure prophylaxis. Like birth control, PrEP is a pill taken daily by people who do not have HIV to protect against HIV.

Truvada was the first drug approved for use as PrEP for both men and women by the Food & Drug Administration in 2012. In 2019, a second drug, Descovy, was approved by the FDA for use by men.

Both forms of PrEP are highly effective when taken as prescribed.

CDC, HIV Basics, PrEP. October 2019.
FDA, FDA Approves Second Drug to Prevent HIV Infection as Part of Ongoing Efforts to End the HIV Epidemic. October 2019.

How Effective is PrEP

Very effective when taken as prescribed. 

According to the U.S Centers for Disease Control and Prevention, daily PrEP reduces the risk of getting HIV from sex by more than 90 percent. Among people who inject drugs, PrEP reduces the risk of getting HIV by more than 70 percent when used consistently.

Some studies have shown even higher effectiveness with consistent PrEP use among gay and bisexual men, and transgender women.

While PrEP is highly effective in preventing HIV, it does not protect against other sexually transmitted diseases (STDs). To prevent gonorrhea, chlamydia, syphilis, and other common STDs, use condoms.

PrEP must be taken for some time before it reaches maximum effectiveness.

See: How quickly does PrEP start working?

CDC, HIV Basics, PrEP. October 2019.

How quickly does PrEP start working?

PrEP must be taken for some time before exposure to HIV to be effective. According to the Centers for Disease Control and Prevention (CDC), PrEP reaches maximum protection from HIV through receptive anal sex after about 7 days of daily use. For receptive vaginal sex and injection drug use, the CDC estimates that PrEP reaches maximum protection after about 20 days of daily use. To maintain maximum effectiveness, PrEP should be taken every day as prescribed.

People who use PrEP must commit to taking the drug daily and seeing their health care provider every 3 months for HIV testing and other follow-up.

CDC, HIV Basics, PrEP. October 2019.

Once I start PrEP, can I stop?

You can go on and off PrEP at different times in your life, but should do so under the guidance of a health care provider. It takes some time after starting PrEP to get to the same high level of protection against HIV as before.

Before restarting PrEP, you will need to get tested again and renew your prescription.

Who is PrEP for?

PrEP is for anyone who wants added protection against HIV. Your health care provider can help you decide if PrEP is a good fit for you. Some things to consider: how often you (and/or your partners) use condoms; whether you know the HIV status of your partners and if they are on ongoing treatment; and/or whether you have recently had any sexually transmitted diseases (STDs). If you or your partner use injection drugs, PrEP may also help protect against HIV.

If you are considering getting pregnant and concerned about HIV, talk with your doctor about PrEP. PrEP may be an option to help protect you and your baby from getting HIV while you try to get pregnant, during pregnancy, or while breastfeeding.

CDC, HIV Basics, PrEP. October 2019.

How much does PrEP cost?

PrEP is covered by most insurance plans and should be covered by Medicaid and Medicare.

If you do not have insurance, or if you have insurance but need help with out-of-pocket costs, there are financial assistance programs that may be able to help. Many people wind up paying very little or nothing at all for PrEP.

How do I get PrEP?

Any medical professional who can prescribe medications, including doctors and nurse practitioners, can prescribe PrEP. Look for a provider nearest you!

If you don’t have a regular healthcare provider, or they don’t know about or are reluctant to prescribe PrEP, our organizations can help you get on PrEP. We can also help you find a provider near you and/or identify financial assistance, whether you have insurance or not.

What about condoms?

While highly effective at protecting against HIV, PrEP does not protect against other sexually transmitted diseases (STDs). Condoms are an easily accessible, highly effective means of preventing the sexual transmission of HIV and many other STDs. Condoms are also the only method of protection that prevents both pregnancy and disease. To be effective, condoms must be used correctly and consistently.

What is PEP?

PEP, short for post-exposure prophylaxis, is a prescription medication to be taken in emergency situations to protect against HIV after exposure.

It must be taken within 72 hours after a possible exposure to HIV. The sooner you start PEP the better. If you are prescribed PEP you will need to take it once or twice daily for 28 days.

For ongoing protection, consider PrEP, a prescription pill for those who do not have HIV. PrEP must be taken for some time before exposure to be effective.

CDC, Post-Exposure Prophylaxis (PEP)November 2019.

I don’t have insurance, can I still get PrEP?

If you are uninsured, there may be resources available that can help pay for PrEP and the necessary clinic visits and tests.

One such source is the U.S. Department of Health and Human Services’ Ready, Set, PrEP Program that provides PrEP at no cost for people who do not have insurance coverage. For more information, and to apply for the program, visit GetYourPrEP.com or call (855) 447-8410.

Another is Gilead’s Advancing Access Program. To see if you are eligible for this program provided by PrEP’s manufacturer call (855) 330-5479. Eligibility is based on income.

What about payment assistance for PrEP?

There are various sources of payment assistance for PrEP for people with and without insurance coverage.

If you don’t have insurance, options are available to get PrEP. The U.S. Department of Health and Human Services’ Ready, Set, PrEP Program provides PrEP at no cost for people who do not have health coverage. For more information, and to apply for the program, visit GetYourPrEP.com or call (855) 447-8410.

In addition, depending on your income, you may be eligible to get PrEP at no cost as part of a program offered by its manufacturer. Gilead’s Advancing Access Program may also be available to those on Medicare who don’t have Part D prescription drug coverage.

To determine if you are eligible, your medical provider needs to submit an application for you. For more information call (855) 330-5479.

For those with insurance who need help with copay and deductible costs, Gilead’s Advancing Access Co-Pay Coupon provides up to $7,200 per year, with no monthly limit, to cover out-of-pocket expenses for PrEP, including copays, coinsurance, and deductibles. The program does not restrict benefits based on income, however it is not available for those on Medicaid, Medicare Part D or any other government prescription drug programs. For more information call 1 (800) 226-2056.

Another option for people who get their PrEP covered by their insurance, including Medicare, is the Patient Advocate Foundation, which provides up to $7,500 per year to help pay for costs related to the prescription. Approval is based on your income. If you earn less than 400 percent of the federal poverty level (or about $49,960 for an individual with no dependents) you may qualify for this program. For more information click here or call (866) 512-3861 and select option 1.

What is the Ready, Set, PrEP program?

The Ready, Set, PrEP Program is a new program by the U.S. Department of Health and Human Services that makes PrEP available at no cost for people without insurance. To receive PrEP through this program, you must test negative for HIV, have a valid prescription for PrEP, and not have prescription drug coverage.

If you receive PrEP through the Ready, Set, PrEP Program, you will not have to pay for the medicine. The costs of clinic visits and lab test costs may vary depending on your income.

Click here for more information about Ready, Set, PrEP. To apply for the program, visit GetYourPrEP.com or call (855) 447-8410.

Does Medicaid cover PrEP? What about Medicare?

Yes. Both Medicaid, as well as Medicare, should cover PrEP.

Depending on what state you live in, Medicaid may require your physician to obtain a pre-approval for PrEP before you fill your prescription.

If you are on Medicare but do not have Part D prescription drug coverage, you may be able to receive PrEP for free from its manufacturer if you have a low income. You may also be eligible for co-pay assistance if you are on Medicare.