HIV PrEP/Pre-Exposure Prophylaxis

What is HIV PrEP?

PrEP stands for “pre-exposure prophylaxis.” It is a medication that prevents infection from the human immunodeficiency virus (HIV) that is transmitted in semen, vaginal fluids, blood and breast milk.

There are several options approved for PrEP:

Truvada (oral, approved in 2012)
Descovy (oral, approved in 2019)
Apretude (injectable, approved in 2021)
Yeztugo (injectable, a newer long-acting option)

Oral PrEP is taken daily. Taken consistently, it reduces the chance of getting HIV from sex by up to 99%. There's less data on the effectiveness of reducing HIV from injection drug use, but daily oral PrEP is thought to reduce that risk by at least 74%.

Injectable PrEP is given as a shot into the muscle by your care team. Some people start with an optional one-month oral lead-in to check how they tolerate the medication. After the first injection, a second follows one month later, then injections continue on a set schedule every two months. Because injectable options are longer-acting, they can be a great fit if remembering a daily pill is a challenge.

PrEP will NOT protect against other sexually transmitted infections (STIs) including chlamydia, gonorrhea, syphilis and herpes. For this reason, condoms and regular STI screenings or checkups are still recommended.

HIV can lead to the disease known as AIDS (Acquired Immunodeficiency Syndrome). AIDS only happens when a person living with HIV (PLWH) does not take medicines to control the infection.

PrEP

Anyone 18 years or older who is likely to be exposed to HIV. Teens age 12 to 17 may also benefit from PrEP but it may be more complex to get because of parental notification requirements for minors.

An important first step is to ask a knowledgeable medical provider about PrEP. They can then help you determine if PrEP is right for you and help you overcome barriers to getting on PrEP.

PrEP may not be the right choice if you:

Do not know your HIV status and do not want to get tested
Are living with HIV
Are not able to commit to routine testing and medical visits every three to six months
Have had a recent HIV exposure, in which case post-exposure prophylaxis (PEP) may be more appropriate

Every medication carries some risk of side effects, but PrEP is generally well tolerated. Some people notice mild, short-lived symptoms such as headaches, abdominal pain, nausea, diarrhea or muscle aches. These usually resolve within a few weeks.

More serious side effects, such as kidney or liver problems, are rare. If they occur, your doctor may adjust your medication or discuss other options with you.

Cost varies by medication and insurance plan. A generic version of Truvada has been available since late 2020, which has expanded access and lowered cost for many people. Many medications also offer copay cards to help with cost, and there are options for people without prescription drug coverage.

At Ochsner, our Specialty Pharmacy team has experience with PrEP and can help you research resources and find an affordable path forward.

Taking charge of your HIV prevention is a proactive step, and you don't have to figure it out alone. A PrEP-experienced doctor at Ochsner can answer your questions, review your options and help you choose the approach that fits your life. Whether you prefer a daily pill or a long-acting injection, we're here to support you every step of the way.