Pre-exposure prophylaxis (PrEP) refers to preventive medication for people who are not HIV-positive but are considered to be at substantial risk of infection. According to the U.S. Centers for Disease Control, PrEP is highly effective; it reduces the risk of contracting HIV from sex by 99%.
PrEP medications fall under two brands in the U.S., Truvada and Descovy. The former is recommended for people who are at risk of HIV through sex or injection drug use. The latter is for people at risk through sex, except for people assigned female at birth who are at risk of contracting HIV through vaginal sex because its effectiveness has not been studied in this population. Both products are intended for use by people who are already HIV negative. In 2021, the FDA approved the first injectable form of PrEP called Apretude.
Both brands of PrEP contain tenofovir and emtricitabinen. Daily intake is necessary for the medication to be effective, and the research has shown that the more closely people adhere to recommended dosing, the more protection they receive. Pre-exposure prophylaxis is another layer of protection from HIV infection, on top of condoms and other preventive measures.
More About Pre-Exposure Prophylaxis
PrEP is predominantly used by men who have sex with men. Although it has been a game-changer in terms of reducing the risk of HIV in this population, it has also been found that PrEP may be used as an alternative to condoms. This is not recommended as it is not 100% effective, nor does it provide protection against other STIs.
PrEP has also been found to have a relatively low uptake considering its effectiveness and relative lack of serious side effects for most people; as of 2017, only about 10% of people who could benefit from the medication were receiving it. Reasons for lack of uptake include cost, access and the stigma of requesting the prescription. This is especially true in LGBTQ communities, especially among trans women, who are disproportionately affected by HIV.
In the U.S., a PrEP prescription costs about $2,200 per month. This cost may be covered by insurance. State and local programs also exist to provide the medication for free or at a lower cost.
