How Easy is It to Get Prep

What is PrEP?

PrEP, or pre-exposure prophylaxis, is medicine people at risk for HIV take to prevent getting HIV from sex or injection drug use. PrEP can stop HIV from taking hold and spreading throughout your body.

Currently, there are two FDA-approved daily oral medications for PrEP. A long-acting injectable form of PrEP has also been approved by the FDA.

Why Take PrEP?

PrEP is highly effective at preventing HIV when taken as indicated.

PrEP reduces the risk of getting HIV from sex by about 99% when taken as prescribed. Among people who inject drugs, it reduces the risk by at least 74% when taken as prescribed. PrEP is much less effective when it isn't taken consistently.

Is PrEP Right for You?

PrEP may benefit you if you test negative for HIV and

• you have had anal or vaginal sex in the past 6 months, and you:
• have a sexual partner with HIV (especially if the partner has an unknown or detectable viral load),
• have not consistently used a condom, or
• have been diagnosed with an STD in the past 6 months.

Or

• you inject drugs and
• have an injection partner with HIV, or
• share needles, syringes, or other injection equipment.

Or

• you've been prescribed PEP (post-exposure prophylaxis) and you
  • report continued risk behavior or
  • have used multiple courses of PEP

If you are a woman and have a partner with HIV and are considering getting pregnant, talk to 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.

What Drugs Are Approved for PrEP?

There are two oral medications approved for daily use as PrEP. They are combinations of two anti-HIV drugs in a single pill:

• Truvada® is for all people at risk for HIV through sex or injection drug use. Generic products are also available.
• Descovy®) is for sexually active men and transgender women at risk of getting HIV. Descovy® has not yet been studied for HIV prevention for receptive vaginal sex.

A long-acting injectable form of PrEP, Apretude®, has also been approved by the FDA. It is administered by a health care provider every two months instead of daily oral pills.

Is PrEP Safe?

PrEP is safe. No significant health effects have been seen in people who are HIV-negative and have taken PrEP for up to 5 years.

Some people taking PrEP may have side effects, like nausea, diarrhea, headache, fatigue, and stomach pain. These side effects are usually not serious and go away over time. If you are taking PrEP, tell your health care provider if you have any side effect that bothers you or that does not go away.

And be aware: PrEP protects you against HIV but not against other sexually transmitted infections (STIs) or other types of infections. Combining PrEP with condoms will reduce your risk of getting other STIs.

How Do You Get PrEP?

If you think PrEP may be right for you, visit your doctor or health care provider. PrEP is only available by prescription. Any health care provider licensed to write prescriptions can prescribe PrEP; specialization in infectious diseases or HIV medicine is not required.

If you don't have a doctor, you can use the HIV Services Locator to find a PrEP provider and other HIV services near you. You can visit many community health centers for a PrEP consultation. More than 190 health centers in the 57 jurisdictions prioritized in the Ending the HIV Epidemic initiative are providing PrEP services. Many health centers in other jurisdictions also provide PrEP services.

Because PrEP is for people who are HIV-negative, you'll have to get an HIV test before starting PrEP and you may need to get other tests to make sure it's safe for you to use PrEP.

If you take PrEP, you'll need to see your health care provider every 3 months for repeat HIV tests, prescription refills, and follow-up.

PrEP and COVID-19

There are options for starting or continuing PrEP while COVID-19 precautions are in effect. Some clinics and health care providers offer self-testing kits so that you can safely take HIV tests at home as part of your ongoing PrEP care. Others offer telehealth appointments or 90-day prescriptions of PrEP medication to help you minimize your trips to the pharmacy. Talk to your clinic or health care provider's office about how you can access PrEP.

Find resources about COVID-19 and people with HIV.

Is PrEP Covered By My Insurance?

In most cases, yes! Under the Affordable Care Act, PrEP must be free under almost all health insurance plans. That means you can't be charged for your PrEP medication or the clinic visits and lab tests you need to maintain your prescription. There are no out-of-pocket costs for you.

This applies to most private health insurance plans you get through your employer or purchase yourself, individual plans you purchase through HealthCare.gov or state-based Marketplaces, and state Medicaid expansion coverage plans. In some states, the traditional Medicaid program also covers PrEP at no charge.^[i] This does not automatically apply to Medicare. (Medicare Part D prescription drug plans cover PrEP medication, but there will still be cost sharing.)

To find out whether your health plan covers PrEP medications without charge:

• If you have private health insurance through your employer or have purchased it yourself: Check with your health insurance company about coverage for PrEP medications, or look on their drug formulary (drug list) online to find information about coverage for the drugs approved for PrEP.
• If you purchased your health plan through HealthCare.gov or a state-based Marketplace: This NASTAD tip sheet can help you verify whether your plan covers PrEP medications.
• If you are on Medicaid: Check with your benefits counsellor.
• If you are on Medicare: Find which plans cover your drugs.

What If I Don't Have Health Coverage or Still Can't Afford PrEP?

Don't have insurance or Medicaid coverage? There are resources that may be able to help you pay for PrEP and your necessary clinic visits and tests.

One source is the U.S. Department of Health and Human Services' Ready, Set, PrEP program that provides PrEP at no cost for people without prescription drug coverage. For more information, and to find out if you qualify, see the blue box below.

Another source is Gilead's Medication Assistance Program for PrEP (Gilead is the company that makes two of the drugs currently approved by the FDA drugs for PrEP). You can apply for this program to see if you can get PrEP at no cost, based on your income. For more information call (877) 505-6986.

If you do have health insurance that still requires a co-pay but you can't afford it, you may receive co-pay assistance from drug manufacturers, state programs, or patient advocacy foundation.

Need help paying for your clinic visits and lab tests?

• You can get them at HRSA-funded Health Centers , where the sliding scale fees are based on your ability to pay. There are more than 12,000 health centers nationwide.
• Some state PrEP assistance programs also cover clinical visits and labs.

If you don't have prescription drug insurance, you may be eligible for Ready, Set, PrEP, a national program that makes PrEP oral medications available at no cost.

To qualify for Ready, Set, PrEP, you must test negative for HIV, have a valid prescription for the medication, and not have prescription drug coverage. All medications are fully covered for qualifying participants; however, the costs of necessary clinic visits and lab tests may vary depending on a person's income.

To find out if you qualify, visit GetYourPrEP.com or call toll-free 855-447-8410.

Learn More About PrEP

If you think PrEP might be right for you, or you want to learn more visit CDC's PrEP Basics.

Use the HIV Services Locator to find a PrEP provider and other HIV services near you.

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^[i] California, Colorado, District of Columbia, Delaware, Hawaii, Iowa, Kentucky, Louisiana, Massachusetts, Montana, Nevada, New Hampshire, New Jersey, Oregon, Washington, and Wisconsin. (NASTAD PrEP Coverage Brief, July 2021)

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Source: https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/pre-exposure-prophylaxis#:~:text=PrEP%20is%20only%20available%20by,other%20HIV%20services%20near%20you.

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