PrEP & PEP Facts

About Pre-Exposure Prophylaxis (PrEP)

You may be able to protect yourself with a once a day pill using PrEP if you:

  • Are HIV-negative;
  • Consider yourself at risk for HIV;
  • Have recently been exposed to HIV; or
  • Have recently had or been exposed to another sexually transmitted disease.

PrEP FAQ: 

What is Pre-exposure Prophylaxis (PrEP)?

  • It is a complicated word for an easy medication. Let's break it down:
    • Pre = before
    • Exposure = coming into contact with HIV
    • Prophylaxis = preventing an infection from occurring
  • Pre-exposure prophylaxis (PrEP) can be used by people who are HIV-negative to reduce their risk of becoming infected with HIV if they come in contact with the virus. PrEP is taken once a day.
  • Studies have shown PrEP can reduce risk of getting HIV by 92-99% if taken everyday.
  • PrEP can be used for heterosexual, bisexual, gay and transgender individuals, and also by injection drug users and pregnant women.
  • It is important to know that PrEP is not a cure for HIV and it cannot protect you from pregnancy or other sexually transmitted infections (STI), like gonorrhea or chlamydia.

Who should take PrEP?

Generally, PrEP can be prescribed for people who are HIV-negative and have a higher chance of coming into contact with HIV. This includes people that are:

  • In an ongoing relationship with an HIV positive partner. Remember, your best protection is to discuss with your partner his or her HIV treatment. Treatment of your partner’s virus to “undetectable” is highly effective at preventing transmission. This is known as treatment prevention.
  • Gay or bisexual men who have sex without a condom or have been diagnosed with a sexually transmitted infection (within the past six months) – even if you don’t consider yourself gay/bisexual, but you are a man who every now and again has sex with other men, PrEP may be right for you;
  • Heterosexual man/woman who does not regularly use condoms and does not know the HIV status of one or more partner(s);
  • Current injection drug use;
  • For heterosexual couples who are trying to have a baby, PrEP is an option to protect the HIV-negative partner while trying to become pregnant.

Is taking PrEP difficult?

No. Taking PrEP can be very easy, but you will have some things to remember while using PrEP, including:

  • Taking one pill once a day, around the same time every day. The pill is called Truvada.
  • Getting regular testing for HIV and STIs (every 3 months); and
  • Regular visits with your healthcare provider - going to see a doctor, nurse practitioner or physician assistant to get your labs checked and refill your medication.

Does PrEP protect against other sexually transmitted infections (STIs) or blood-to-blood contact diseases, like Hepatitis?

No, PrEP only decreases the risk of getting HIV, it will not protect you against other STIs. Even while on PrEP, you should still use condoms to protect yourself. Free condoms can be mailed to you from Gilead Pharmaceuticals.

If you are currently an injection drug user, using clean needles that haven't been used by anyone else will help reduce your risk significantly of getting HIV or other blood-to-blood contact diseases like hepatitis. Baltimore City Health Department sponsors a Free Clean Needle Exchange.

How well does PrEP work at preventing HIV?

PrEP can be 92%–99% successful in decreasing the risk of getting HIV, if taken everyday without missing any pills.

If I’m using PrEP, do I still have to use condoms?

PrEP can be 92%–99% successful in decreasing the risk of getting HIV, if taken everyday without missing any pills. Condoms can also help prevent HIV when used consistently and correctly. You have to figure out what works best for you, and how comfortable you are with uncertainty; again PrEP is only 92-99% successful if you take the medication daily. Some people will keep using condoms while on PrEP and others will decide to stop using them. If you are already using condoms consistently, and doing so makes you feel comfortable and protected, then keep doing what feels right to you. Many people struggle with using condoms consistently or prefer sex without condoms. You have to decide for yourself what level of protection feels right and gives you the peace of mind to lead a sexually fulfilling life. Remember, PrEP does not protect against other STIs like gonorrhea, chlamydia, syphilis, or herpes, nor does it prevent pregnancy.

What are the side effects of taking PrEP?

The medication used for PrEP is called Truvada and has only a few mild side effects. During the first 2-3 weeks that Truvada is started, some people have nausea, fatigue and dizziness. Some people report an increase in gas. These side effects should go away after those first 2-3 weeks once your body becomes used to the medication. The better you are at remembering to take your pill everyday, without missing doses, the faster the side effects will go away.

What are the long-term effects of taking PrEP?

There is no current research that shows the long-term effects of using Truvada for PrEP, but this medication has been used for many years for treatment of HIV. Truvada may decrease kidney health and your bone density. If you have any side effects while taking Truvada, it is important to tell your healthcare provider. Your provider will monitor your kidney and, if needed, your bone health during your treatment.

How much does PrEP cost?

There are many options to cover the costs of Truvada, this includes the majority of insurance plans, including plans obtained through Maryland Healthcare Exchange.

  • With no healthcare insurance the drug can cost between $8,000 and $14,000 per year.
  • You will also have to also think about the cost of following up with your healthcare provider for blood work at least four times per year. Depending on your out of pocket deductible (the amount you are required to pay), the costs of your visits may vary widely. It is important to discuss your options for health coverage with your healthcare team.
  • Check with your insurance provider to see if PrEP is covered .
  • See the Maryland Health Connection website.

About Post-Exposure Prophylaxis (PEP):

Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) are not the same thing. Post-Exposure Prophylaxis (PEP) prevents HIV infection after coming into contact with HIV. PEP is an emergency medicine that can stop HIV infection if taken as soon as possible, but not greater than 72 hours after coming in contact (or potential contact) with HIV.

PEP: The Basics

  • Why take PEP? PEP can protect you if you had anal or vaginal sex without a condom with someone who has, or might have, HIV. PEP can also prevent HIV if you were exposed while injecting drugs. PEP can also be used if you have recently been forced to have sex against your will, particularly if the HIV status of the individual is not know.
  • When to take PEP? PEP works best if started right away. Go to an emergency room or clinic as soon as possible and ask about PEP. You should begin PEP within 72 hours after the exposure.
  • Take PEP for 28 Days. PEP is taken in pill form for 28 days. You need to take PEP each day to keep enough medicine in your body to stop HIV. If you want to stop taking PEP, talk to your doctor first.
  • Are there any side effects? PEP can have mild side effects, like nausea and headache.
  • Follow-up with your healthcare provider. After you finish taking PEP, your healthcare provider will give you an HIV test to make sure PEP worked.
  • Want to reduce your risk for HIV before coming into contact with HIV? If you usually worry that you are at risk of getting HIV, ask your healthcare provider about pre-exposure prophylaxis (PrEP) – a once a day pill that prevents HIV, if taken correctly. [Add PrEP info for patients link]
PEP FAQ: 

What is Post-Exposure Prophylaxis (PEP)?

  • Post = after
  • Exposure = coming into contact with HIV
  • Prophylaxis = preventing an infection from occurring
  • Post-exposure prophylaxis (PEP) is an HIV prevention option where HIV-negative individuals take HIV medications after coming into contact with HIV to reduce their risk of becoming infected. PEP medication is taken everyday for one month and must be started as soon as possible after contact with HIV.

How do I know if I need PEP?

PEP is for HIV-negative people that had vaginal or anal sex without a condom (or a condom broke) with an HIV-positive person. PEP can also help if you were a victim of sexual assault or exposed to HIV due to injection drug use. It works best if taken within 72 hours after contact with HIV.

How does PEP work at stopping HIV?

PEP uses some of the same medicines that people living with HIV take to stay healthy. If you are exposed to HIV, it takes a few days for an HIV infection to spread in your body. As soon as you start PEP, these medicines begin to stop the virus from growing.

How well does PEP work?

PEP is not 100% effective. If PEP is taken as soon as possible after an exposure and consistently for 28 days, it can prevent HIV infection. It works best if taken within 72 hours after contact (or potential contact) with HIV. In one research study of healthcare workers who were accidentally exposed to HIV, PEP reduced their chances of getting HIV by 80%.

If I take PEP, do I still have to use condoms?

  • PEP does not fully protect you against HIV, nor is it a cure for HIV. Condoms give you and your partners’ additional protection, even while on PEP. Condoms also protect against other sexually transmitted infections (STIs) and pregnancy.
  • PEP is only for emergency situations. If you are often concerned about getting HIV, Pre-exposure Prophylaxis (PrEP) may be a better option for you. [Link to PrEP patient information]