HIV pre-exposure prophylaxis (PrEP)

When used correctly, PrEP is very effective: It lowers the risk of getting HIV through sex by about 99% and lowers the risk of getting HIV through injection drug use by at least 74%. But it’s important to know that there’s still a small chance of getting HIV even if you take PrEP exactly according to directions. Using condoms every time you have sex and not sharing needles will reduce your HIV risk even further, and these steps will also help to prevent other infections that PrEP doesn’t protect against.

Most people on PrEP take a daily pill by mouth. There are a couple of options available, and your provider will make a specific recommendation based on your health history, lab results, and cost considerations. There’s also an injectable medication that’s given by a health care provider every two months. The injection is a good option for people who can’t take other PrEP medications or would have trouble taking a pill every day, but it’s also more expensive, may not be covered by insurance, and requires more visits to a healthcare provider.

A provider will determine if you need prescription medication to treat your conditions and/or symptoms. If your care plan includes a prescription, you'll be asked to select a pharmacy. You can send it to your preferred pharmacy or select Amazon Pharmacy to get your medications delivered right to your door.

PrEP 2-1-1 is an “on-demand” approach to HIV prevention that may be an option for some people who were assigned male at birth and can plan ahead for sex. PrEP 2-1-1 involves taking two pills 2 to 24 hours before having sex and one pill 24 hours after sex. PrEP 2-1-1 isn’t for everyone: It hasn’t been shown to work for people who were assigned female at birth or for people who inject drugs and isn’t recommended for those with an active hepatitis B infection.

PrEP medications are safe and pose far fewer health risks than HIV infection. Your provider will likely recommend that you continue PrEP for as long as you’re at increased risk of getting HIV. If your risk changes or you need to stop PrEP for another reason, talk with your provider about the best timing and any special precautions you should take rather than stopping medication on your own.

If you’re starting PrEP medication or restarting PrEP after a break, it will take some time for your body to build up enough of the drug to prevent HIV effectively. For receptive anal sex (bottoming), daily PrEP pills reach maximum protection from HIV after about 7 days. It takes around 21 days after starting PrEP pills to reach maximum protection for receptive vaginal sex and injection drug use. It’s less clear how long it takes to be maximally protected when taking injectable PrEP medication, but it’s safest to avoid situations that would put you at higher risk for getting HIV for at least a week and up to a month after starting injectable medication.

PrEP medication causes few or no side effects for most people. A small percentage of people who take an oral pill for PrEP notice side effects like headache, nausea, or abdominal pain during the first few weeks after starting PrEP, but these side effects should go away with time. People taking injectable PrEP medication may notice diarrhea, headache, fever, fatigue, difficulty sleeping, nausea, or dizziness when first getting started.