PrEP is short for “Pre-Exposure Prophylaxis” but we like to call it the HIV prevention pill. When taken every day, the antiretroviral medicine in PrEP can protect an HIV negative person from becoming infected with HIV if exposed to the virus through sex or needle sharing with an HIV positive person.

When taken every day, PrEP reduces the risk of getting HIV from sex by more than 90%. Among people who inject drugs, it reduces the risk by more than 70%. Your risk of getting HIV from sex can be even lower if you combine PrEP with condoms and other prevention methods.

PrEP can protect you from HIV but it cannot protect you from other STIs like gonorrhea, chlamydia, and syphilis. While these other STIs are treatable, they are not fun and can potentially become dangerous, so your best plan is to maximize your protection from all STIs by taking PrEP and using condoms.

Young, old, gay, straight or trans—if you are HIV negative but at higher risk for HIV infection, PrEP could be a good HIV prevention method for you. PrEP is a great prevention option for HIV negative people who:

• don’t always use condoms
• have ever had an STI
• are men who have sex with men
• have HIV positive partners
• don’t know whether their partner is HIV positive but do know they either inject drugs or have sex with other people

The best way to find out if PrEP is right for you is to call us or visit our clinic. One of our providers will explain in detail how PrEP works, and determine if you meet certain medical requirements such as an HIV negative status, weight of at least 77 pounds, and no kidney, bone, or liver problems, including hepatitis

A lot of people fear the side effects of PrEP but the majority of people don’t get any. For those who do experience side effects, they usually only last for a couple of weeks. The most common side effects of PrEP are headache, stomach pain, and decreased weight. Rarely, some people can experience more serious kidney and bone problems, but your provider will monitor you before and during PrEP to catch problems before they become serious. After a few weeks of PrEP use when any side effects have subsided, most PrEP users find the protective benefits of PrEP are well worth any problems from temporary side effects.

Health experts like the CDC report that people who are HIV negative and have been taking PrEP for up to 5 years, have had no significant health effects. Truvada, the medicine in PrEP and HIV treatment, is associated with kidney and bone problems in people living with HIV but these side effects are not significant in HIV negative, healthy people with no previous problems. One advantage of PrEP is the routine medical visits, where your provider will closely monitor any potential long-term effects of PrEP. Because PrEP is relatively new, there is no data on its long-term effects.

PrEP doesn’t necessarily need to be taken forever; it’s only needed during periods or “seasons” of high risk behavior. Someone can be at high risk for HIV today but next month find themselves in a different situation where their risk of HIV infection is low. Someone can engage in weeks, months or years of sometimes unsafe casual hookups (season of risk) and then either begin a monogamous relationship with an HIV negative partner or choose not to have sex for a while (no longer in a season of risk). Some people even find that they might be more sexually active in the spring and summer than in other months, so that can also be a season of risk when PrEP could be a good HIV prevention option.

PrEP is now covered by most insurance plans, including Medicaid. If you do not have any health insurance, we can help you look for other ways to cover the cost including medication assistance programs sponsored by the New York State Department of Health and the maker of PrEP.

Montefiore has a number of PrEP options for youth and adults. If you are between the ages of 13-25, you can get PrEP from the Adolescent AIDS Program (AAP). To make an appointment at the AAP, call or text 347-514-0785. If you are aged 26 or older, there are several Montefiore clinics throughout the Bronx that offer PrEP. To make an adult appointment for PrEP, call or text 718-644-2937.

No. In New York State, minors have the right to consent on their own to testing, prevention and treatment for all sexually transmitted infections including HIV. While we encourage young patients to discuss with their parents their health issues and any medications they take, we recognize that this is not always possible.

Speed of protection depends on whether you are at risk for HIV from anal sex or vaginal sex. The highest level of protection against anal exposure to HIV is achieved after 7 daily doses of PrEP. High-level protection for vaginal exposure comes after 20 daily doses of PrEP.

For men, if a daily dose is missed, PrEP is still effective but the level of HIV protection may decrease depending on the number and frequency of missed doses and when you have sex. We don’t yet know if women still have protection if they miss doses. The best way to ensure you are fully protected with PrEP is to get into the habit of taking it correctly and consistently.

Yes, but be sure to discuss PrEP with your obstetrician or midwife before starting. The medicines in Truvada (PrEP) have been studied among pregnant women living with HIV and hepatitis B and there is no known increased chance of birth defects, growth problems, or complications during pregnancy, including preterm birth and miscarriage. Research has also shown that Truvada is safe during breastfeeding. Only a very small amount of Truvada gets into babies through breastmilk, so babies do not likely experience side effects when their mother is taking PrEP.

Yes, though you need to consult with your provider to coordinate your hormone and PrEP therapies. Good news: PrEP does not lower feminizing hormone in trans women.

Yes. So far, there have been no reports of negative interactions between PrEP and alcohol, weed or party drugs. In fact, many people who report high risk behaviors as a result of drinking or drugs find that PrEP is a good prevention option because it can be taken before partying when they are sober, whereas a condom needs to be used correctly at the time of sex, when judgement may have been impaired by substance use.

Data from many PrEP studies has found no complaints of sexual side effects like problems with erections or ejaculations caused by using PrEP. In fact, many people on PrEP have stated the opposite: many have said sex has improved because they have less anxiety and fear about HIV.

It’s not about who you are but what you do. PrEP is a good prevention option for people who engage in insertive anal sex but it is an even better option for those who have receptive anal sex. Because the tissue in and around the anus is more susceptible to HIV than the tissue around the penis, people who bottom are biologically more at risk for HIV than those who top. For those who bottom, one of the great things about PrEP is that once absorbed into the body, a lot of the medicine concentrates in the bowel tissue, ready to fight any HIV encountered in that area. But again, that doesn’t mean PrEP isn’t also a good prevention option for tops or versatile guys, too.

No. At the beginning you will be seen more frequently but once your PrEP care is established, you will likely only be seen every 3 months. At the AAP, these check-ups include a phone call from your provider 2 weeks after you start PrEP to make sure you are doing well, followed by an office visit 2 weeks after that call. Thereafter, you will be scheduled for an office visit every 3 months while you are taking PrEP. Many people on PrEP enjoy the fact that they are being seen regularly by healthcare professionals and many have benefitted from providers identifying and addressing other health issues that might have gone ignored.

This issue is called “drug resistance” but since most people taking PrEP are HIV negative, drug resistance is not a problem because there is no HIV to make copies of itself in the body. Studies show no resistance in people who test negative and take PrEP correctly and consistently. Before starting PrEP, it is important to make sure you are HIV negative because you run the risk of developing HIV drug resistance if you already are living with HIV. This is because Truvada, the medicine in PrEP, is not sufficient on its own for treating HIV. To protect people on PrEP from developing HIV drug resistance, you must engage in regular HIV testing so that if you do become infected with HIV your provider can keep you healthy by taking you off PrEP and putting you onto HIV treatment.

As described above, PrEP is a medication taken daily to prevent HIV infection when an HIV negative person becomes exposed to the virus. PEP, which is short for “Post-Exposure Prophylaxis” is a medication an HIV negative person takes immediately after a possible exposure to HIV to help prevent infection. One important fact: in order for PEP to work it must be taken within 72 hours of exposure to HIV through sex or needle sharing.

It is true that modern HIV treatments are highly effective at keeping people living with HIV healthy but it is still somewhat of a burden to treat a disease for the rest of your life. Ask anyone living with HIV if they would rather have had the option to take PrEP instead of maintaining lifelong treatment for HIV, and you will likely hear many reasons why PrEP is the easier, healthier, less stressful choice.