What is PrEP and how can I get on it?

Being informed and proactive is very sexy!

Listen, we are all about being sex positive over here. We want you to get out there, live your wildest dreams, act out your craziest fantasies, and do what you can to make us want to live vicariously through you.

However, just like consent is sexy, so is protecting yourself against sexually transmitted infections (STIs), especially ones like HIV.

There’s still a lot of stigma out there about HIV, which is unfortunate but not the topic at hand for the day. However, there are ways to protect yourself against the virus, and the best way is through PrEP.

Unsure what PrEP is or trying to broaden your knowledge? Keep reading for some basic tips, as well as how you can get some for yourself.

What is PrEP?

PrEP stands for “Pre-Exposure Prophylaxis” and is used as a medication to reduce the risk of contracting HIV through sex or injection. According to the Centers for Disease Control and Prevention (CDC), PrEP reduces the risk of contracting HIV through sex by about 99% when taken as prescribed. Conversely, less information is known about its effectiveness against injection from those who use drugs, thought it is estimated that the pill can be up to 74% effective when taken as prescribed. However, those who do inject drugs are not recommended to take the injectable form of PrEP, which we will talk more about next.

What are the different types of PrEP?

On that note, there are two ways PrEP can be administered, and that is either orally or by gluteal intramuscular injection. Both require prescriptions from a doctor and frequent labs to make sure you’re still both negative from HIV and also that your body isn’t having any adverse reactions to the medication.

On the oral side of things, there are two different types of pills you can use: Truvada and Descovy. Truvada was the first of its kind on the market, but these days is more commonly used for those at risk of HIV contraction through either sex or drugs, whereas Descovy is used more for people who are only at risk through sex. Both pills are to be taken daily, with or without food but ideally at or around the same time, and can take up to seven days before they reach their full effectiveness.

For the injection, this is newer to the market, and the medication is called Apertude. It’s injected into your butt and must be administered by a doctor. Be forewarned: The injection hurts. A lot.

There’s an initial injection in one butt cheek, followed by a second injection on the other side one month later. After the second injection, you only need to get the dosage every other month, which is great for people who struggle to remember taking a daily pill. There may or may not be a period of time using the pill version of Apertude first just to make sure your body doesn’t have any adverse reactions.

Where can I get PrEP?

PrEP needs to be prescribed by a doctor. However, there are a number of online services you can go through, such as MISTR or Nurx, that will help set you up if you don’t want to visit your doctor in-person or you don’t have access to a doctor who you feel comfortable discussing this medication and/or your sexual health with.

Can HIV-positive people go on PrEP?

No. PrEP is used as an HIV preventative and is not made for those who have already contracted HIV. If you’ve already contracted the virus, you will need to go onto an Antiretroviral (ARV) medication, such as abacavir or didanosine to monitor your viral load. There are currently eight FDA-approved ARVs in the nucleoside reverse transcriptase inhibitors (NRTIs) base.

Does PrEP protect against any other STIs?

This is a major, major, major NO. No it does not. It does not do a single thing to prevent against chlamydia, gonorrhea, syphilis, or anything else. Not one single thing.

Is PrEP only for gay people?

This is also a major, major, major NO, but I’m less angry at you for thinking so. PrEP can be used by anybody who is currently at risk of HIV, and that most definitely includes women and straight men. Cis straight people made up 22% of new HIV diagnoses in 2020, and a lot of them are missing out on some much needed protection because they view HIV as a “gay disease” and let their stigma get in the way of their prevention. If you happen to be either straight or a woman reading this, you can go on PrEP if you want to!

What is the difference between PrEP and PEP?

PrEP and PEP are by and large the same thing, but PrEP is used for people who have not yet been exposed to HIV, where as PEP stands for “Post-Exposure Prophylaxis,” meaning it’s used as an emergency measure during a last resort, such as losing a condom during sex. It’s super important to note that PEP must be taken as soon as possible and can’t be taken more than 72 hours after exposure. It is not guaranteed to work.

Is PrEP covered by insurance?

What a great question! What a complicated answer, as it always is when it comes to insurance. For the long story short, yes, for the most part, most insurance plans and state Medicaid programs cover PrEP. The same goes if you wind up needing PEP. However, keep in mind that a lot of insurance plans don’t actually cover the Apertude, but a lot of state Medicaid programs do.

How much does PrEP cost out of pocket?

Hold your horses on this one, because your wallet’s going to gasp for you. The average price for Descovy is $2,392 per month, with Truvada averaging $2,022, a round of PEP between $600 to $1000, and Apertude is around $4,084 for the 3 milliliter supply. Keep in mind there are the initial months of going on Apertude before it becomes every other month, but for the most part, it’s about the same price as the others.

Can’t afford the out of pocket costs and still don’t have insurance? Fortunately, there are a few options you could choose from that may be able to help:

• Ready, Set, PrEP makes the medication available at no cost to those who qualify through HIV.gov.
• ViiVConnect offers a financial support program for various medications.
• Gilead’s Advancing Access program will help you understand your financial options
• Q Care Plus offers free online PrEP and is one of the few that also offers doxy-PEP.
• You can also check to see if you live in a state that offers a PrEP Assistance Program of any kind

I want to be discreet about my PrEP usage, what do I do?

I used to be afraid to ask any questions about PrEP or to go on it, so I totally get the desire to have discretion. However, it can be a little tricky to have it, though not all the way impossible. If you’re just wanting to avoid dealing with anything involving PrEP in public, online services like the ones listed above or others you find in your own research will be your best bet. However, if you’re wanting to hide the pills completely, you might be better off getting the injectable, though you will have to deal with your doctor in person to do so.