The pill that prevents HIV.

There are about 1.2 million Americans living with HIV with about 15 percent (1 in 7) unaware they are infected. An estimated 38,700 became newly affected Americans in 2016 and there are an estimated 39,000 new cases of HIV transmission each year. Sadly, most of these cases are among gay and bisexual men of color. That’s why now, more than ever, we need to increase awareness and uptake for Pre-Exposure Prophylaxis (PrEP), a new, highly effective tool to prevent the transmission of HIV.

In October 2019, California Governor Gavin Newsom signed Sen. Scott Wiener (D-San Francisco) and Asm. Todd Gloria’s  (D-San Diego) Senate Bill 159 — co-sponsored by Equality California — expanding access to life-saving HIV prevention medication. When it goes into effect on January 1, 2020, California will become the first state in the nation to authorize pharmacists to furnish at least a 30-day supply — and up to a 60-day supply — of PrEP and a complete course of PEP without a physician’s prescription. The bill is a key step in California’s work to eliminate HIV and delivers on Newsom’s campaign pledge to take aggressive action to end the HIV epidemic.

PrEP involves an HIV-negative person taking the antiretroviral medication Truvada preventatively, once per day, to provide a high-level of protection against HIV. When used correctly, studies have shown that PrEP reduces the risk of getting HIV from sex by up to 99%. The medication Truvada is currently the only medication approved by the U.S. Food and Drug Administration (FDA) for PrEP.

If you decide that PrEP is right for you, you can speak with your primary care physician or, starting  January 1, 2020, Californians can receive PrEP and PEP directly from a pharmacist and without a physician’s prescription. PrEP is for HIV negative patients only, and routine HIV screening and blood work is required to remain on the medication. To determine if you can get PrEP for free or low cost, check out NASTAD’s PrEP cost calculator, here: PrEPcost.org.

How does PrEP work?

Truvada works by preventing HIV from establishing in the body. If you are exposed to semen, vaginal fluids or blood from an HIV-positive person, then Truvada acts as a protective measure to halt transmission. For optimal protection, the pill should be taken daily.

The CDC has determined that 1 in 4 gay and bisexual men should be on PrEP. Who else should be on PrEP?

• If you are HIV-negative and have anal or vaginal sex without a condom.
• If you have sex with an HIV-positive person or someone whose HIV status you’re unsure of.
• If your primary sex partner is HIV-positive.
• If you engage in sex with multiple partners.
• If you or your sex partner(s) exchange sex for money, housing, or other needs.
• If you or your sex partner(s) engage in injectable drug use.
• If you occasionally, rarely, or never use condoms.
• If in the past year you have taken post-exposure prophylaxis (PEP) to prevent HIV infection, had a sexually transmitted infection (STI), or used recreational drugs such as cocaine, ecstasy, stimulants, or GHB.
• Are you trying to safely have a child with an HIV-positive partner?

Does PrEP have side effects?

• The majority of PrEP users report zero side effects. However, some people experience nausea, dizziness, and weightloss, with these minor side effects usually resolving within the first few weeks of starting PrEP.
• A very small number of individuals experience modest declines in kidney function¹ or bone mineral density², both of which returned to normal once PrEP was discontinued. Your provider will do tests while you are taking PrEP to determine if you are experiencing any of these problems.
• Importantly, a new study has shown PrEP to be as safe as aspirin.

Talking to your doctor:

• Patients interested in PrEP should also check out LA County Department of Public Health’s Patient PrEP Self-Assessment Card to see if PreP is right for you!
• Any doctor can prescribe PrEP. It’s important that you have an open and honest conversation with your doctor about your sexual behavior.
• Be honest. If you rarely or never use condoms, then tell your doctor. Inconsistent condom-use is a great reason to be on PrEP, and you shouldn’t be ashamed to tell that to your doctor. Remember, while PrEP helps prevent HIV, it does not protect against other sexually transmitted infections (STI). Condoms remain the most effective tool to protect against all STIs.
• You might need to educate your doctor about the availability and effectiveness of PrEP. The CDC has created a PrEP Healthcare Provider Guidelines document which provides comprehensive information for the use of daily oral antiretroviral PrEP to reduce the risk of acquiring HIV infection in adults. You should also bring this PrEP Service Delivery Checklist, created by the County of Los Angeles Department of Public Health, to ensure your healthcare provider obtains the information necessary to prescribe you PrEP and conducts appropriate follow-up appointments. Additional information on PrEP can be found here.
• Most hospitals and clinics will have a physician that specializes in HIV. Your doctor might want to talk to them before prescribing you PrEP. This is completely okay! This just means that your doctor might have additional questions on PrEP and is going through the appropriate channels to get you the medicine that you need.
• If your doctor refuses to prescribe your PrEP, questions your motives, or makes you feel uncomfortable for requesting it, then try to find another doctor. It is important to find a doctor that supports and respects any available preventative tools to enhance your sexual health.

All PrEP educational content and information on this website has been compiled from information consistent with current CDC guidelines for use of PrEP, Risk Evaluation and Mitigation Strategy (REMS) guidelines, and clinical trials of oral daily PrEP.

The information provided on this website is intended for your general knowledge only and is not a substitute for professional medical advice or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your health, including HIV prevention.

Supported by grant funding from Gilead Sciences, Inc. Gilead Sciences, Inc. has had no input into the development or content of these materials.