PrEP FAQ

  • What is PrEP?

    PrEP (short for Pre-Exposure Prophylaxis) is medication that prevents HIV and promotes sexual health.

    PrEP is for anyone – straight, gay, or bisexual. PrEP is for male, female, transgender, or gender non-conforming individuals.

    When a person takes PrEP as directed, it is 99% effective at preventing HIV.

    There are four medications approved by the FDA as PrEP for HIV: Truvada (TDF/FTC), Descovy (TAF/FTC), Apretude (CAB LA), and Yeztugo (lenacapavir). A health care provider will work with you to determine which may be best for you. Truvada and Descovy are oral medications, and Apretude and Yeztugo are injectable medications.

  • Yes. PrEP is very safe. Most people have few or no side effects. Some people get an upset stomach when they first start taking oral medication. For those who are on injectable PrEP (Apretude or Yeztugo), there may be soreness or irritation at the injection site. Talk to your health care provider about any side effects, especially if they last more than a week or so.

  • PrEP is individualized to support your sexual health and HIV prevention needs. You will need to consult with a health care provider in order to start a PrEP regimen. You can talk with your healthcare provider about PrEP or you can find a provider by clicking here.

  • Effective January 1, 2020 all issuers, except for grandfathered health plans*, must provide coverage for PrEP for the prevention of HIV infection at no cost sharing and cover screening for HIV infection at no cost-sharing. Everyone interested in PrEP, including both oral and injectable PrEP, will be able to afford it because there are many options for covering the costs. The cost of PrEP includes the cost of medication, medical appointments, and lab tests. Medicaid, Medicare (Part B, at no cost-sharing as of 2024), and most health insurance plans cover all the costs for PrEP, without co-pays or cost-sharing. Drug manufacturers offer assistance and the New York State DOH offers a PrEP Assistance Program (PrEP-AP). For information, see PrEP Payment Options (PDF).

  • Daily PrEP
    Taking PrEP once a day is the preferred method for those on oral medication. Talk with your healthcare provider about how long you need to take PrEP before you are fully protected. Daily PrEP with Truvada is the one method proven to be effective for cis-gender women and transgender men who have vaginal intercourse.

    On-Demand PrEP (2-1-1)
    On-demand PrEP is an option for you if you are a cisgender man who has sex with men and you can predict when you will have sex at least 2 hours beforehand. With on-demand PrEP, you take two pills at least 2-24 hours before sex. Then you take one pill once a day for two days after you have had sex. The only PrEP medication recommended (by CDC) for off-label on-demand use is Truvada.

    Injectable PrEP
    Injectable PrEP is an option for those who do not want to take a pill every day. Injectable PrEP is administered by a health care provider. There are two injectable options — Apretude (cabotegravir) and Yeztugo (lenacapavir). With Apretude, the initial administration will require two injections be given one month apart, and then administration will move to once every 2 months after initial establishment for lasting effectiveness. Yeztugo is given as a starter regimen and then just twice a year — one injection every six months. Injectable PrEP is another method proven to be effective for cis-gender women and transgender men who have vaginal intercourse. If you miss a dose of injectable PrEP by more than 7 days, please consult with a health care provider to be reassessed for a preventative plan.

    If you feel you no longer need PrEP, talk with your health care provider about how to discontinue it.

  • Yes. PrEP is a safe, effective and approved option for you if you weigh at least 35 kg (about 77 lbs). Your healthcare provider will determine if you are a candidate for PrEP. You can consent to the medication on your own, but billing information is something your parent or guardian may receive. PrEP is available for adolescents orally (by mouth) and as an injectable. Talk to your healthcare provider about which option is best for you.

  • PrEP is for people who are HIV negative, so the first step is an HIV test. While you are taking PrEP, you should get tested for HIV periodically to make sure you remain HIV negative.

  • PrEP does not protect you from sexually transmitted infections (STIs) like syphilis, gonorrhea, or chlamydia. Using a condom with PrEP will protect you from most STIs. When you are taking PrEP, you should get tested periodically for STIs. Early diagnosis and treatment of STIs protects your health and prevents passing STIs to your partners. Using PrEP and condoms together gives you protection from both HIV and most STIs.

  • U=U stands for Undetectable equals Untransmittable. It means that a person who has HIV and is on treatment and virally suppressed for 6 months or longer cannot transmit HIV to a partner through sex. To learn more: https://www.preventionaccess.org

    If your partner is living with HIV and their HIV is virally suppressed (or undetectable), there is no risk of you getting HIV from sex with this partner.

     

     

     

FAQs for Women

For more specific information for women, click here to access additional information about PrEP for Women.

  • What should women know about PrEP?

    PrEP is about empowerment. PrEP is under YOUR CONTROL – you don't have to tell your partner (or anyone else). Cis-gender women who have vaginal intercourse can consider daily oral PrEP with Truvada, or a long-acting injectable option — Apretude (an injection every two months) or Yeztugo (an injection twice a year). All three are proven effective for cis-gender women who have vaginal sex. (Descovy is not recommended for people who have receptive vaginal sex.) If you'd like to talk with a health care provider or counselor about PrEP, check out the Department of Health PrEP Provider Directory or talk with your own health care provider.

  • As a woman, you have special health care needs such as family planning/birth control, regular breast exams and PAP smears. You can talk about PrEP with any of your health care providers. Since PrEP involves medical appointments, it may be more convenient if you get PrEP from a health care provider you already see.

  • If you are seeking to become pregnant with someone who is living with HIV, PrEP can protect you from HIV exposure during sex when trying to become pregnant. If you are thinking about becoming pregnant, are already pregnant, or are breastfeeding, talk with your health care provider about whether PrEP is right for you. Daily oral PrEP (Truvada) has the most safety data in pregnancy; if you are considering a long-acting injectable option, your provider can help you weigh the choices.

  • PrEP is an option if you are someone who trades sex for something you need (housing, drugs, money).

  • If you are afraid of your intimate partner, and negotiating sex may be difficult, PrEP is a way to take control of your sexual health. If you've experienced domestic violence, call the National Domestic Violence Hotline at 1-800-799-SAFE (7233). All calls are free and confidential.

     

     

     

FAQs for Older Adults

Older adults date, fall in love, and have sex — and HIV doesn’t retire at 50. Yet many older adults, and even some providers, assume HIV prevention is a younger person’s concern. It isn’t. People aged 50 and older account for more than half (about 54%) of all people living with diagnosed HIV in the United States, and roughly one in six (about 16%) of new HIV diagnoses each year is in someone aged 50 or older. Older adults are also more likely to be diagnosed late — after HIV has already advanced — often because no one thought to test or to talk about prevention. PrEP is a safe, effective option at any age.

  • I'm over 50. Is PrEP really for me?

    Yes. PrEP is approved for adults of all ages, and there is no upper age limit. If you are HIV-negative and sexually active — especially with new or multiple partners, a partner whose status you don’t know, or a partner living with HIV who is not virally suppressed — PrEP can protect you. Being in a new relationship after a divorce or the loss of a spouse is a common and completely normal time to start thinking about it.

  • After menopause, lower estrogen can cause the vaginal walls to become thinner and drier. That tissue is more likely to develop small tears during sex, which can make it easier for HIV to enter the body during unprotected sex. Many older women also stop using condoms once pregnancy is no longer a concern. Together, these factors mean HIV risk does not disappear with age — and PrEP is a viable, worthwhile option to discuss with a provider.

  • For most people, no. Oral PrEP medications (Truvada and Descovy) have no known major interactions with common blood-pressure medicines, statins (cholesterol medicines), or erectile-dysfunction medicines.

    A few things are still worth a conversation with your provider or pharmacist: the older oral option, Truvada (TDF), is processed by the kidneys, so your provider may check kidney function and take extra care if you also take medicines that affect the kidneys (including some blood-pressure medicines, diuretics, or regular NSAID pain relievers). Descovy (TAF) is gentler on the kidneys and bones but can slightly affect weight and cholesterol.

    As with any new medication, bring a full list of your medications and supplements to your PrEP visit so your provider can pick the option that works best for you.

  • Yes. As of September 30, 2024, Medicare Part B covers FDA-approved PrEP medications (oral and injectable) and the related care — provider counseling, HIV testing, and Hepatitis B screening — with no cost-sharing when your provider determines you are at increased risk for HIV. If you have a Medicare Advantage plan, that plan must cover it too. Medicaid and most private plans also cover PrEP at no cost, and New York’s PrEP Assistance Program (PrEP-AP) can help with remaining costs.

  • PrEP is safe for older adults. Because kidney function and bone density can change with age, your provider may run simple lab tests before you start and periodically while you’re on PrEP, and can choose the formulation that best fits your health profile. For some older adults, the injectable options (every two months, or twice a year) are appealing because they remove the need to remember a daily pill alongside other medications.

  • You can keep it simple: “I’m sexually active and I want to stay HIV-negative. Am I a candidate for PrEP?” If your provider hasn’t discussed PrEP with older patients before, you can share that CDC guidance recommends PrEP for anyone who could benefit, regardless of age. You have every right to ask — protecting your health is a sign of power, not embarrassment.

  • Sometimes a provider may seem unsure about PrEP or hesitant to prescribe it. That does not mean it is wrong for you. PrEP is safe and effective for adults of any age. If your provider seems uncertain, you can ask questions. Try saying, "I'd like to talk about PrEP for HIV prevention. Can we discuss whether it's right for me?" You can also ask them to explain their concerns. If you still feel unheard, you have the right to a second opinion. You can also ask if there is someone at the clinic that may be more comfortable having these conversations with you, like a nurse practitioner. You can also ask for a referral or find another provider who has experience with PrEP. Your local health department or a sexual health clinic can help you find one. The PrEPforSex.org website has a provider directory that includes providers familiar with PrEP. You deserve care that takes your health and your needs seriously. Keep asking until you get it.