PrEP to Prevent HIV - NYC Health

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PrEP to Prevent HIV

Pre-exposure prophylaxis (PrEP) is safe and effective medicine that prevents HIV.

To get started on PrEP, talk to your health care provider, or visit an NYC Sexual Health Clinic. You can find clinics that provide PrEP by visiting the NYC Health Map or calling 311. Your PrEP provider will test you to make sure you do not have HIV.

Taking PrEP

PrEP is available as a pill or a long-acting injection.

Daily PrEP

Once a day: Take a pill that contains PrEP medicine – either Truvada (available as a generic) or Descovy.

Every 3 months: Check in with your provider to refill your prescription and get tested for HIV and other sexually transmitted infections (STIs). Some clinics offer check-ins by phone or video chat.

PrEP on Demand

Men who have sex with men can take Truvada as PrEP on demand. With PrEP on demand, take PrEP pills only before and after sex:

2 pills 2 to 24 hours before sex (the first dose)

1 pill 24 hours after the first dose

1 pill 48 hours after the first dose

If you keep having sex, continue taking 1 pill every 24 hours until you have taken two pills after you last had sex.

When taken as prescribed, PrEP on demand prevents HIV during anal sex. Taking PrEP on demand may not protect you during receptive vaginal sex.

PrEP on Demand (PDF)

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Injectable PrEP

Every 2 months: Visit your provider to receive an injection of Apretude, a long-acting PrEP medicine, and get tested for HIV and other STIs.

Talk to your provider before you stop taking injectable PrEP.

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Compare Daily PrEP, PrEP on Demand and Injectable PrEP

Daily PrEP

Medicines to use: Truvada (available as a generic) or Descovy

Who can take it: Anyone can take Truvada as daily PrEP. Descovy has not been approved for people who may have receptive vaginal sex.

When to take it: Every day

Planning around sex: None

If you miss a pill or injection: Protects during anal sex even if you occasionally miss a pill. May not protect as well during receptive vaginal sex if you miss pills.

PrEP on Demand

Medicines to use: Truvada

Who can take it: Only shown effective for cisgender men who have sex with men. Not for people having receptive vaginal sex.

When to take it: Before sex and then every day until two days after you last have sex

Planning around sex: Must take first dose two to 24 hours before sex — closer to 24 hours is better

If you miss a pill or injection: You must take each pill as prescribed. Use condoms if you are unable to take a pill in time, or emergency PEP if you miss a dose.

Injectable PrEP

Medicines to use: Apretude

Who can take it: Anyone who may be exposed to HIV during sex

When to take it: Every two months

Planning around sex: None

If you miss a pill or injection: If you delay a scheduled injection by more than seven days, you must take the medicine in pill form until your next injection.

How to Pay for PrEP

In New York State, PrEP is covered by Medicaid and most health insurance plans without any co-pays for medicines, lab work or clinic visits.

Ask your clinic about patient assistance programs that help people who are uninsured or undocumented pay for PrEP.

Learn more about your Payment Options for PrEP (PDF).

Who Should Take PrEP

Consider taking PrEP if you do not have HIV and any of the following apply to you. If you:

Are worried you may be exposed to HIV

Do not always use condoms during sex

Recently had a sexually transmitted infection (STI)

Recently took emergency PEP to prevent HIV

Inject drugs and share syringes or other injection equipment

Have a partner who has HIV and a detectable or unknown viral load

Have a partner who may have HIV or who refuses to get an HIV test

How PrEP Stops HIV

If you take PrEP and are exposed to HIV, the medicine in PrEP stops the virus from spreading throughout your body.

PrEP only stops HIV if you have enough medicine in your body, so you need to take it as prescribed.

When taken as prescribed, PrEP reduces the risk of getting HIV through sex by about 99%. In rare cases, people have gotten HIV despite taking PrEP as prescribed.

PrEP Only Prevents HIV

To prevent other STIs, get tested regularly and use condoms correctly and consistently.

To prevent pregnancy, use birth control.

PrEP Is Safe

The medicines used for PrEP are safe. Truvada has been used to treat people with HIV since 2004 and has been used for PrEP since 2012. Clinical trials have shown that Descovy and Apretude are also safe medicines.

Side Effects

Most people on PrEP do not report any side effects. The most common side effects are nausea, upset stomach, fatigue and headaches. These symptoms often get better or go away within the first month or two of taking PrEP. PrEP injections may cause swelling or redness at the injection site. Rare side effects of PrEP include kidney or bone problems.

Your health care provider can help you manage any side effects.

Stopping PrEP

PrEP protects you against HIV as long as you take it as prescribed. Tell your provider if anything makes it difficult for you to take PrEP.

Talk to your provider before you stop taking PrEP. You will need to use another method to prevent HIV.

PrEP for Adolescents

In New York State, you can get PrEP or other sexual health services without a parent’s permission, including at NYC Sexual Health Clinics. Learn about your rights and steps you can take (PDF) to keep your PrEP prescription or other sexual health services confidential.

PrEP for Women

PrEP is a safe and effective HIV prevention option for women.

Truvada pills and injectable Apretude are approved for cisgender women and transgender women, and Descovy is approved for transgender women. Descovy may not be appropriate for cisgender women or transgender men because of a lack of research on how well it prevents HIV during receptive vaginal sex.

People who have receptive vaginal sex need to be especially careful to take PrEP pills every day to maintain enough medicine in their vaginal tissue to prevent HIV.

PrEP Does Not Interfere with Hormone Therapy

There is no evidence that PrEP interacts with estrogens or affects the levels of hormones in your body. Research has found that transgender women who take PrEP as prescribed are protected from HIV.

PrEP Does Not Interfere with Birth Control

Research shows that PrEP does not interfere with any kind of birth control.

PrEP Can Protect You and Your Fetus During Pregnancy and Your Baby If You Are Nursing

PrEP protects people who are pregnant from getting HIV, which protects their fetus and baby from being exposed to HIV during and after pregnancy.

PrEP is safe to use during and after pregnancy and has not been shown to affect fertility.

If you would like to take PrEP while trying to conceive, talk to your health care provider.

Additional Resources

User's Guide to Daily PrEP (PDF)

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User's Guide to Injectable PrEP (PDF)

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User's Guide to PrEP on Demand (PDF)

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PrEP Prevents HIV: Pocket Guide (PDF)

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Payment Options for PrEP in New York State (PDF)

More Information

HIV PrEP and PEP Information for Providers

Emergency PEP to Prevent HIV

HIV Main Page

HIV PrEP and PEP Action Kit