Pre-Exposure Prophylaxis (PrEP): Effectiveness, Adverse Effects, Cost Implications, and Other Factors

Pre-Exposure Prophylaxis (PrEP): Effectiveness, Adverse Effects, Cost Implications, and Other Factors

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PrEP, or preexposure prophylaxis, is a treatment for HIV prevention for people who do not have HIV but have an increased risk of contracting the virus. This article provides an overview of PrEP, its effectiveness, side effects, and availability.

Most insurance plans cover the cost of PrEP, including the medication, lab tests, and clinic visits. However, for those without insurance, some programs may cover PrEP for free or at a reduced price. One such program is Ready, Set, PrEP. Other programs that may offer PrEP at a reduced fee include co-pay assistance programs and state PrEP assistance programs.

PrEP is a treatment regimen for people who have a high risk of contracting HIV. It contains antiretroviral medications that lower the risk of acquiring HIV for people exposed to the virus. Truvada is an oral PrEP medication made of emtricitabine in combination with tenofovir disoproxil fumarate, while Descovy is an oral PrEP medication made of emtricitabine in combination with tenofovir alafenamide. Apretude is an injectable PrEP medication made of cabotegravir.

While the medications doctors use for PrEP are the same as those they prescribe for treating HIV, taking only Truvada or Descovy to treat HIV is ineffective. People can use an online tool to locate a PrEP provider.

PrEP is primarily for people who have an ongoing risk of contracting HIV. This includes people who have had sexual contact with a partner living with HIV, have received a sexually transmitted infection (STI) diagnosis in the last 6 months, or have not consistently used a condom or other barrier method during sex. People who use injected recreational drugs and share needles or other equipment with others may also need PrEP.

If a person believes that they have already had exposure to HIV, PrEP will not provide adequate protection. PEP medication is an option for preventing HIV in people exposed to HIV in the past 72 hours. A person may be eligible for PEP if they consult a healthcare professional within 72 hours of potential exposure. PEP prevents HIV in people who have had exposure to the virus.

A person will need to take PEP for 28 days. During treatment, a person will have routine follow-up appointments with their healthcare professional for HIV tests.

With proper use, PrEP treatment is 92% effective in reducing the chance of contracting HIV via sex and 74% effective in reducing HIV contraction via injection drug use. However, it is important to note that while PrEP is highly effective, no PrEP method is 100% protective; rare cases of HIV infection with drug-resistant strains have been documented with Truvada despite adherence.

Adults and adolescents need to weigh at least 77 pounds (lbs.) to take PrEP. Side effects that people may experience include diarrhea, nausea, headaches, fatigue, and stomach pain. The following list shows some additional side effects of Truvada: depression, dizziness, upper respiratory infection, rash, and sleeplessness.

Apretude requires strict HIV testing before and during treatment to avoid drug resistance. If injections are delayed past two months, oral PrEP or other prevention methods must be used to prevent development of resistance to integrase inhibitors. Descovy is not recommended for individuals with severe renal impairment or end-stage renal disease unless on hemodialysis.

In summary, daily oral Truvada and Descovy offer convenient pill-based PrEP with excellent efficacy, while Apretude provides a long-acting injectable alternative with potentially higher effectiveness due to better adherence. Each has manageable side effect profiles and specific clinical considerations regarding kidney function and adherence monitoring.

Certain programs in the United States provide PrEP at a reduced cost or for free. If a person has a partner with HIV and is considering getting pregnant, they should talk with a healthcare professional about taking PrEP. People can find more information about programs that cover PrEP by speaking with a doctor or pharmacist.

[1] CDC. (n.d.). PrEP Basics.

[2] Gilead Sciences. (n.d.). Apretude.

[3] FDA. (n.d.). FDA Approves Descovy for Use as Daily PrEP.

[4] CDC. (2019). Cases of HIV Drug-Resistant Strains Among People Using PrEP.

1. The health-and-wellness sector funds programs like Ready, Set, PrEP to provide free or reduced-price PrEP for those without insurance, contributing to the accessibility of sexual health protection.
2. In the science of HIV treatment, while there are effective medications like Truvada and Descovy for PrEP, it's important to note that no PrEP method is 100% protective, and rare cases of drug-resistant strains have been documented.

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