PrEP to Prevent HIV

PrEP is for people who do not have HIV and are ready to take a pill for HIV prevention.

You should consider taking PrEP if you:

• Do not always use condoms during sex
• Recently had a sexually transmitted infection (STI)
• Have a partner who has HIV and a detectable or unknown viral load
• Are trying to conceive with a partner who has HIV
• Have a partner who has an unknown HIV status or who refuses to get an HIV test
• Have sex for money, drugs or a place to stay
• Inject drugs or have a partner who injects drugs

The recommended way to use PrEP is to take one pill once a day, even on days when you do not have sex or inject drugs. Gay and bisexual men can also take PrEP “on demand” (PDF), only before and after sex.

If taken correctly, PrEP on demand is highly effective at preventing HIV during anal sex. PrEP on demand only works if you can anticipate when you will have sex.

PrEP is safe. Truvada®, has been used to treat people with HIV since 2004.

Most people on PrEP do not report any side effects. For those who do, the most common side effects are nausea, upset stomach, fatigue and headaches. These symptoms often get better or go away within the first month of taking PrEP. Rare side effects include kidney or bone problems. Your doctor or nurse can help you manage any side effects.

You take PrEP on demand on a 2-1-1 schedule:

• Two to 24 hours before sex: take two pills
• Then take one pill daily for two days after sex

PrEP on demand has only been studied and endorsed for cisgender men who have sex with men.

• It can protect the top and bottom partner during anal sex.
• Persons who have vaginal or front sex should take PrEP every day because it takes more days to achieve protective levels of medicine in vaginal tissue.

If you want to use PrEP on demand, visit a Sexual Health Clinic or talk to your health care provider.

• It can protect the top and bottom partner during anal sex.
• People who have vaginal or front sex should take PrEP every day because it takes more days to achieve protective levels of medicine in vaginal tissue.

If you want to use PrEP on demand, visit a Sexual Health Clinic or talk to your health care provider.

PrEP is prescribed by a health care provider.

• Before you start PrEP: Your health care provider will test you to make sure that you do not have HIV and that your kidneys are healthy.
• While you are on PrEP: Your health care provider will test you every three months for HIV and every three to six months for other STIs. They will also check your kidneys at least once every six months.

To learn more about what to expect when taking PrEP, see theUser's Guide to PrEP (PDF)
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Since PrEP was introduced in 2012, it has helped reduce new HIV infections across New York City.

The medicines in PrEP stop HIV 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. PrEP only protects you against HIV. It does not prevent other STIs or unintended pregnancy.

If taken almost every day, PrEP reduces the risk of getting HIV through sex by 99% for men and over 90% for women having vaginal sex. In rare cases, people have gotten HIV despite taking PrEP as prescribed.

Two drugs have been approved for PrEP: Truvada® and Descovy®. Truvada® has been used to treat people with HIV since 2004 and has been used for PrEP since 2012. Descovy® was approved for gay and bisexual men and transgender women in 2019. Descovy® is as safe and effective as Truvada®.

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 of taking PrEP. Rare side effects include kidney or bone problems. Your health care provider can help you manage any side effects.

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.

If you do not have insurance or your insurance plan charges you high co-pays for PrEP, you may be eligible for a patient assistance program that helps pay for PrEP. Medical clinics can help patients apply.

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

Immigration status should not affect your ability to get PrEP. New York City’s Sexual Health Clinics can help you explore your options for getting PrEP or other sexual health services, and do not require you to provide a Social Security Number.

If you are 17 or younger, you have the right to get sexual health services, including PrEP, without parental consent in New York.

If you are covered by your parents' insurance, you can take steps to stop an “Explanation of Benefits” form from being sent to your parents or policyholder. This will help keep your PrEP prescription and related clinic visits confidential. Your PrEP provider can help you with this process.

• Use PEP in an emergency. If you are not taking PrEP and think you were recently exposed to HIV, go immediately to your health care provider. Ask for PEP, an emergency medicine that can prevent HIV. You can also call the NYC PEP hotline at 844-3-PEPNYC (844-373-7692), to get started on PEP right away. You can also get PEP at an emergency room if the other options are unavailable. If you are a sexual assault survivor, go immediately to an emergency room to ask for PEP and other medical services.
• Use condoms. Find the size and type of condom you like. Condoms are available for free in all five boroughs. To find out where you can get free condoms, call 311 or visit the NYC Health Map.
• Use lube. Use water-based or silicone-based lubricant, especially during anal sex.
• Get tested for HIV. An HIV test is the only way to know if you or a partner has HIV.
• Talk to your partners about testing. Ask your sex partners about the last time they had an HIV test. To be sure, get tested together.
• Support your partners living with HIV. Encourage partners living with HIV to get HIV care and take their medicines every day, so they stay healthy and Get checked for other STIs. STIs can make it easier to get or spread HIV.
• Limit alcohol and drug use when you have sex. Drinking or getting high when you have sex can put you at risk of HIV as it can make it hard to remember to use condoms. For help to stop using, call 888-NYC-WELL (888-692-9355). Interpreters are available for over 200 languages.
• Use new syringes. If you inject drugs, avoid sharing syringes, cookers, cottons and drug solutions. Find out where you can get no cost new syringes in the city.

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.

Research shows that PrEP does not interfere with hormone-based birth control. PrEP only prevents HIV, so you still need to use birth control or condoms to prevent unintended pregnancy and other STIs.

PrEP can protect people who are trying to conceive with a partner that is living with HIV. 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 with your doctor. You may need to consult an expert for more guidance.