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Pre-exposure prophylaxis (PrEP) is a safe and effective daily pill that can greatly reduce your risk of HIV infection.
To get started on PrEP, talk to your health care provider, or visit a NYC Sexual Health Clinic. You can find other clinics that provide PrEP by calling 311 or visiting the NYC Health Map.
Who can benefit from taking PrEP
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:
An option for gay and bisexual men: Take PrEP only when you have sex
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.
Is PrEP safe? What are the side effects?
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:
PrEP on demand has only been studied and endorsed for cisgender men who have sex with men.
If you want to use PrEP on demand, visit a Sexual Health Clinic or talk to your health care provider.
If you want to use PrEP on demand, visit a Sexual Health Clinic or talk to your health care provider.
Taking PrEP
PrEP is prescribed by a health care provider.
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.
How PrEP stops HIV
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.
PrEP is safe
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®.
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 of taking PrEP. Rare side effects include kidney or bone problems. Your health care provider can help you manage any side effects.
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.
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).
PrEP for undocumented immigrants
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.
PrEP for adolescents
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.
Other options for HIV prevention
PrEP is an effective HIV prevention option for cisgender and transgender women.
Two drugs – Truvada® and Descovy® – are approved as PrEP for transgender women. Only Truvada® has been approved for cisgender women. There have been no studies of Descovy® to see if it prevents HIV during receptive vaginal sex. This means Descovy® may not be appropriate for cisgender women or transgender men.
Women who have vaginal sex need to be especially careful to take Truvada® daily to maintain enough medicine in their vaginal tissue to prevent an HIV infection. Women who have sex with women and who may be exposed to HIV through sex or injecting drugs can also benefit from PrEP.
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 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 you and your fetus during pregnancy and your baby if you are nursing
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.