What Is PrEP?

PrEP (short for Pre-Exposure Prophylaxis) is a pill that protects you from getting HIV.

Truvada is the brand name for the medication used as PrEP. HIV positive people have been using this medication for years to fight off the virus and stay healthy. Now it is being used to help keep people HIV negative. So Truvada is both a treatment for HIV and a way to prevent it.

How effective is it?

For HIV negative people who take it every day, PrEP can lower the risk of getting HIV by greater than 99%. This means that PrEP is as effective as the correct use of condoms.

How does it work?

PrEP is a pill that you take once a day. When taken daily, PrEP builds up to maximum protective levels in the rectum and anus after 7-10 days and in the vagina and bloodstream after 21 days and continues to protect you for as long as you continue taking it every day. PrEP does not protect against other sexually transmitted infections like syphilis or gonorrhea.

Does it have side effects?
PrEP has been shown to be very safe. However, like with any medication there may be minor side effects. Some people get an upset stomach when they first start taking it.
How do I get it?

To get PrEP, talk to your primary care provider about getting a prescription. While you are using PrEP you will need to check in with your doctor every three months.

You can also search for a PrEP-friendly provider by visiting PleasePrEPMe.org

Or call the Countywide PrEP Navigation Services Line for assistance: (408) 792-3750.

Talking to your doctor

Having as much information about why you want to be on PrEP is a great way to start that conversation with your provider. The CDC has provided this handy guide on what to do before, during, and after your appointment with your provider.

How much does it cost?

PrEP should be covered by your health insurance. If you do not have health insurance you can get help signing up for a low cost plan that covers PrEP. Copayment assistance programs are available to help cover out-of-pocket costs of PrEP.

If you do not have health insurance or if you have questions about how to pay for PrEP, call the Countywide PrEP Navigation Services Line for assistance: (408) 792-3750.

Is PrEP for everyone?

Most people can safely use PrEP, but a doctor will need to determine if there is any reason why you should not take it. PrEP is only for people who are HIV negative.

Everyone’s situation is different. PrEP is recommended for individuals with high risk of HIV exposure. That may include anyone in an ongoing relationship with an HIV positive partner; people who inject drugs; and men who have sex with men (MSM).

When considering PrEP you will need to think about your health, the kind of sex you have, your partners, and other factors. It is best to learn all you can about PrEP, and then get some advice from a doctor or healthcare professional.

Who Can Take PrEP?

In 2012, the Food and Drug Administration (FDA) approved PrEP (Truvada) for HIV prevention in people ages 18 and over. In 2018, the FDA expanded this approval to include adolescents (13-17) who weigh at least 77 pounds.

Condoms

The World Health Organization (WHO) and the US Centers for Disease Control (CDC), recommend using condoms along with PrEP. Think of it as using seatbelts andairbags in a car. Using PrEP and condoms together provides the best protection, even though each is highly effective on its’ own.

PrEP only protects you from HIV. Condoms prevent most STDs. This is why using PrEP and condoms might be the best choice for your sexual health.

Uninsured or underinsured?

Advancing Access provides assistance to appropriate patients who are uninsured or underinsured regardless of their citizenship status, or who need financial assistance to pay for PrEP. Program offerings include:

  • Access to counselors who can help patients and their providers with insurance-related questions, including coverage options.
  • The Advancing Access Co-pay Coupon Program, which provides co-pay assistance for eligible patients (up to $4,800 in co-pays per year with no monthly limit).
  • The Advancing Access PAP, which provides Gilead medications at no charge for eligible patients with no other insurance options. Patient must have annual income less than 500% of the FPL (in 2018, $60,700 for a one-person household).
  • Contact: 1-800-226-2056 or visit www.gileadadvancingaccess.com

Santa Clara County residents can find a PrEP provider near them using the “Please PrEP Me” tool.

If you need additional assistance you can contact Santa Clara County PrEP Navigation Service’s line 408-7923750 or by email at HIVPrevention@phd.scgov.org

How About PEP?

PEP (short for Post-Exposure Prophylaxis) is a pill that an HIV-negative person can take if they believe they have been exposed to HIV. PEP must be started within 72 hours of exposure or the effectiveness begins to decrease.

PEP is a daily pill that is taken for 28 consecutive days and should only be used in emergency situations.

PEP is for people not already on a daily PrEP regimen. If someone is using PrEP as prescribed, there is no need for them to begin PEP.

To Learn More About PrEP and PEP

Denied Life or Disability Insurance?

Earlier this year, The New York Times reported on PrEP users being denied life or disability insurance because companies did not understand that PrEP was a pre-exposure prophylaxis however state investigators have since stepped in to correct this error. If you believe you have been denied any form of insurance for taking PrEP, you should contact the California Insurance Commissioner, Dave Jones at the California Department of Insurance

Resources

Santa Clara County Public Health Department

The Santa Clara County Public Health Department provides low-cost diagnosis & treatment of sexually transmitted diseases. They offer free condoms, HIV and Hepatitis C free and anonymous rapid testing. As well as navigation assistance for people interested on Post-Exposure Prevention (PEP) and/or PrEP. This website can answer many questions related to your sexual health.

Learn More

Asian Americans for Community Involvement AACI – HOPE Program

The AACI HIV Outreach, Prevention, and Education (HOPE) Program provides free HIV Rapid Testing, Counseling and Referrals, in addition to different outreach activities, to the community in Santa Clara County.

Learn More

PrEP 101 - Centers for Disease Control

CDC is the nation’s health protection agency; their website has good PrEP 101 information and answers to Frequently Asked Questions.

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Project Inform

Project Inform has many resources on PrEP including downloadable brochures and educational materials.

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PrEP Facts - San Francisco AIDS Foundation

The San Francisco AIDS Foundation has a long history in helping people access PrEP and has materials specific to gay men, to transwomen and to women on their website.

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PrEP Watch

PrEP Watch uses education, policy analysis, advocacy and a network of global collaborations to accelerate the ethical development and global delivery of new and emerging HIV prevention options as part of a comprehensive response to the HIV/AIDS pandemic.

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Positively Aware

Positively Aware is a publication of TPAN, the Test Positive Aware Network which empowers everyone living with or at risk for HIV/AIDS to live open, healthy, and productive lives. Lots of downloadable materials, especially for those wondering whether PrEP is the right choice.

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NMAC

Formerly known as National Minority AIDS Council, NMAC leads with race to urgently fight for health equity and racial justice to end the HIV epidemic in America. NMAC’s PrEP Education and Awareness program target audience is young gay men, in particular Black and Latino gay men aged 18-25 years old.

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University of California San Francisco: HIVE

HIVE is a leader in prenatal, pre-conception and women’s HIV care, and the program’s mission is to advance reproductive and sexual wellness for individuals, families and com munities affected by HIV in San Francisco and beyond. The website has information for on PrEP implementation outside of family planning as well and has information specific to transwomen and transmen.

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Please PrEP Me

This website has a location-based searchable PrEP provider directory to make it easier for people to gain access to the medication. Simply enter your zip code and nearby providers and their contact information will be displayed.

Learn More

For Providers:

San Francisco City Clinic PrEP Resources

UCSF Clinical Consultation Center.

Expert Clinical Consultation on PrEP is available by emailing prep@sfdph.org

Download this brief how-to guide intended for providers interested in providing PrEP to their patients: Pre-Exposure Prophylaxis (PrEP): A primer for primary care providers (PDF)

PrEP Facts Facebook Group

PrEP Facts: Rethinking HIV Prevention and Sex Facebook group has a wealth of information and discussion topics surrounding PrEP. It was included as a resource in the 2015 and 2016 World Health Organization PrEP Guidelines as well by the New York State Health Department.

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