Prevention & Testing

Pre-Exposure Prophylaxis, or PrEP, is a way for people who do not have HIV, but who are at substantial risk of getting it, to prevent HIV infection by taking a pill every day. The pill (brand name Truvada) contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV. When someone is exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from establishing a permanent infection.

When taken consistently, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by up to 92%. PrEP is much less effective if it is not taken consistently.

PrEP is a powerful HIV prevention tool and can be combined with condoms and other prevention methods to provide even greater protection than when used alone. But people who use PrEP must commit to taking the drug every day and seeing their health care provider for follow-up every 3 months.

Who does PrEP work for?

PrEP has been shown to reduce risk of HIV infection through both sexual intercourse (for gay and bisexual men, transgender women, and heterosexual men and women), as well as among people who inject drugs.

Truvada as PrEP provides a significant reduction in HIV risk for HIV-negative individuals who take the pill every day as directed. If a daily dose is missed, the level of HIV protection may decrease. It only works if you take it. People who use PrEP correctly and consistently have higher levels of protection against HIV. It does not protect against other sexually transmitted infections (STI) or pregnancy and should still be used in conjunction with condoms. It is not a cure for HIV.

Is PrEP right for me?

PrEP may be right for you if you have a partner or partners known to be HIV-1 infected OR are a gay, bisexual, or other man who has sex with men in a high HIV-prevalence area or social network and has one or more of the following conditions:

• a diagnosis of a bacterial sexually transmitted infection (STI) in the last year;
• exposure to an STI through a sexual network in the last year;
• 10 or more sexual partners in the last year;
• used methamphetamine in the last year;
• or, had unprotected anal intercourse with a partner of unknown HIV-1 status with any of the factors listed above.

We tend to go through life thinking, “it will never happen to me”…until it does. Anyone who is sexually active is at risk of contracting HIV. HIV can lead to AIDS, and even some cancers. But now there is a way to protect yourself. Taking PrEP once a day gives you over a 90% chance of living HIV-free. Combined with condoms for protection from other STIs, PrEP can help you have a safe sex life that YOU are in control of.

You ask “Why take PrEP?”
…we ask, “Why not?”
Protect yourself, and others, by adding PrEP to your daily healthcare routine.

Medicines to treat HIV can eliminate the risk of sexual transmission. In August 2016, the New York City Health Department agreed with other public health and medical organizations that people with HIV who maintain an undetectable viral load for at least six months do not transmit HIV through condomless sex. This is known as: Undetectable = Untransmittable, or U = U.

Antiretroviral medicines control HIV very effectively. They do not cure HIV or remove the virus from the body, but if taken every day as prescribed, HIV medicines stop the virus from multiplying. This prevents the virus from damaging the immune system and stops sexual transmission to others.

Undetectable means that the level of HIV in a person’s blood is so low that it doesn’t show up on a viral load test. If a person is undetectable, HIV can still be hiding in their body, but the amount is so low that HIV cannot be passed to others through sex.

Three recent studies – HPTN 052, PARTNER and Opposites Attract – followed male couples and heterosexual couples in which one partner was HIV positive and the other HIV negative. During these studies, not one HIV-positive person who was taking antiretroviral medicines and was undetectable passed HIV to their negative partner – in over 34,000 instances of condomless anal sex among male couples, and over 36,000 instances of condomless vaginal or anal sex among heterosexual couples.

If you have HIV, take antiretroviral medicines as prescribed by your health care provider. After you start your medicine, your provider will take blood samples to determine when the level of HIV in your blood has become undetectable. Once you have been undetectable for six months, you will not sexually transmit HIV as long as you take your antiretroviral medicines and keep your viral load undetectable.

Having sex with someone who has HIV but is on treatment and is undetectable is much safer than having sex with someone who has HIV but is not on treatment or doesn’t know their status. A person who was recently infected with HIV can have a very high viral load and easily pass HIV to their partners through condomless sex. A person with HIV who is undetectable for six months will not pass HIV to their sexual partners, even if they have sex without condoms.

Having an undetectable viral load prevents HIV transmission but does not protect against other sexually transmitted infections (STIs) or unintended pregnancy. If you are unsure about whether your partner is undetectable, consider using condoms or take daily PrEP (Pre-Exposure Prophylaxis) to protect against HIV. To learn more about PrEP, speak to your doctor or visit prepdaily.org. You should never feel pressured to have sex without condoms.

Couples share the responsibility of preventing HIV. HIV-positive people and their partners should discuss how they can have a healthy, fulfilling and worry-free sex life by using condoms, HIV treatment, PrEP or emergency PEP (Post-Exposure Prophylaxis). HIV-negative partners may choose to take PrEP, especially if: they have other sexual partners: are unsure of their partner’s HIV status; are unsure of their partner’s ability to keep their viral load undetectable or feel more secure in their sex lives with the added protection of PrEP.

Get an HIV test. A positive test is an opportunity to treat HIV, stay healthy and prevent HIV transmission to others. A negative test gives you the chance to discuss ways to stay negative, like using condoms, taking daily PrEP or taking emergency PEP. Get tested regularly for other STIs. STIs may not cause you to show symptoms, but they can increase an HIV-positive person’s viral load or make it easier for the virus to enter an HIV-negative person’s body.