7 Myths About HIV PrEP

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    bottle of PrEP HIV pills spilling on table near additional pills

    If you are at high risk of becoming infected with HIV, you may want to consider something called pre-exposure prophylaxis, often referred to as PrEP. Currently, Truvada is the only PrEP medication approved by the U.S. Food and Drug Administration (FDA) for preventing HIV. Truvada combines two anti-HIV drugs, tenofovir and emtricitabine, into a single daily pill.

    When used correctly, PrEP can be a highly effective method of HIV prevention, but there remain a number of common misconceptions about this treatment. Make sure you know the real facts about HIV PrEP.

    Myth #1: HIV PrEP is only for gay males.

    Regardless of your sex or sexual orientation, PrEP may be an option if you’re HIV-negative but have an increased risk of contracting HIV. Consider talking to your doctor about PrEP if you:

    • Are in a sexual relationship with an HIV-positive partner

    • Do not regularly use condoms while engaging in sex with partners whose HIV status is unknown or who are also at a higher risk of contracting HIV

    • Inject drugs and share needles

    Myth #2: People only need to take the PrEP pill before they’re exposed to HIV.

    PrEP should be taken every single day. PrEP can reduce the risk of contracting HIV through sex by over 90% and the risk of contracting HIV by injecting drugs by over 70%, but these numbers decline when it’s not taken as directed. It also takes time to build up in your system. Full protection from PrEP isn’t achieved until after 7 to 20 days of daily use.

    Myth #3: There’s no need to use condoms when taking HIV PrEP.

    HIV prevention is maximized when condoms are used in addition to daily PrEP. Since PrEP doesn’t provide any protection against other STDs, such as gonorrhea and chlamydia, consistent use of condoms is still highly recommended. 

    Myth #4: The PrEP pill is too expensive.

    PrEP is not a cheap medication, but in many cases, it can be made more affordable. Most health insurance plans cover PrEP. If you don’t have health insurance or have a low annual income, you may be eligible for a medication assistance program which provides PrEP at little to no cost.

    Myth #5: PrEP has severe side effects.

    Most people tolerate PrEP quite well. Minor side effects include nausea, dizziness, headaches, and fatigue, but they often go away over time. Rarely, more serious side effects, including problems with your kidney, liver, or bones, can occur. Once you start on PrEP, you should see your doctor every three months for repeat HIV tests and follow-up, so be sure to let your doctor know if you are experiencing any issues with the medication.

    Myth #6: PrEP can make someone resistant to HIV medications if they do become infected with HIV.

    People have questioned whether taking PrEP can cause the virus to mutate and become resistant to medications that treat it. Studies have shown this occurs in only a very low percentage of cases. In most situations, resistance develops because:

    • The individual is unknowingly HIV-positive at the time PrEP is initiated, as PrEP doesn’t work for people who are HIV-positive

    • The individual is not taking PrEP daily as directed and becomes HIV-positive while still taking the medication

    To prevent this, regular HIV screenings before and during PrEP treatment, along with consistently taking the medication, are essential. For the small number of individuals who develop resistance to Truvada, other anti-HIV medications may still be able to treat HIV infection.

    Myth #7: PrEP can be used in emergencies after a potential exposure to HIV has already occurred.

    Although they are both used for HIV prevention, PrEP is not the same as PEP, or post-exposure prophylaxis. PrEP is started before exposure to HIV, while PEP must be taken within 72 hours of possibly being exposed to HIV. PEP involves the use of HIV medications once or twice a day for 28 days to prevent an HIV infection from developing.

    When it comes to HIV prevention, PrEP can be a great tool, but persistent misconceptions may make people hesitant to try it. Ask your doctor if you’d like more information about HIV PrEP. Increased knowledge about this intervention can help overcome barriers to its use.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jul 11
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