Pre-Exposure Prophylaxis for HIV Prevention

Maine Family Planning now offers consultations and prescriptions for HIV pre-exposure prophylaxis – commonly called PrEP – a daily pill that significantly reduces the risk of HIV infection (HIV is the virus that causes AIDS). You can talk to a Nurse Practitioner at any of our 18 clinics about your HIV status, your individual risk, and whether PrEP is a good option for you.

What is PrEP?

PrEP (brand name Truveda) is an antiretroviral medication that can be taken by an HIV negative person before potential HIV exposure to reduce risk of HIV infection. When taken consistently and correctly, PrEP is over 90% effective at preventing HIV transmission through sex, and over 70% effective at preventing HIV transmission through IV drug injection.

How does it work?

Truvada/ PrEP is an antiretroviral drug, which means that it stops HIV from being able to replicate itself and establish itself in a person’s body. In order for PrEP to work effectively, it must be taken every day. It can take one to three weeks for PrEP to start working, depending on your individual risk factors. Your health care provider will help you figure out when PrEP will start working for you.

Is PrEP a good option for me?

If you’re interested in PrEP, the first step is to meet with a health care provider to discuss whether it’s right for you.  You’ll need an HIV test and blood tests to make sure you’re healthy enough to take PrEP.

The Centers for Disease Control and Maine Family Planning recommend that PrEP be considered for people who are at significant risk for HIV. PrEP might be a good choice for you if:

  • Your partner has HIV;
  • Your partner’s HIV status is unknown, you and your partner(s) are not monogamous, and/or you and your partner(s) do not use condoms;
  • You’ve had an STD in the last 6 months;
  • You’re a man or woman who has sex with (cisgender) men, or a transgender person who engages in high-risk sexual activity;
  • You engage in transactional sex, such as sex for money, drugs, or housing;
  • You or your partner use injection drugs.

Will I still need to use condoms?

You should still use condoms on PrEP, as Truvada does not protect against other STIs such as syphilis, chlamydia, or gonorrhea. PrEP and condoms can be used together for increased protection against HIV.

If you don’t use a condom because they are not available or were forgotten, if the condom broke, or if you and your partner(s) just prefer not to use them, daily use of PrEP still reduces HIV risk significantly.

Keep in mind that the most effective way to prevent HIV is to abstain from sex and IV drug use.

Is it safe? Are there any side effects?

The majority of PrEP users report no side effects.  In a small number of people, there is some nausea, headaches, gas, and loose stool when starting PrEP.  These symptoms almost always go away on their own after about a month. Contact your health care provider if you experience discomfort.

PrEP is generally a very safe medication for healthy people. Your health care provider will want to run some tests before prescribing PrEP and will want to monitor your health, as PrEP may worsen existing kidney conditions and can reduce bone density.  

What about costs?

You can see a health care provider at Maine Family Planning to discuss and start on PrEP; that visit can be billed to your insurance provider. If you don’t have insurance, we can charge for the visit using our sliding scale.

The PrEP prescription itself will need to be picked up at a pharmacy (we don’t keep this medication at MFP clinics). Most private health insurance plans, as well as Medicaid, cover the cost of PrEP.  If you don’t have insurance, don’t have prescription coverage, or if you have a high co-pay, there is an assistance program available that provides free medication for most people.  We can help you apply for financial assistance.

When you are calculating your health costs for PrEP, remember that it involves more than just the drug itself—you will also need to account for regular blood tests and health screenings.