PrEP vs. PEP: HIV Prevention Compared

1. PrEP (Pre-Exposure Prophylaxis)

For: HIV-negative people at ongoing risk of HIV exposure.
Goal: Prevent infection before exposure.

Types of PrEP:

TypeFormDosingEffectivenessDaily Oral PrEP Pill (Truvada, Descovy) 1 pill/day ~99% if taken daily On-Demand (2-1-1) PrEP Truvada only 2 pills 2–24 hrs before sex, then 1 pill 24 & 48 hrs after ~86% (studies in gay/bi men) Injectable PrEP (Apretude) Cabotegravir shot Every 2 months ~99% (more effective than pills for some)

Who Should Use PrEP?

• Men who have sex with men (MSM)
• Heterosexuals with high-risk partners (e.g., HIV+ not on ART)
• People who inject drugs (PWID)
• Sex workers
• Serodifferent couples (one partner HIV+, one HIV-)

Side Effects:

• Truvada (TDF/FTC): Kidney strain (rare), bone density loss (monitor with blood tests).
• Descovy (TAF/FTC): Safer for kidneys/bones but not for vaginal/frontal hole exposure.
• Cabotegravir (Apretude): Injection-site pain, flu-like symptoms.

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2. PEP (Post-Exposure Prophylaxis)

For: HIV-negative people after potential exposure (e.g., unprotected sex, needle stick).
Goal: Stop HIV infection within 72 hours.

How PEP Works:

• Must start within 72 hours (sooner = better).
• 28-day course of ART (usually Truvada + Dolutegravir or Raltegravir).
• Effectiveness: Up to ~80% if started early and taken correctly.

When to Use PEP?

• Condomless sex with someone HIV+ (or unknown status).
• Sharing needles.
• Sexual assault survivors.
• Healthcare workers after needle-stick injuries.

Side Effects:

• Nausea, fatigue, headache (usually temporary).
• Rare: Liver/kidney issues (monitored by doctors).

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How to Access PrEP/PEP?

• PrEP:
• Doctors: Primary care, HIV clinics, Planned Parenthood.
• Programs: Ready, Set, PrEP (free for uninsured in the US).
• Telehealth: Services like Nurx, Mistr.
• PEP:
• Emergency rooms, urgent care, HIV clinics.
• Plan B vs. PEP? Plan B prevents pregnancy, not HIV!

Final Advice

✔ PrEP = Best for ongoing risk (take daily or as prescribed).
✔ PEP = Emergency backup (act fast after exposure).
✔ Test regularly (every 3 months if on PrEP/high risk).

Need help finding PrEP/PEP?

• US: CDC PrEP Locator
• Global: Check local HIV clinics or WHO guidelines.