Pre-Exposure Prophylaxis (PrEP) is one of the most powerful HIV prevention tools ever developed. When taken as prescribed, PrEP reduces the risk of HIV infection from sex by over 99% and from injection drug use by more than 74%. Yet only about 30% of the 1.2 million Americans who could benefit from PrEP are actually taking it.
What is PrEP?
PrEP (Pre-Exposure Prophylaxis) is medication taken by HIV-negative individuals to prevent HIV infection. When HIV enters the body of someone on PrEP, the medication prevents the virus from establishing a permanent infection.
Who Should Consider PrEP?
The CDC recommends PrEP for HIV-negative adults and adolescents who are at substantial risk of HIV:
- Gay and bisexual men who have had sex without a condom or been diagnosed with an STI in the past 6 months
- Heterosexual men and women who don't regularly use condoms and have partners of unknown HIV status at higher risk
- People with an HIV-positive partner
- People who inject drugs and share injection equipment
- People who have been prescribed PEP multiple times
- Transgender women at elevated risk
If you're not sure whether you qualify, ask Dr. Kaura. PrEP candidacy is a medical determination, not a judgment about your character or lifestyle.
PrEP Medication Options
Truvada (tenofovir DF/emtricitabine)
The original daily oral PrEP. Taken as one pill daily. Highly effective for all routes of HIV exposure. Generic versions are now available, dramatically reducing cost.
Descovy (tenofovir AF/emtricitabine)
Newer daily oral PrEP with a different tenofovir formulation that is better for kidney health and bone density. Preferred for patients with kidney concerns. Currently not approved for receptive vaginal sex.
Apretude (cabotegravir injection)
The newest PrEP option — two injections given 2 months apart by a healthcare provider. No daily pills required. Shown to be more effective than daily oral PrEP in clinical trials. Ideal for patients who struggle with daily pill adherence. Available at Synergy MD Clinic.
The PrEP Process at Synergy MD Clinic
- Initial Evaluation — HIV test (must be HIV-negative), kidney function labs, STI screening, hepatitis B testing
- Prescription — PrEP medication selected based on your specific situation and preferences
- Follow-up — HIV test every 3 months (required while on PrEP), kidney function every 6 months, STI screening every 3-6 months
PrEP is Available via Telehealth
Initial PrEP consultation and follow-up visits can be done via telehealth for Texas residents. Lab work is ordered and done at a local lab of your choice. Prescription is sent electronically to your pharmacy. Same-day consultations often available.
Cost and Insurance Coverage
The Affordable Care Act mandates that most insurance plans cover PrEP at no cost to the patient, including lab testing and clinical visits. Gilead (Descovy/Truvada manufacturer) offers a patient assistance program for uninsured or underinsured patients. The generic Truvada is available for $30-60/month at discount pharmacies.