HIV

Is PrEP available at VA or can I use the national Ready, Set, Prep donation program?

PrEP (Truvada®, Descovy®, and Apretude) is available for Veterans who use VA for their health care. There may be a copay associated with PrEP.

If you are not eligible for VA care or have a non-Veteran partner who might need assistance getting PrEP, please see the national Ready, Set, PrEP donation program for more information. Details on eligibility are available on getyourprep.com. There are also programs available that provide co-pay assistance.

Several states also offer PrEP programs in addition to the national Ready, Set, PrEP program. Check with your local health department to learn more.

Do I have to take PrEP every day?

There are two daily oral medications for PrEP, Truvada® and Descovy®. These work best if you take them 7 days per week. Some studies have shown that on-demand PrEP (or PrEP 2-1-1) can work for some populations but until we know more, we recommend you take it every day. In addition to oral medications, there is a monthly injectable PrEP option, Apretude. If you have difficultly taking a daily medication, talk to your provider about whether injectable PrEP may be an option for you.

Do I still need to use condoms?

PrEP is highly effective if it is used correctly and consistently. But, it is not 100% effective. So it is recommended that you use condoms or other methods of reducing HIV risk at the same time you use PrEP. Condoms are also important for preventing pregnancy and sexually transmitted infections like syphilis or gonorrhea.

What should I do if I miss a dose?

It is very important to take PrEP every day—it is most effective if the drug levels in your body are consistently high. If you do miss a dose, don’t panic. Take the pill as soon as you remember, unless it is already almost time to take the next dose (in that case, do not take a double dose). Contact your provider if you notice that you are missing doses on a regular basis (and especially if you miss more than 1 or 2 doses each week).

What might happen if I miss doses?

If you miss doses of PrEP, your chances of becoming infected with HIV may rise significantly. In addition, if you become infected while you are on PrEP, your HIV virus may become resistant to the medications used to treat HIV.

What are the side effects of PrEP?

Most people who take PrEP have no side effects. Some experience nausea, diarrhea, fatigue, or headache when they first start it; these symptoms usually get better within a couple of weeks. PrEP can cause problems with kidney function—this is uncommon, and your provider will monitor your kidneys. It may slightly decrease the strength of your bones; the significance of this is not clear. If you take injectable PrEP, injection site soreness is common. Discuss all potential side effects with your provider.

Can I take PrEP with my other medicines?

Truvada® and Descovy® do not affect most other medications. For example, they can be taken with blood pressure and diabetes medications, methadone, and hormones (including birth control pills).

Will I have to take PrEP for the rest of my life?

No, unlike HIV medications for people who are infected with HIV, PrEP is not lifelong therapy. It is intended to help during periods when you may be at risk of getting HIV infection. If your risk for HIV decreases, talk to your provider about stopping PrEP.

Will I have to take PrEP for the rest of my life?

Yes, PrEP can be used around the time of conception to reduce the risk of infecting the HIV-negative partner. Discuss this with your provider.

What if I want to stop PrEP?

Discuss this with your provider. In general, we recommend continuing PrEP for 28 days after your last high-risk exposure.

What if I become infected with HIV?

If you develop HIV, your provider will have you stop taking PrEP and will refer you for treatment for HIV. PrEP alone is not strong enough to control HIV infection, and if you continue taking it, the HIV virus may become resistant to the medications.

Does PrEP interfere with hormone therapy for transgender patients?

While PrEP does not interfere with the hormones used as part of feminizing hormone therapy (FHT), there is some evidence that estrogens used in FHT may interact with the tenofovir component in PrEP medicine. Some studies have shown that taking FHT may lower the amount of tenofovir in your body. We do not know for sure if it lowers it enough to make PrEP less effective. Just to be sure, it is best to always use condoms if you are on FHT and taking PrEP and be sure not to miss any doses. Please talk with your VA provider about starting PrEP and about other ways to take care of your health.