Is Prep Right For You
PrEP may benefit you if you test negative for HIV and
- you have had anal or vaginal sex in the past 6 months, and you:
- have a sexual partner with HIV ,
- have not consistently used a condom, or
- have been diagnosed with an STD in the past 6 months.
- have an injection partner with HIV, or
- youve beenprescribed PEP and you
- report continued risk behavior or
- have used multiple courses of PEP
If you are a woman and have a partner with HIV and are considering getting pregnant, talk to your doctor about PrEP. PrEP may be an option to help protect you and your baby from getting HIV while you try to get pregnant, during pregnancy, or while breastfeeding.
What Qualifies As Undetectable
Undetectable describes when the copies of HIV in a persons blood is so low that it does not show up on a lab test. The test measures a persons viral load. Untransmittable means that a person living with HIV has virtually no chance of transmitting the HIV virus to someone else through sexual contact.
Importance Of Getting Hiv Tested Before Starting Prep And Going Forward
The updated 2017 PrEP guidelines published by Centers for Disease Control and Prevention offer a protocol of medical and ethical best practices for offering and prescribing PrEP. Of great importance is the guideline that you are confirmed HIV negative through an antigen and/or antibody HIV test before starting PrEP. In some cases, a provider may wish to do an additional test 30 days after starting PrEP. Both of these tests are there for your protection, as starting PrEP while already having HIV could result in developing a strain that is harder to treat.
It is recommended that you use PrEP daily while you are at risk of acquiring detectable HIV. Your provider will likely ask you to be tested for HIV every three months, as well as to receive screening for syphilis, gonorrhea, and chlamydia quarterly .
When getting tested for sexually transmitted infections , you will most likely be offered a swab in your throat, your rectum, your vagina. People with penises will be asked to submit a urine sample. This is called “multi-site testing,” which maximizes the identification of infection in any of the sites where STIs can be found. Multi-site testing is done because an STI in your rectum would not show up in urine or in other areas, thus with limited testing it would not get properly treated.
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Does Menstruation Raise The Risk Of Hiv Transmission To Sexual Partners In Other Ways
If a person living with HIV is not taking antiretroviral treatment, levels of HIV in their vaginal fluid are likely to be higher during menstruation. Several studies have shown that viral load in the female genital tract can vary during the menstrual cycle, including a 2004 study which found that viral load levels in cervico-vaginal fluid tended to peak at the time of menstruation and fall to the lowest level just prior to ovulation, usually midway through the cycle. This would raise the risk of HIV transmission if preventative methods werent being used.
However, due to the effectiveness of HIV treatment, the bodily fluids of someone living with HIV are likely to have no detectable virus . Levels of HIV in blood and cervico-vaginal fluid are usually correlated, although viral load in vaginal secretions may fall more slowly than in blood so may not be undetectable for a few months after viral load has become undetectable in blood.
Measurement of the amount of virus in a blood sample, reported as number of HIV RNA copies per milliliter of blood plasma. Viral load is an important indicator of HIV progression and of how well treatment is working.
If unsure, condoms, dental dams and PrEP are all options that reduce the risk of HIV infection during sex with a person living with HIV who is menstruating.
If My Viral Load Is Undetectable Can I Transmit Hiv To Other People

Im very happy to say that we know the answer to this. If you are undetectable, and have been on HIV medications for at least six months, and you continue that treatment, the risk of transmitting HIV is effectively zero.
This finding has been well-established over the last six to seven years . After studying thousands of couples, over many years, research has shown that if an HIV-positive person is on effective HIV medications for at least six months, is undetectable, and stays on their HIV medications, they will not transmit HIV to other people.
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Prep Is A Pill That Can Help Prevent Hiv
PrEP is a combination of two antiretroviral medications, tenofovir and emtricitabine, that, if taken every day, can now prevent HIV. The pill is FDA approved. Truvada works by blocking an enzyme so that HIV cannot reproduce and establish infection in the body.
The pill is taken by mouth with or without food. It is best if taken at the same time every day, as this helps establish a routine. Skipping days isnt recommended. If you forget a dose, take it as soon as you remember. If it is almost time to take the next dose, skip the missed dose and continue the regular dosing schedule. Truvada takes full effect seven to 20 days after starting the medication. It can be discontinued whenever the protection it offers is not necessary . Do talk to your doctor when stopping or starting any medication.
Can You Get Help Paying For Pep
- If youre prescribed PEP after a sexual assaultYou may qualify for partial or total reimbursement for medicines and clinical care costs through the Office for Victims of Crime, funded by the U.S. Department of Justice .
- If youre prescribed PEP for another reason and you cannot get insurance coverage Your health care provider can apply for free PEP medicines through the medication assistance programs run by the manufacturers. These requests can be handled urgently in many cases to avoid a delay in getting medicine.
- If youre a health care worker who was exposed to HIV on the jobYour workplace health insurance or workers compensation will usually pay for PEP.
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What Are The Side Effects Of Prep
PrEP is very safe. No serious problems have been reported in people who are taking PrEP.
PrEP may cause side effects like nausea, loss of appetite, and headaches. These side effects arent dangerous and they usually get better with time, once your body gets used to PrEP. Most people on PrEP have no side effects at all.
If you do have side effects that bother you and dont go away, talk with your doctor or nurse. They can help you figure out ways to deal with side effects and make sure everythings ok.
What We Know About Injecting Silicone
Silicone injections can be done safely by a health care provider, but sometimes people inject silicone with friends or acquaintances at parties. Theres a chance that someone can get or transmit HIV if an HIV-negative person uses needles, syringes, and other injection equipment after someone with HIV has used them. This is because the needle, syringe, or other injection equipment may have blood in them, and blood can carry HIV. Likewise, youre at risk for getting or transmitting hepatitis B and C if you share needles, syringes, or other injection equipment because these infections are also transmitted through blood.
More information:More information:
More information: Hepatitis B and C are viruses that infect the liver. Many people with hepatitis B or C dont know they have it because they dont feel sick. Even if you dont feel sick, you can transmit the virus to others. The only way to know for sure if you have hepatitis B or C is to get tested. Your health care provider will recommend a hepatitis B or C test if you have risk factors for these infections, such as injection drug use. If you dont have a health care provider, click here to find contact information for your local health department.
If a person with HIV takes their HIV medicine as prescribed and gets and keeps an undetectable viral load , their chance of transmitting HIV through sharing needles, syringes, or other drug injection equipment is reduced.
More information
Explore other resources from CDC:
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Sex Toys Fingering Fisting And Hiv
Sex toys, such as dildos, come into direct contact with rectal/vaginal fluids and mucous membranes. This means sharing an uncleaned dildo or other toy can pass on HIV. Using sex toys on your own has no risk.
There is no direct risk of HIV from fingering or fisting , but be aware of being rough. Damage to anal/vaginal tissues, especially if there is any bleeding, will increase risk of HIV transmission if you then have anal, vaginal or oral sex later.
What We Know About Injecting Drugs
The risk for getting or transmitting HIV is very high if an HIV-negative person uses needles, syringes, or other drug injection equipment after someone with HIV has used them. This is because the needles, syringes, or other injection equipment may have blood in them, and blood can carry HIV. Likewise, youre at risk for getting or transmitting hepatitis B and C if you share needles, syringes, or other injection equipment because these infections are also transmitted through blood.
More Information
In 2017, 6% of new HIV diagnoses in the United States were attributed to injection drug use and 3% were attributed to injection drug use and male-to-male sexual contact . On average, an HIV-negative person has about a 1 in 160 chance of getting HIV every time they share needles, syringes, or other injection equipment with a person who has HIV.
More Information There may be extremely tiny amounts of blood in syringes or works that you may not be able to see, but could still carry HIV. Be aware that HIV can survive in a used syringe for up to 42 days depending on temperature and other factors.
There are medicines to treat hepatitis B. If youve never had hepatitis B, theres a vaccine to prevent it. There are medicines to treat hepatitis C, but they arent right for everyone. Theres no vaccine to prevent hepatitis C. Talk to your health care provider to learn more about hepatitis B and C.
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Be Aware Of Potential Symptoms
If you have sex, knowing what symptoms could indicate an STI is a must.
See a healthcare professional if you notice any of the following:
- unusual discharge from the anus, penis, or vagina
- changes in urination, like pain or burning, frequency, or urgency
- sores, warts, or blisters on or around your genitals or anus
- unusual vaginal bleeding, like after sexual activity or between periods
- genital itching
Are certain activities higher risk?
Penis-in-anus sex is the riskiest, especially for the receptive partner because the rectums lining is thin, making it easier for the virus to enter the bloodstream.
Penis-in-vagina sex, though not as risky, is also considered higher risk activity for both parties.
Can I Get The Prep Medication From My Regular Healthcare Provider Or Do I Have To Go To A Special Doctor

It depends on your doctor. Any physician, nurse practitioner or physician assistant can prescribe PrEP. It is important to have a healthcare provider who you can work with to individualize PrEP to your needs and circumstances. The New York State Department of Health has prepared a directory of healthcare providers that prescribe PrEP that can be found online.
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Is There Anything You Can Do To Prevent Other Forms Of Transmission
For sure!
Blood-to-blood contact between people sharing drug equipment like needles and syringes is the most common nonsexual form of HIV transmission.
If youre injecting drugs recreational or medical always use clean equipment. Dispose of needles and other paraphernalia properly to avoid accidental needle sticks and exposure.
Though the risk is low, its possible to contract HIV from contaminated tattooing and piercing equipment. Avoid home tattoos and piercings and stick with a reputable studio that follows proper sterilization practices.
Potential exposure to HIV can be stressful for all involved. Finding someone to talk with about your concerns and getting support can help.
Talk with your doctor or another healthcare professional if you or your partner needs help with:
- HIV and other STI testing
- treatment and prevention drugs
Is There Anything You Can Do To Reduce Your Risk Of Contracting It
If youve potentially already been exposed, then taking PEP is the only way to reduce your risk from that exposure.
PEP or post-exposure prophylaxis is an emergency prescription for people who are HIV-negative who may have been exposed to HIV.
Its a 28-day course of anti-HIV medication that can reduce the risk of contracting HIV by as much as when started within 72 hours of possible exposure and taken as directed.
You can get the medication at your nearest clinic or emergency department.
Yes, but keep in mind that not everyone shows symptoms in the early stages of an HIV infection. The only way to know for sure if you contracted HIV is to get tested.
In the first two to four weeks after infection, two-thirds of people experience flu-like symptoms.
See your doctor if you experience any of the following after a possible exposure:
- fever
If theres a chance youve been exposed to HIV, a convo with your other current or potential partners is a must until you get your results.
To help make the talk a little easier:
- Pick a time and place that you can talk freely without interruptions.
- Keep it simple and to the point.
- Be prepared with information and resources that can help answer their questions about their risk level and options for prevention.
- Be ready for the possibility that they may not take it well, and try not to take their reaction personally.
Theres a lot you and your partner can do to reduce the risk of HIV transmission.
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Tattoos And Body Piercings
- There are no known cases in the United States of anyone getting HIV this way.
- However, it is possible to get HIV from tattooing or body piercing if the equipment used for these procedures has someone elses blood in it or if the ink is shared. This is more likely to happen when the person doing the procedure is unlicensed because of the potential for unsanitary practices such as sharing needles or ink.
- If you get a tattoo or a body piercing, be sure that the person doing the procedure is properly licensed and that they use only new or sterilized needles, ink, and other supplies.
How Well Does Prep Work
PrEP is very effective when you take it every day. It reduces the risk of getting HIV from sex by more than 90%. In people who inject drugs, it reduces the risk of HIV by more than 70%. PrEP is much less effective if you do not take it consistently.
PrEP does not protect against other STDs, so you should still use latex condoms every time you have sex. If your or your partner is allergic to latex, you can use polyurethane condoms.
You must have an HIV test every 3 months while taking PrEP, so you’ll have regular follow-up visits with your health care provider. If you are having trouble taking PrEP every day or if you want to stop taking PrEP, talk to your health care provider.
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What We Know About Hormone And Steroid Injecting
Hormone and steroid injections can be done safely by a health care provider. But theres a chance that someone can get or transmit HIV if an HIV-negative person uses needles, syringes, or other injection equipment after someone with HIV has used them. This is because the needles, syringes, or other injection equipment may have blood in them, and blood can carry HIV. Likewise, youre at risk for getting or transmitting hepatitis B and C if you share syringes because these infections are also transmitted through blood.
More Information About 1 out of every 10 HIV diagnoses in the United States is among people who inject drugs. This includes gay and bisexual men who inject drugs. On average, an HIV-negative person has a 1 in 420 chance of getting HIV from a needlestick if the needle or syringe contains HIV-infected blood.
More Information There may be extremely tiny amounts of blood in syringes or works that you may not be able to see, but could still carry HIV. Be aware that HIV can survive in a used syringe for up to 42 days depending on temperature and other factors.
There are medicines to treat hepatitis B. If youve never had hepatitis B, theres a vaccine to prevent it. There are medicines to treat hepatitis C, but they arent right for everyone. Theres no vaccine to prevent hepatitis C. Talk to your health care provider to learn more about hepatitis B and C.
Can You Get Hiv From Having Sex With Someone Who Has Aids
If you have sex with someone who has AIDS, not HIV, can you still get HIV? Sarah*
Yes. People who have AIDS are infected with the HIV virus. This means they can pass HIV on to others.
AIDS happens after someone has had HIV for many years. In AIDS, the immune system is severely weakened. When someone gets HIV, that person can spread the infection to other people immediately. And if HIV develops into AIDS, the virus can spread to others.
HIV/AIDS spreads when infected blood or body fluids enter the body. This can happen:
- during sex
- through sharing needles for injecting drugs or tattooing
HIV/AIDS also can pass from mother to child during pregnancy, childbirth, or breastfeeding.
To reduce your risk of getting HIV/AIDS if you are sexually active:
- Use a condom every time you have sex .
- Get tested for HIV and make sure all partners do too.
- Have fewer sexual partners.
- Get tested and treated for STDs having an STD increases the risk of HIV infection.
- Consider taking a medicine every day if you are at very high risk of getting infected .
It’s also important to:
- not inject drugs or share any kind of needle
- not share razors or other personal objects that may touch blood
- not touch anyone else’s blood from a cut or sore
*Names have been changed to protect user privacy.
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