PrEP & HIV Treatment

What is PrEP?

PrEP is the medication used to protect someone from becoming HIV positive.
There are four prescriptions drugs currently prescribed for PrEP. They are:

• Truvada and Descovy, both in pill form and taken daily
• Apretude, an injection given every other month
• Yeztugo, an injection given twice per year

All four medicines reduce a person’s chance of getting HIV by 99 percent or more when taken as prescribed. 

How does PrEP work?

PrEP works by putting antiretroviral medication in your body. If you are exposed, these drugs will prevent you from becoming HIV positive.

Taking Truvada or Descovy once a day will help prevent HIV. Receiving your Apretude and Yeztugo shots on time will prevent HIV as well. Your primary care provider can start you on PrEP as long as they can write prescriptions. This includes doctors, nurse practitioners, and physician assistants. A person on PrEP will get blood work done every 3 months to test for HIV and STIs, as well as organ function.

PrEP does not protect against other sexually transmitted infections (STI) or pregnancy. It is not the same as birth control. It is neither a replacement for condoms nor a cure for HIV.

To reduce these risks, continue to use condoms for oral, vaginal, or anal sex. 

What are the side effects of PrEP?

PrEP is generally safe and well-tolerated. Most people on PrEP do not report side effects. For information about the possible side effects of your specific medication, ask your provider.

Some general side effects to b

e on the lookout for after starting PrEP may include:

• Injection site reactions with Apretude and Yeztugo (pain or swelling)
• Rash, redness, or blisters on the skin
• Cold symptoms, like fever, sore throat, body aches, or runny nose
• Stomach pain
• Nausea
• Headaches
• Chest pain or tightness
• Unusual tiredness
• Difficulty concentrating
• Mood changes, like irritability

For most people, side effects are mild and go away on their own after the first couple of weeks.

There are some less common side effects that can be severe. If you experience any vision changes, sharp pain, tingling or weakness in the hands or feet, let your provider know right away.

How long do I have to be on PrEP for it to be effective?

Oral PrEP must be taken every day to reach its highest effectiveness. After 7 days in a row of taking oral PrEP, you are protected from HIV during condomless anal sex. For vaginal sex, oral PrEP can take up to 21 days to reach greatest efficacy.

You may also be able to time your oral PrEP dose around when you have sex and still be fully protected. On-demand dosing, or 2-1-1 dosing, can be a good option for people who do not want to take a daily pill, or those who can anticipate when they will have sex.

Research is still needed to determine when injectable PrEP reaches its greatest efficacy. What we do know is that it is important to stay current on your injection schedule to stay protected from HIV once you are on injectable PrEP.

Is PrEP right for me?

PrEP is effective for people of all genders above 77 pounds, including adolescents. There are different forms of PrEP (pill, injection) and dosing schedules (daily, bimonthly, or every 6 months). As long as you take PrEP as prescribed, it will reduce your risk of HIV from condomless sex.

What option is right for you is a personal decision based on your health and your life. Ask a PrEP Navigator or your healthcare provider if you have questions so you can make an informed decision.

Can I get PrEP at MetroHealth?

Yes! In fact, we offer PrEP-specific clinics:

• In person appointment: Second and fourth Tuesday from 1 p.m. – 4:30 p.m.
  • Main Campus: Outpatient Health Center (OPHC), 4th floor, Medical Specialties clinic
  • Park in the P1 visitor garage and use the entrance connected to the hospital. Take the patient elevators to the fourth floor, then turn left and walk down the hall to the Medical Specialties check-in desk.
• Televisits: First and third Tuesdays from 12 p.m. – 4 p.m. and Tuesday and Thursday evening appointments available, 4 to 9 pm.

Call our PrEP navigators to make an appointment in PrEP clinic today: 216-957-PrEP (7737)

You can also get PrEP through MetroHealth’s Pride Network. Call 216-957-4905 for a Pride appointment.

Can I afford PrEP?

While most health insurance plans cover PrEP with little to no cost to you, some people may still have out-of-pocket costs. If these costs are challenging for you to pay, you may be eligible for help from the drug manufacturer.

In Ohio, the Patient Assistance Program Intervention (PAPI) program helps people to access PrEP by c. Contact a PrEP Navigator to learn more and sign up or visit the OHIV website to get connected to a PrEP Navigator near you.

A PrEP Navigator can assist with obtaining co-pay cards, applying for PAPI, or other assistance. You can also visit the manufacturer's website or call 1-877-505-6986 for more information.

Is PrEP covered by health insurance?

Yes. In Ohio, Medicaid completely covers PrEP with no out of pocket expense.

Most private health insurance plans must also cover PrEP under the law. This includes the cost of the medication, medical appointments, and lab tests associated with PrEP care.

If you have private health insurance, check with your insurance plan to learn about how PrEP is covered and if you have a co-payment.

Sometimes your insurance may not cover your first-choice form of PrEP. In this case, they should still cover labs and other appointment costs. You may also choose the form of PrEP that is fully covered – this is totally up to you and your doctor.

What if I’m uninsured?

You may be eligible for help with the cost of PrEP through the manufacturer. To find out if you are eligible, visit:

• Gilead Patient Assistance Program (Truvada, Descovy, Yeztugo) or call 1-800-226-2056 (9 am – 8 pm EST, M – F)
• ViiV Connect Patient Assistance Program (Apretude) or call 1-844-588-3288 (8 am – 8 pm EST, M – F)

Our PrEP Navigators are trained to help you access financial assistance to make your PrEP care affordable. Call 216-957-PrEP (7737) to find out if you are eligible for these programs.

How do I access off hours secual care?

MetroHealth has a telemedicine clinic specifically for emergency sexual health care at your convenience. Call 216-778-8305.

Services provided include:

• Emergency contraception
• Having symptoms of an STI
• Treatment for contact with an STI
• Testing for all STIs
• PrEP
• PEP (Post-Exposure Prophylaxis) within 72 hours of exposure to HIV
• Referrals for syphilis or herpes infections
• Labs can be ordered and you can go to your nearest MetroHealth lab
• Prescriptions will be sent to your pharmacy of choice or mailed to your house.

Weekday afternoon and evening appointments available. Ask to be put on the Nurse Practitioner Meyer or the STI or the PrEP schedule. A PrEP navigator can also help find off-hours sexual health care.

Local PrEP Resources

Visit The Cleveland AIDS Clinical Trials Unit for more information, a local directory of PrEP providers, and additional resources.

LoveLeadsHere.org has information about where to go for HIV testing, PrEP navigation, and other STI testing as well.

Outside of Cuyahoga County?

Visit Ohio PrEP for a statewide directory of PrEP providers, more information, and other resources.

I need immediate or off-hours sexual health care, what should I do?
MetroHealth has a telemedicine clinic specifically for emergency sexual health care at your convenience. Call 216-778-8305 to get scheduled.

Services provided include:

• Emergency contraception
• Testing for all STIsTreatment for STI symptoms
• Treatment for contact with an STI
• PrEP
• PEP (Post-Exposure Prophylaxis) within 72 hours of exposure to HIV
• Prescriptions can be sent to your pharmacy of choice or mailed to your house

Weekday afternoon and evening appointments are available. A PrEP navigator can also help find off-hours sexual health care.