What is PrEP?
PrEP is the medication used to protect someone from becoming HIV positive. There are currently 3 medicines approved for PrEP:
- Truvada (a pill available in generic form)
- Descovy (also in pill form) and
- Apretude, a bimonthly (every other month) injection
Truvada was approved for HIV prevention by the FDA in 2012, Descovy in 2019, and Apretude was approved in 2021. All 3 medicines reduce a person’s chance of getting HIV by 99 percent or more, when taken as prescribed. PrEP does not protect against other sexually transmitted infections (STI) or pregnancy. It is neither a replacement for condoms nor a cure for HIV.
How does PrEP work?
Taking Truvada or Descovy once a day will help prevent HIV. Staying current with the Apretude shots will prevent HIV as well. Any provider who can write prescriptions can prescribe PrEP (Nurse Practitioner, Primary Care Physician, etc.). A person on PrEP will get blood work done every 3 months to check for STIs, proper kidney function, and HIV.
Continued condom use when appropriate is strongly recommended, as PrEP does not offer protection against other sexually transmitted infections, like syphilis or chlamydia.
Is PrEP right for me?
PrEP reduces the risk of HIV infection from condomless sex. PrEP is effective for men, women, and Trans individuals, although Descovy is not yet approved for vaginal intercourse or IV drug users. It can also help relieve the anxiety from sexual relationships between someone who is HIV positive and someone who is HIV negative.
Ask a PrEP Navigator or your health care provider if you have additional questions on how PrEP will work for you.
What are the side effects of PrEP?
PrEP is generally very safe and well-tolerated. Most people on PrEP report experiencing no side effects, however, some have. Those side effects are listed below and ordered from most to least common:
- Injection site reactions with Apretude (pain or swelling)
- Nausea
- Headaches
- Slight weight loss (Truvada)
- Slight weight gain (Descovy)
- Slight cholesterol changes (Descovy)
- Slight decrease in bone mineral density (No risk of fracture or damage. Returns to normal after PrEP is discontinued)
- Slight decrease in kidney function (returns to normal after the discontinuation of PrEP)
For those who experience symptoms, these side effects went away on their own after the first couple weeks of taking PrEP.
How long do I have to be on PrEP for it to be effective?
PrEP reaches its maximum efficacy after 7 consecutive days of use for anal sex, although there is alternative intermittent dosing that works for condomless anal sex. PrEP must be taken every day to be fully effective. Learn more about 2-1-1 Intermittent dosing for anal sex here.
For vaginal sex (for people who have a vagina and engage in vaginal sex), PrEP can take up to 21 days to reach maximum efficacy. 2-1-1 dosing is not recommended for those who engage in vaginal sex.Can I get PrEP at MetroHealth?
Yes. There are many physicians and nurse practitioners across the MetroHealth System who are qualified and familiar with administering PrEP. In fact, we offer PrEP-specific clinics:
- In person appointment: Second and fourth Tuesday from 1 p.m. – 4 p.m.
- Main Campus on West 25th St. in the Medical Specialties Pavilion, Second Floor, Med Specialties Clinic.
- Televisits: First and third Tuesdays from 1 p.m. – 4 p.m. and Tuesday and Thursday evening appointments available, just ask.
You can call our PrEP navigator to make an appointment today: 216-957-PrEP (7737)
PrEP can also be obtained through providers at MetroHealth’s Pride Network. Call 216-957-4905 for a Pride appointment.
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.
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.
Can I afford PrEP?
Absolutely. Medicaid and most private health insurance plans cover the cost of PrEP, including the medication, medical appointments, and lab tests associated with PrEP care.
In Ohio, Medicaid completely covers PrEP with little to no out of pocket expense. If you have private health insurance, check with your plan to get more details about how PrEP is covered and ask about the amount of any medication co-pay.
According to the United State Preventative Services Task Force (USPSTF), PrEP is classified as a class A preventative medicine and should be covered by private health insurers under the Affordable Care Act. Even if your insurance doesn’t have the form of PrEP you and your doctor find appropriate for you, your insurance is still supposed to cover your medical office visits, labs, and medication at zero cost sharing to patient.
If you have health coverage, but the amount of medication co-pay or deductible would present a financial challenge, you may be eligible for a co-pay card from the drug manufacturer. A PrEP Navigator can assist with obtaining co-pay cards or you can visit the manufacturer's website or call 1-877-505-6986 for more information.
For people without access to health coverage, a medication assistance program is available from the drug manufacturer. To find out if you are eligible for the Gilead medication assistance program, visit Truvada or call 1-855-330-5479.
Our PrEP Navigators are trained to help you access financial assistance to make your PrEP care affordable. In Ohio, the Patient Assistance Program Intervention (PAPI) program helps those who are insured and uninsured access PrEP. Contact a PrEP Navigator to learn more and sign up.
For additional information or assistance, Project Inform provides this reference chart.
Have a question about PrEP?
Contact one of the PrEP Navigators:
AKeem Rollins
[email protected]
216-957-PrEP (7737) or text 216-714-2223
or
Sahara Rivera
[email protected]
216-778-7267 or text 216-538-6912
Local PrEP Resources
Visit The Cleveland AIDS Clinical Trials Unit for more information, a local directory of PrEP providers, and additional resources.
Outside of Cuyahoga County?
Visit Ohio PrEP for a statewide directory of PrEP providers, more information, and other resources.
