PrEP Facts: Starting and stopping PrEP care

It’s important to think about how you expect to take PrEP, and to plan ahead for things that might get in the way.

PrEP Facts: Comenzar y dejar los cuidados de PrEP [Spanish]

Starting PrEP care

Once you’ve decided you want to start, contact your healthcare provider (or a telehealth service). During your first visit, your provider will do a general health exam and ask questions about your sexual history, your use of hormones, and your desire for and understanding of PrEP. You’ll be tested for HIV, other STIs, hepatitis B, and pregnancy if applicable, and your provider will write a prescription for PrEP.

It is very important to make sure you don’t have HIV before starting PrEP. If you had sex within a week or two before your first PrEP care visit or have symptoms of early HIV infection, share this with your healthcare provider during your visit. You may need another HIV test a couple weeks later to confirm your status.

If you take oral PrEP, you’ll see your healthcare provider every three month after your first visit. If you take injectable PrEP (Apretude), you’ll see your healthcare provider for injections once a month for the first two months, and then every other month. Follow-up visits will be to check in on how you’re doing with the medication, administer follow-up dosing (if applicable), and to screen for HIV and other STIs. You’ll also be tested for hepatitis B and changes in kidney health, because the drugs in Truvada and Descovy can impact these conditions.

Keep up with your visits to ensure you always have enough PrEP on hand or receive your injections on time. Request other appointments in between if you think you have an STI or if you have symptoms of acute HIV infection.

PrEP Medication Adherence

As with any medicine, PrEP works best if you take it as prescribed. It’s important to understand how to take it properly, whether you use daily PrEP or PrEP 2-1-1, or receive the PrEP inkection, to make sure enough medicine is already inside your immune cells to stop HIV if you come in contact with the virus.

It’s important to think about how you expect to take PrEP, and to plan ahead for things that might get in the way.

Tips & tricks

Ideas for remembering to take PrEP

What habits in your life can you piggyback on to remind you to take your pill? A morning routine, like brushing your teeth?

Tips & tricks

Ideas for remembering to take PrEP

Where do you plan to keep your pills? On a nightstand, a bathroom counter, or tucked away out of sight of others?

Tips & tricks

Ideas for remembering to take PrEP

What gadgets might help you remember? A pill box, medicine reminder app or service, or recurring alarm?

Tips & tricks

Ideas for remembering to take PrEP

What things could make you forget? Traveling, stressful situations, drinking, or depression?

For more information on how to take PrEP, read PrEP Facts: What are the ways to take PrEP?

Is it OK to stop using PrEP?

It is possible to safely stop using PrEP. Check in with your healthcare provider about why you want to stop, when you want to stop, and how to stop safely. Consider also talking with your healthcare provider about other HIV prevention methods you can use.

You may decide to stop if your level of HIV risk has changed and you no longer need or want to use PrEP. Maybe you find you’re not taking every dose. Whatever the reason, consider sharing it with your healthcare provider in case there’s a solution you haven’t thought of.

If you’re taking oral PrEP, you’ll continue taking doses after the last time you had sex, to make sure the drugs remain in your body long enough to prevent infection if you were exposed to HIV. If you’ve been receiving injectable PrEP, you’ll want to talk to your healthcare provider about what to do when you want to stop PrEP.

Here are the current recommendations for stopping PrEP:

Daily PrEP

Daily PrEP can be stopped with 28 daily doses after the last exposure. For those at risk for HIV due to anal sex, PrEP can be stopped after two daily doses. If you have chronic hepatitis B disease, daily PrEP should be stopped with your health care provider’s support to avoid liver damage.

PrEP 2-1-1

With PrEP 2-1-1, once you’ve taken your two daily doses after having sex, you’ve “stopped.”

Injectable PrEP

Talk to your healthcare provider when you decide you want to stop receiving PrEP. With injectable PrEP, you have the option of switching to oral PrEP if you decide to change the method of PrEP you use. If you decide to stop injectable PrEP, you should continue to have HIV testing for approximately 12 months afterwards. This HIV testing should include HIV viral load testing per CDC recommendations.

What HIV prevention methods will you use after stopping PrEP?

PrEP Facts content written by Alan McCord and Reilly O’Neal. Medical review by Janessa Broussard, RN, MSN, AGNP-C, vice president of medical affairs at San Francisco AIDS Foundation.