Should I start PrEP?

Dear Reader, 

Being close with your partner doesn’t have to take a pause because of HIV. To briefly clear the air: antiretroviral therapy (ART) is a long-term medication for people living with HIV. Alternatively, post-exposure prophylaxis (PEP) is a short-term emergency fix after possible HIV exposure. If your partner is on ART consistently, the risk of HIV transmission is very low. Adding a condom can also give you an extra layer of protection. But if you’re thinking about starting pre-exposure prophylaxis (PrEP), a longer-term, daily or on demand HIV prevention medication, a health care provider can help you decide if it’s a good fit. Read on to learn more about PEP, ART, PrEP, and other ways to reduce chances of HIV transmission. 

What is the difference between PEP and ART? 

While PEP and ART might seem similar, they play very different roles. 

Post-exposure prophylaxis (PEP) is a short-term preventive medication used after a possible exposure to HIV. Think of it as giving your immune system a little PEP in its step; if taken within 72 hours, it helps block the virus before it has a chance to settle in for good. Keep in mind that PEP isn’t designed for ongoing use and isn’t used by people who are already living with HIV.  

In contrast, antiretroviral therapy (ART) is a daily, long-term treatment for people living with HIV. ART doesn’t cure HIV, but it reduces the amount of HIV in the body (also known as the viral load). ART has the potential to lower a person’s viral load to a level so small that it becomes ‘undetectable’ on a standard test. This means there’s little to no risk of spreading HIV to partners. Reaching an undetectable viral load can also strengthen the immune system, this may lower the risk of getting other serious infections.   

What can you do if you’re considering taking PrEP? 

Pre-exposure prophylaxis (PrEP) is a medication that helps prevent people from contracting HIV. Unlike PEP that’s taken after exposure, PrEP is the prep work you do before possible exposure. This medication is used by people who don’t have HIV but are at higher risk of getting HIV.  

If pregnancy is part of your plans, a health care provider can also explain how PrEP may be used safely during that journey. If PrEP doesn’t feel like the right choice, after getting all the information, providers can also suggest other ways to lower HIV risk while still supporting your goals for pregnancy and parenting. 

What are other ways you can reduce the chances of HIV transmission? 

There are a couple of ways to reduce the chances of HIV transmission. While none of these methods eliminate risk entirely, they can add layers of protection. Some options to lower risk include: 

• Barrier methods of protection: external condoms, internal condoms, and dental dams can reduce the risk of HIV during all types of sex, such as anal, vaginal, or oral sex. Using them consistently is key to preventing HIV transmission.
• STI testing: Sexually transmitted infections (STIs) can cause sores or inflammation that makes it easier for HIV to enter the body, so scheduling routine testing keeps your risk low. 
• Lower-risk sexual activities: masturbation and dry humping (or grinding) with clothes on are safe play options that let you enjoy intimacy with minimal risk.
• Circumcision: this is a preventive measure for people with penises. Studies show that circumcised individuals are less likely to contract HIV compared to those who aren’t.
• Avoid needle sharing: avoid sharing needles or other equipment that can carry blood. This can prevent the spread of HIV through non-sexual routes like the bloodstream. 

It’s also worth noting that medications like PEP and ART don’t protect against other STIs. Therefore, using these additional methods could help protect you from a variety of things by adding another layer of safety.  

How can you get support for starting PrEP? 

Deciding to start PrEP can feel like a big step, but you don’t have to make that choice alone. Talking with your partner can create space to prep-are together. This can be done by sharing concerns, asking questions, and making decisions as a team. Couples counseling might be an option to help discuss these topics as well as dive more into what that means for the two of you to have the potential for HIV transmission during sex. That said, a conversation with a health care provider or an HIV specialist can provide more guidance on whether PrEP is a good option for you. Together, you can discuss its advantages, potential risks, and address any concerns you might have. 

Considering PrEP yourself alongside other prevention strategies like your partner doing ART, incorporating protection, and opting for safer sex practices can all help to reduce your risk of contracting HIV.  

Way to stay PrEP-ared,