New cases of human immunodeficiency virus, or HIV, have steadily declined in the U.S. since 1995. Still, an estimated 1.2 million people in the U.S. have HIV, and many don’t know they have it.
Fortunately, there are medications to help prevent HIV, called pre-exposure prophylaxis (PrEP), and to treat HIV, called antiretroviral therapy (ART).
PrEP is usually taken as daily pills or monthly injections. And, on June 18, the Food and Drug Administration approved a new type of injectable PrEP, Yeztugo, for administration every six months. However, it’s still unclear whether insurance will cover it and when it will become available.
Read on to learn how PrEP works, who it’s for, how much it costs, and what types are available now.
What is HIV?
HIV is a virus that attacks the immune system, making people with HIV more at risk of getting sick. There is no cure for HIV, but ART is a combination of medications that prevent the virus from reproducing and doing more damage. People with HIV who receive early treatment can live long, healthy lives.
However, if left untreated, HIV can progress to acquired immunodeficiency syndrome. At that point, the virus has severely weakened the infected person’s immune system, which makes them extremely vulnerable to infections and certain cancers that could cause severe illness or death.
How does HIV spread?
HIV spreads when certain body fluids from an infected person—like blood, vaginal fluids, semen, and breast milk—enter another person’s body through the mouth, genitals, anus, or broken skin. You cannot get HIV from touching someone who has it. You also cannot get it from kissing someone who has HIV, unless you both have open mouth sores or bleeding gums.
Most people with HIV got it from having unprotected sex or sharing drug injection equipment. It can also spread from birthing parents to their babies during pregnancy, birth, or breastfeeding.
What is PrEP?
PrEP is any prescription medication that lowers the risk of getting HIV.
“Today, we know that HIV is incredibly treatable,”said Dr. Joanne Stekler, an infectious diseases doctor at the Madison Clinic at Harborview Medical Center in Seattle, in a 2019 UW Medicine article. “People who are living with HIV are living normal lives because they have access to medicine.”
When taken correctly, PrEP reduces the risk of getting HIV through sex by 99 percent and reduces the risk of getting HIV from sharing drug injection equipment by 74 percent. It does not protect against other sexually transmitted infections. Using condoms while taking PrEP further reduces your risk of contracting HIV and protects against other STIs.
There are three FDA-approved PrEP medications:
- Truvada, a daily pill that prevents HIV from replicating inside the body.
- Descovy, a daily pill that prevents HIV from replicating. It’s only approved for some people.
- Apretude, an injectable medication that starts with two injections one month apart. After that, people taking Apretude can get an injection once every two months. Apretude is only approved for people at risk of getting HIV through sex.
When does PrEP become effective?
PrEP pills offer maximum protection during receptive anal sex after about seven days of daily use. They offer maximum protection during receptive vaginal sex after about 21 days of daily use. It’s unclear when PrEP reaches maximum protection for insertive vaginal or anal sex.
Researchers don’t yet know how long it takes for PrEP shots to reach maximum protection.
Who can take PrEP?
PrEP is safe for most adults and adolescents who are HIV-negative. Truvada and Descovy are approved for anyone who weighs at least 77 pounds, and Apretude is approved for anyone who is over 12 years old and weighs at least 77 pounds.
It’s especially beneficial for people at increased risk of contracting HIV through sharing drug injection equipment or sex.
“People who are having unprotected sex—so not using condoms every single time they have sex—and if they have a partner who has HIV, or they have multiple sexual partners who have not been tested for HIV, or if they’ve had an STD in the last six months, those are the folks we consider to be at risk for HIV and who may want to get on PrEP,” said Dr. Céline Gounder, an infectious diseases doctor and editor-at-large for public health at KFF Health News, in a 2024 CBS News interview.
PrEP may not be right for you if you are allergic to its ingredients, have liver or kidney problems, are pregnant or breastfeeding, or are immunocompromised.
What are the side effects?
PrEP is not known to cause serious side effects. Some common mild side effects include stomach problems, fatigue, weight loss, and headaches.
“But in most everyone, this goes away,” Stekler said. “Very few people stop using PrEP because of those effects.”
People who get PrEP injections may also experience some pain and swelling at the injection site.
How can I get PrEP?
If you’re interested in taking PrEP, talk to a health care provider or visit a health clinic like Planned Parenthood. Find PrEP providers near you using the National Prevention Information Network locator or Greater Than HIV’s provider database. You can also get a prescription for PrEP online through some telehealth providers.
Your health care provider will likely ask you questions about the type of sex you have, your drug use, and your medical history to determine if PrEP is right for you. Your provider may also test you for HIV, hepatitis B and C, and other STIs.
“Sometimes potential PrEP users feel a little nervous about approaching their provider because it means they need to talk about sex. But for the vast majority of people, it is a very straightforward intervention,” said Dr. Matthew Hamill, an infectious diseases doctor and associate professor at Johns Hopkins University, in a Johns Hopkins Bloomberg School of Public Health article.
Once you start taking PrEP, you will need to get tested for HIV every two to three months. If pregnancy is a possibility, you may also need a pregnancy test.
How much does it cost?
Right now, most health insurance plans, including Medicaid, cover PrEP. However, in April, the U.S. Supreme Court heard a case challenging a provision of the Affordable Care Act that requires insurance companies to provide free preventative care like PrEP. As of June 2025, the court has not yet reached a decision.
You may be able to get help covering copays, coinsurance, and deductibles from Gilead, the company that makes Truvada and Descovy. Gilead also has a medication assistance program for people who are uninsured. The out-of-pocket cost of PrEP ranges from $60 to $2000 per month.
Talk to a health care provider to find out if you qualify. You can find other patient advocacy groups that help cover the cost of PrEP through the Patient Advocate Foundation.
What are other ways to protect against HIV?
If PrEP isn’t right for you, you can protect against HIV by using safer sex barriers like condoms and avoiding sharing drug injection equipment.
If you think you may have been exposed to HIV, contact a health clinic like Planned Parenthood to see if they have post-exposure prophylaxis, a series of pills that reduce your risk of getting HIV after an exposure. PEP must be taken within 72 hours of exposure to be effective, so it’s important to see a health care provider right away. You can also get PEP at emergency rooms.
Unsure of your HIV status? Find out where to get tested from the CDC.
For more information, talk to your health care provider.