PrEP for Women

PrEP stands for pre-exposure prophylaxis. It is the use of medication to prevent HIV infection. PrEP is used by HIV-negative people who are at risk of being exposed to HIV through sexual contact or injection drug use. Right now, there is only one medication approved to use as PrEP called Truvada.

Truvada for PrEP is taken one-time a day by mouth. Taking PrEP also requires talking about reducing HIV risk with an HIV testing counselor and getting tested for HIV and STDs every three months. Also, because PrEP only protects against HIV, condom use is recommended to protect against other STDs (chlamydia, syphilis, gonorrhea, etc.).

PrEP may be for women who meet any of the following criteria:

• Is in an ongoing sexual relationship with an HIV-positive person who is
  • not on HIV treatment OR
  • is on HIV treatment but is not virally suppressed (or has detectable levels of HIV in their body) OR
  • is within 6 months of initiating HIV treatment.
• Is in a relationship with an HIV-positive person where the woman is trying to get pregnant.
• Has been recently diagnosed with early syphilis. (Studies show that 55%-60% of syphilis cases in LA County occur in HIV+ persons, so a recent syphilis diagnosis may show an increased risk for HIV.)
• Exchanges sex for money or drugs.
• Injects drugs or hormones that are not prescribed by a medical provider.
• Is in a relationship with a man who has sex with other men or is suspected to be having sex with other men.
• Is requesting PrEP.

Adherence is important for women and all patients on PrEP. Studies show that excellent adherence for women (taking PrEP 6 days out of the week) is critical in order to reach protective levels in cervical and vaginal tissue.

Studies suggest that women need to take PrEP for:

• At least 7 days to provide protective levels if they are having anal sex.
• At least 20 days to provide protection if they are having vaginal sex.

Yes, Truvada as PrEP is safe and well-tolerated for women.

No, current studies show that PrEP does NOT affect hormone-based birth control.

Currently, there is no evidence to show that PrEP will interfere with estrogens in hormone therapy. However, more research is needed to better understand the relationship between taking estrogens and PrEP.

Yes, women can take PrEP when attempting to get pregnant and/or during pregnancy. The Center for Disease Control and Prevention (CDC) recommends PrEP as an option to reduce the risk of HIV from an HIV-positive male partner during conception. The CDC also recommends that women with ongoing risk of HIV continue PrEP throughout her pregnancy and breastfeeding to protect herself and her infant.

Yes, PrEP is safe to use while breastfeeding. No negative side effects have been found among infants exposed to Truvada when the medication was taken as part of the treatment for women living with HIV during pregnancy or during breastfeeding. Studies show that infants are exposed to very small amounts of PrEP during breastfeeding. However, no long-term safety studies have been done to determine the long-term health effects.

Any licensed medical doctor, nurse practitioner, or physician assistant can prescribe Truvada as PrEP. Specialization in HIV Medicine or Infectious Disease is NOT required.