If you are just starting your PrEP journey or if you have never taken a daily medication before, the thought of starting out can be intimidating. For the purpose of this article, we’ll be discussing the daily pill for PrEP.
How many days does it take for PrEP to be effective?
PrEP, like other daily medications, takes time before your body absorbs it enough to reach full efficacy. It generally takes at least 7 to 22 days of daily use for it to reach full effectiveness depending on what type of sex you’re having. It takes 7 days if you are having anal sex and 21-22 days if you are having vaginal sex.
Tips for remembering to take your PrEP
Remembering to take your PrEP to hit maximum protection levels and for it to remain effective is key. But, it can be difficult. To help you remember, here are a few tips:
- Keep your pill bottle in the same place where you will see it every day.
- Take PrEP at the same time every day. This means you may want to take PrEP before or after a daily activity. After a specific meal, after you go to the gym, or before you brush your teeth at night. Whatever is a consistent routine for you, find a way to incorporate it and to establish a routine.
- Set a daily alarm reminder on your phone.
How long do I take PrEP after I have started taking it?
Once you start taking PrEP, how long should you stay on it? Every person is different, and before making any decision that impacts your health, you should speak to your primary care provider or a specialist, like the ones at Q Care Plus. But, to provide some insight, a few of Q Care Plus’s medical providers weigh in.
Dr. Jennifer Belfry, DNP, FNP-BC, AAHIVS, Clinical Lead
“For sexual exposure, you should take daily oral PrEP for however long you are sexually active,” says Dr. Belfry. “If you’re looking to stop oral PrEP, continue taking it for 7 days after your last sexual encounter to protect yourself on the tail end too. There is less data on intravenous exposure and oral PrEP, but it would be best to continue daily oral PrEP for however long you may be having intravenous exposure, plus at least 7 days after your last intravenous use.”
Dr. Julie Graves, MD, MPH, PhD
“It’s okay to take PrEP for as long as you need it to prevent HIV. There are a lot of factors involved on how long you’ll take it. That includes how many partners you have, what relationship status you have, and how often you’re having sex. Talking with our providers at Q Care Plus, we’ll work together to come up with a strategy that works best for you.”
Anthony Interrante, NP
“In my professional opinion, PrEP is for anyone at increased risk for contracting HIV,” says Anthony. “This includes anyone who is in a relationship with someone living with HIV, anyone who does not use condoms (even once), and anyone who shares injection drug or hormone equipment. This includes all genders: men, women, nonbinary, and transgender individuals. This also includes all sexual orientations: gay, bi, and straight. Finally, it includes individuals of all races and ethnicities. There is one person who you can 100% trust to safeguard your sexual health, and that is you. By taking a once-a-day PrEP pill, you can safely and confidently reduce your risk of contracting HIV to nearly 0%.”
Do I have to take PrEP for the rest of my life?
In other words, do you have to be “on the pill” forever?
“Knowing when to stop PrEP can be tricky,” says Chief Medical Officer Dr. Christopher Hall. “Often, we reach a point when there is a lull in our sexual activity, and we think ‘do I really need PrEP?’ While stopping PrEP 7 days following the last sexual encounter is a recommended option, you’re then susceptible to HIV risk when the next opportunity comes along, perhaps unexpectedly. Restarting PrEP in that instance should involve at least 7 daily doses (for anal sex risk) or 20 days (for vaginal sex). While 2-1-1 dosing can decrease the anal sex time window, to avoid the possible need for nPEP, folks might err on the side of continuing daily PrEP during short breaks in sexual activity, both for ease of dosing and for peace of mind.”
It’s rare that someone must take PrEP for their entire life. For many people, life circumstances change over time and the risk for HIV may be reduced or eliminated. Many people end up in monogamous relationships. In this case, if their partner is HIV-negative, the risk of exposure to HIV is greatly reduced!
For those who do have a partner or partners who are HIV positive, if the person living with HIV’s viral load is low enough, they cannot transmit HIV. This is called U=U (undetectable equals untransmittable). While many medical providers will recommend long-term PrEP for the HIV-negative partner as a precaution, this might be overkill if there are no other partners in the picture.
But, again, our medical team and other providers must speak with a patient directly and assess their situation before giving any advice or direction.
If you have concerns about the length of time you’ll be on PrEP, you should discuss the issue with your provider from the beginning. The more information medical providers have about your comments, questions, and concerns, the more they can guide you in your journey to get on PrEP.
What if I had unprotected sex after missing doses of PrEP?
When adhering to the recommended dosage of PrEP, you are 99% protected against HIV. If you missed a dose or are not on PrEP regularly and believe you have been exposed to HIV, you should talk to your provider as soon as possible to see if PEP is right for you.
PEP (post-exposure prophylaxis) is an emergency measure (prescription medication) taken after potential exposure to HIV. It is a time-sensitive intervention, ideally initiated within 24 hours but as late as 72 hours (about 3 days) following exposure. PEP involves a month-long course of antiretroviral medications and is intended to prevent the virus from establishing itself in the body. Q Care Plus offers PEP within the 72-hour limit when delivery is feasible. When time is short, your Q Care Plus provider will refer you to the best possible local care as required.
Make an appointment and learn more about PrEP
Knowing all your options will help you make the best decision for your health and your future.
At Q Care Plus, we have expedited appointments with sexual health professionals who can help you get connected to resources like PrEP, PEP, on-demand-PrEP, longitudinal HIV care in select states, and DoxyPEP (aka STI-PEP) in select states.
Make an appointment today to speak with caring, compassionate, expert providers.