Can heterosexual people use PrEP?

Sexual Health

Can heterosexual people use PrEP?

Ash Wellness

Yes, heterosexual people can use PrEP, also known as pre-exposure prophylaxis. PrEP reduces the risk of getting HIV from sex by about 99% when taken as prescribed, and reduces the risk from injection drug use by about 74%. One type of PrEP — the pill Descovy — is not prescribed for people assigned female at birth who could contract HIV through receptive vaginal sex, but all types of at-risk people, including heterosexual people, can benefit from PrEP. 

How does PrEP work?

Pre-exposure prophylaxis works by preventing HIV from replicating in the body. PrEP helps the body create antibodies, proteins produced in the immune system that protect the body against unwanted substances. PrEP all but eliminates the possibility of contracting HIV after exposure. 

How long does PrEP take to work?

PrEP can be taken as pills (Truvada and Descovy) or shots (Apretude). PrEP pills reach maximum protection for receptive anal sex after 7 days of daily use, and for receptive vaginal sex and injection drug use at 21 days. The CDC does not provide data for how long it takes for PrEP shots to reach maximum protection during sex. 

Who uses PrEP?

PrEP is for people without HIV who are at risk of being exposed to HIV through injection drug use or sexual intercourse. PrEP use is uneven across racial, ethnic, and gender demographics. Transgender women, for example, are at greater risk for contracting HIV — a study found that four in 10 transgender women in seven major U.S. cities have HIV — but report low uptake of PrEP. 32.3% of heterosexual adults are aware of PrEP, and less than 1% use it.

Men who have sex with men are often prescribed PrEP because HIV has affected gay men disproportionately in the U.S. While HIV infection rates in the U.S. among men who have sex with men are higher than those of the rest of the population, more heterosexual people were diagnosed with HIV in 2020 in the UK than gay and bisexual men. 

PrEP should be taken once daily for maximum effectiveness.

Should I consider PrEP?

According to the CDC, PrEP could be right for you if you have had anal or vaginal sex in the past 6 months and you:

  • have a sexual partner with HIV
  • have not used a condom consistently, or
  • have been diagnosed with an STI in the past 6 months.

Women and other people who have receptive vaginal sex can take Truvada pills or Apretude shots to protect against HIV. If you are a person trying to conceive with an HIV positive or unknown status partner, PrEP may be an option to help protect against getting HIV (and transferring it to your baby) while trying to get pregnant, during pregnancy, or while breastfeeding. The risk of HIV transmission through receptive vaginal sex is at 0.08% and the risk from insertive vaginal sex is estimated to be 0.04%.

Does PrEP only prevent against HIV from sexual contact? 

PrEP also reduces the risk of getting HIV from injection drug use by at least 74%. If you or someone you love is an injection drug user, PrEP is an excellent harm reduction strategy to limit HIV risk after exposure. The CDC urges injection drug users not to have sex while high on drugs, as they are more likely engage in risky sexual behaviors.

Another way for injection drug users to reduce harm is to not share needles and syringes. If use of a new, sterile syringe is not possible, the CDC recommends cleaning any injection equipment with pure bleach. Some community-based programs provide access to sterile needles and syringes and facilitate safe disposal of used syringes. 

Where can I get PrEP?

PrEP is not available over the counter, and requires a prescription. Ask your doctor for more information. If HIV risk behaviors such as sex or intravenous drug use are difficult to discuss with your doctor or healthcare professional, say so. It helps get the conversation started. 

Federal law prohibits your doctor from telling the police about your drug use.

Can I use at-home PrEP testing? 

Some digital health companies and traditional medical institutions help patients get and stay on PrEP through telehealth services and home diagnostics.  At-home PrEP testing lets patients meet medication adherence requirements by testing HIV in PrEP every quarter and Creatinine every six months

At-home PrEP testing makes care more accessible and helps individuals without easy access to traditional healthcare services receive ongoing HIV protection.  

Ash Wellness offers 150+ diagnostic tests to support all types of care, including medication adherence, population health, primary care, and digital health. Schedule a time to chat about how to reach and maintain patients and customers with our unique platform. 

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