Meet the pill
that can
prevent HIV.

WHAT IS PrEP?

“PrEP” stands for Pre-Exposure Prophylaxis.
Pre = before
Exposure = coming into contact with HIV
Prophylaxis = treatment to prevent an infection from happening

It is an FDA-approved prevention pill for people who don’t have HIV, but who have a greater chance of becoming HIV-positive. When taken every day, PrEP can prevent an HIV infection by over 92%. You can use PrEP with other prevention methods, like condoms, to offer more protection. For PrEP to work, people who use it must take it every day and follow up with their doctor or medical team member every 3 months.

IS PrEP RIGHT FOR ME?

Let’s find out. PrEP is designed for anyone who does not have HIV, but who have a greater chance of becoming HIV-positive. It can be prescribed to heterosexual people, gay and bisexual people, transgender people, non-binary people, and more. PrEP allows people who inject drugs to stay HIV-negative, and those whose sexual partner(s) include people who are HIV-positive, stay HIV-negative.

You might consider PrEP if:

• You and/or your partner(s) don’t always use condoms (external or internal) when you have sex.
• You have been diagnosed with a sexually transmitted infection (STI) in the last six months.
• You’re unsure of the HIV status of your sexual partner(s).
• Your sexual partner(s) are HIV-positive.
• You are a person who injects drugs, or you’re having sex with an injection drug user.
• You are HIV-negative and interested in taking PrEP.

ARE THERE SIDE EFFECTS?

The good news is most people who’ve taken PrEP reported they’ve had no side effects. However, as with any drug, it is good to know all the risks.

• About 10% of the people taking PrEP experience mild side effects at the beginning. Examples of side effects include nausea, diarrhea and headaches. These were reported to go away quickly.
• A small number of people taking PrEP may experience changes in their kidney function and in their bone density. These side effects are not common.

When on PrEP, you should check in with your doctor or medical team member regularly so they can help you with any issues you may experience.

HOW WELL DOES PrEP ACTUALLY WORK?

When taken every day, PrEP has been proven to reduce the risk of HIV infection, in people who have a greater chance of becoming HIV-positive, by more than 90%. However, keep in mind that PrEP is much less effective if it is not taken consistently.

Studies have shown for rectal tissue:

• If you take PrEP pill 7 days a week, your estimated level of protection is 99%.
• If you take a PrEP pill 4 days a week, your estimated level of protection is 96%.
• If you take a PrEP pill 2 days a week, you estimated level of protection is 76%.

More studies are needed for vaginal and cervical tissue. But, research says PrEP should be taken daily for an estimated 90% level of protection.

*According to data analysis from the iPrEx study that found PrEP to be effective.

HOW DOES PrEP AFFECT MY HORMONE THERAPY?

Studies have shown that hormone therapy (HRT) does not make PrEP less effective.

If you have concerns about PrEP interacting with your HRT, talk to your doctor or medical team member.

WHERE CAN I GET PrEP?

PrEP starts with a conversation. You can talk to any primary care doctor, medical team member, or HIV testing counselor to determine if PrEP is right for you.

Our team at the Whitman-Walker PrEP Clinic would be happy to discuss PrEP with you. We promise it will only take a few minutes, and it can be life-changing.

The Whitman-Walker PrEP Clinic is a program designed to make it easier to get more people on PrEP. The PrEP Clinic may be a great option for you! The process combines your medical and pharmacy visits into one. Each visit is about 20 minutes and includes getting your lab work and PrEP medicine that same day.

Whitman-Walker PrEP Clinic benefits include:

• One person to guide you through the entire program.
• Short follow-up visits four times a year.

Have questions? Schedule a PrEP talk here or call (202) 939-7690.

Schedule an appointment with Whitman-Walker Health.

HOW DO I PAY FOR PrEP?

PrEP can be expensive, but most insurance policies (public and private) can cover the costs. If you don’t have insurance, we can help. Our PrEP Navigator can connect you to our insurance navigation team. They are a team of trained experts who can help screen and enroll you in the best coverage option for which you are eligible.

Public Insurance Options

• Medicaid: PrEP is covered in full. Many people who are enrolled in Medicaid will be enrolled in a “Managed Care Organization.” Examples include AmeriGroup DC, AmeriHealth Caritas and more.
• Medicare: PrEP is covered through the prescription plan. Your portion of the drug cost (i.e., co-payment or co-insurance) differs greatly by plan, so contact your plan for specifics. You may be eligible for “Extra Help” to lower your prescription cost-sharing.
• DC Healthcare Alliance: Residents of the District of Columbia (DC) may qualify for “DC Healthcare Alliance.” This program will cover the cost of medical visits, labs, and some prescribed medications. However, it does NOT cover the cost of PrEP. Even though DC Healthcare Alliance does not cover the cost of PrEP, there may be other options available.

Have questions or need help? Call our Insurance Help line at (202) 745-6151 to speak with one of our Public Benefits and Insurance Navigators.

Private Insurance Options

Most insurance plans cover PrEP, but the monthly out-of-pocket costs can change from person to person. This depends on a few factors:

• Prescription Drug Tier: Drugs on a formulary are normally grouped into tiers. Truvada is the medication used for PrEP and made by Gilead. The tier it is in determines your portion of the drug cost.
• Plan Deductible: This may be Pharmacy, Medical or a mix of both. If your policy has a Pharmacy deductible, you will need to spend that amount down before your portion of the drug cost begins (prescription co-payment/co-insurance).
• Prescription Co-payment or Co-insurance: This is the fee you must pay each month for your medicine.

Contact your plan’s Member Services for specifics about your out-of-pocket costs to access PrEP.

Options for the Uninsured or Underinsured

When paying for PrEP, if…

• you do not have insurance, OR
• your private insurance does not cover PrEP, OR
• you are unable to pay your portion of the cost of PrEP

…there are options:

• For the Uninsured: Our insurance navigation team can help you seek options to enroll in an insurance plan that’s right for you.

  Have questions or need help? Call our Insurance Help Line at (202) 745-6151 to speak with one of our Public Benefits and Insurance Navigators.

• Assistance Programs: Gilead (the maker of Truvada used for PrEP) has two programs for individuals who need help paying for PrEP:

  • Uninsured: If you do not qualify for insurance or your insurance plan does not cover PrEP, you may qualify for the Gilead Patient Assistance Program. In this program, Gilead pays the cost of PrEP for a period of time.

    For this option, call our PrEP Navigator at (202) 745-6145.

  • Co-Pay Assistance: If you have a co-pay at the pharmacy when you fill your PrEP prescription, you may qualify for Gilead’s Co-Pay Card. Under this form of assistance, Gilead provides those enrolled with funds to help cover the cost of their Co-Pays. You can re-apply for this assistance every year.

    For more information about PrEP, contact us at (202) 939-7690.