PrEP, or pre-exposure prophylaxis, is a form of HIV prevention for people who do not have HIV but may have a higher chance of exposure.
PrEP uses antiretroviral medicine to reduce the likelihood of HIV infection when taken or administered according to an appropriate prevention schedule. It is part of a broader approach to HIV prevention that can also include condoms, HIV testing, and other prevention methods.
What PrEP Means
The term “pre-exposure” means that PrEP is used before a possible exposure to HIV. “Prophylaxis” refers to measures intended to prevent an infection. PrEP is therefore different from PEP, which is used after a possible exposure and needs to be started promptly.
PrEP can be provided in different forms depending on the country, regulatory approval, and individual circumstances. Oral PrEP involves taking preventive medicine on a prescribed schedule, while long-acting injectable PrEP involves medication administered at intervals determined by the specific product and health guidance.
How PrEP Fits Into HIV Prevention
PrEP does not treat an existing HIV infection. HIV testing is important before starting PrEP and during ongoing prevention because the appropriate approach can differ when a person already has HIV. Long-acting PrEP also requires appropriate HIV testing before and during its use.
PrEP is focused specifically on HIV. It does not prevent every sexually transmitted infection or pregnancy. Other prevention methods may therefore have a separate role depending on a person's circumstances.
Why PrEP Matters Today
HIV prevention involves more than one method because people's circumstances, preferences, and patterns of potential exposure differ. Some people may find a daily tablet practical, while others may prefer a longer-acting approach that reduces the need to remember medication as frequently.
Who May Consider PrEP
PrEP may be relevant to adults and adolescents without HIV who may be exposed through sex or injection drug use. It may also be considered in circumstances involving pregnancy, trying to conceive, or breastfeeding, although individual decisions require appropriate medical assessment.
Potential reasons a person may discuss PrEP with a healthcare professional include:
- Having a sexual partner whose HIV status is unknown or whose HIV is not controlled.
- Having sexual exposure that may increase the possibility of HIV transmission.
- Sharing injection equipment that may be contaminated with HIV.
- Experiencing changes in relationships or circumstances that alter HIV exposure.
- Wanting an additional HIV prevention method as part of a broader prevention plan.
These situations do not automatically mean that PrEP is required. HIV exposure varies between individuals, so eligibility, testing, and the appropriate prevention method should be assessed using current medical guidance.
Understanding the Practical Challenges
One challenge with HIV prevention is maintaining an approach that fits everyday life. Remembering regular medication, attending appointments, arranging testing, and discussing sexual health can sometimes create practical or social barriers.
Long-acting approaches have expanded the range of PrEP choices. WHO has noted that having additional options may help people select an approach that fits their circumstances and preferences.
PrEP can also be part of conversations about stigma. Because HIV prevention can involve private health decisions, some people may have concerns about confidentiality, judgment, or how others perceive their medication. Clear health information can help distinguish HIV prevention from assumptions about a person's health status or behavior.
Recent Developments in PrEP
PrEP has continued to evolve, particularly through the development of longer-acting prevention methods and changes in international guidance.
Growth of Long-Acting Prevention
A major development in recent years has been the expansion of long-acting injectable PrEP. WHO has recommended long-acting injectable cabotegravir as an HIV prevention option, and its guidance has subsequently expanded to include injectable lenacapavir as an additional PrEP choice.
The newer approach involving lenacapavir is administered twice a year. WHO's guidance also addresses HIV testing strategies for people starting or continuing long-acting injectable PrEP.
Changes in Prevention Choices
Recent research has increased attention on prevention options that reduce the need for frequent dosing. Research reported during the period from 2024 onward helped establish evidence for twice-yearly injectable lenacapavir in HIV prevention, including research involving women.
WHO's current approach emphasizes choice within combination HIV prevention. Oral PrEP, long-acting injectable options, and other prevention approaches may have different practical considerations, and availability can vary by country.
PrEP and HIV Testing
HIV testing remains an important part of PrEP use. This is particularly important with long-acting injectable approaches because identifying HIV infection correctly helps determine the appropriate medical pathway.
WHO has also highlighted the use of rapid diagnostic tests in connection with initiating or continuing long-acting injectable PrEP.
| PrEP consideration | General purpose |
|---|---|
| HIV testing | Helps establish HIV status before and during prevention |
| Oral PrEP | Provides HIV prevention through a prescribed oral schedule |
| Long-acting injectable PrEP | Provides prevention through longer-acting medication |
| STI screening | Helps identify infections that PrEP does not prevent |
| Follow-up care | Supports ongoing assessment and prevention planning |
Tools and Resources for PrEP Information
Reliable educational resources can make PrEP easier to understand. Official public-health websites, HIV prevention guides, testing information, and clinical discussion tools can help explain eligibility, testing, prevention choices, and follow-up requirements.
HIV Prevention Guides
The CDC provides educational material covering PrEP, who may use it, how it reduces HIV risk, safety considerations, and ongoing testing. Its PrEP resources were updated during the current period, making them useful for checking general prevention information.
WHO also maintains PrEP implementation guidance covering oral and long-acting prevention approaches. Its more recent guidance includes information about long-acting injectable lenacapavir and HIV testing.
Questions to Discuss With a Healthcare Professional
Before beginning or changing PrEP, useful questions can include:
- Which PrEP options are appropriate for my circumstances?
- What HIV testing is needed before starting?
- How often should testing and follow-up take place?
- Which schedule applies to the selected PrEP option?
- Does the selected option interact with any medicines or health conditions?
- What should happen if a dose or appointment is missed?
These questions can help make conversations about HIV prevention more specific and easier to understand.
Frequently Asked Questions About PrEP
What is PrEP and how does it help prevent HIV?
PrEP is pre-exposure prophylaxis, a preventive approach for people without HIV who may experience HIV exposure. When used according to the appropriate medical schedule, it reduces the chance of acquiring HIV.
Is PrEP suitable for everyone?
PrEP is intended for people who do not have HIV and may have a meaningful possibility of HIV exposure. The appropriate option depends on factors such as exposure, health history, testing, and the prevention methods available in a particular country.
What are the current PrEP options?
PrEP options can include oral medication and long-acting injectable approaches. WHO has expanded its guidance to include twice-yearly injectable lenacapavir as an additional HIV prevention choice, alongside other established PrEP approaches.
Does PrEP prevent other sexually transmitted infections?
No. PrEP is specifically intended to prevent HIV. It does not protect against other sexually transmitted infections or pregnancy, so other appropriate prevention measures may still be relevant.
What is the difference between PrEP and PEP?
PrEP is used before potential HIV exposure, while PEP is used after a possible exposure. WHO states that PEP should be started as soon as possible after exposure and no later than 72 hours in the circumstances covered by its guidance.
Conclusion
PrEP is an important part of modern HIV prevention for people who may experience HIV exposure. It can involve oral or long-acting approaches, with recent developments expanding the range of prevention choices. HIV testing and appropriate follow-up remain important parts of PrEP use. Understanding how PrEP differs from PEP and from other prevention methods can provide a clearer picture of HIV prevention.