Guide
PrEP for HIV: what it is, how to get it and what it costs
Medical review pendingWritten by the STD Test Prices editorial team using CDC sources
PrEP (pre-exposure prophylaxis) is medicine, as pills or shots, that lowers the chance of getting HIV from sex or injection drug use. It's for people who don't have HIV. Taken as prescribed, it reduces the risk of getting HIV from sex by about 99%, CDC says. You need an HIV test before you start and regular tests after. If you pay for an HIV test yourself, the cheapest lab test we track costs $49 () at STDcheck.com.
Key points
- PrEP comes as daily pills (Truvada or its generic, and Descovy) or shots (Apretude every 2 months, Yeztugo every 6 months).
- You need an HIV blood test before starting, then at least every 3 months on pills. CDC also recommends regular syphilis, gonorrhea and chlamydia tests.
- PrEP doesn't prevent other STIs or pregnancy.
- Under the Affordable Care Act, almost all health plans must cover PrEP, its visits and its lab tests at no cost to you, CDC says. Drugmaker and state programs help people without insurance.
What is PrEP?
CDC describes PrEP as medicine for adults and adolescents without HIV who may be exposed to it through sex or injection drug use, including people trying to conceive, pregnant or breastfeeding. It works only against HIV. For syphilis, chlamydia and gonorrhea, some people add doxy-PEP, an antibiotic taken after sex.
PEP (post-exposure prophylaxis) is different. It's for emergencies, started within 72 hours after a possible exposure and taken for 28 days, CDC says. If the exposure was in the last 72 hours, ask a health care provider, urgent care center or emergency room about PEP now.
How well does PrEP work?
Taken as prescribed, PrEP pills and shots reduce the risk of getting HIV from sex by about 99%, and pills reduce the risk from injection drug use by at least 74%, CDC says. If you don't take PrEP as prescribed, there may not be enough medicine in your blood to block the virus.
Daily pills reach their highest protection after about 7 days for receptive anal sex and about 21 days for receptive vaginal sex and injection drug use, CDC says. After you stop them, protection fades over 7 to 10 days.
PrEP medications: pills and shots
CDC's clinical guidance lists three FDA-approved PrEP medicines for adults and adolescents who weigh at least 77 pounds (35 kg). A fourth, Yeztugo, is approved for the same group in its FDA label, and HIV.gov lists it with the others. A health care provider gives the shots.
| Medicine | How you take it | Approved to prevent |
|---|---|---|
| Truvada (emtricitabine/tenofovir disoproxil fumarate) or a generic | One pill a day | HIV from sex or injection drug use |
| Descovy (emtricitabine/tenofovir alafenamide) | One pill a day | HIV from sex, except for people who could get it through receptive vaginal sex |
| Apretude (cabotegravir) | Two shots a month apart, then one every 2 months | HIV from sex |
| Yeztugo (lenacapavir) | Shots and tablets to start, then shots every 6 months | HIV from sex |
CDC says Descovy hasn't been studied for people assigned female at birth who could get HIV through receptive vaginal sex. Some clinicians prescribe Truvada "on demand" to gay and bisexual men, timed around sex, on what's called the 2-1-1 schedule. CDC says that schedule isn't FDA approved and CDC doesn't recommend it.
Who should take PrEP?
CDC says you may be a good candidate if you don't have HIV and:
- in the past 6 months you've had anal or vaginal sex and have a partner with HIV, haven't used condoms consistently, or had an STI diagnosed
- you inject drugs and share equipment or have an injection partner with HIV
- you've been prescribed PEP and could still be exposed, or have taken PEP more than once
You can choose PrEP even if none of these apply. CDC tells clinicians to prescribe it to anyone who asks.
The HIV and STI tests PrEP requires
Before you start, CDC says, you must have an HIV test to confirm you don't have HIV. Its clinical guidance calls for an antigen/antibody blood test, plus an HIV RNA test in some cases, such as recent PrEP use. CDC says to avoid oral rapid tests, such as the OraQuick self-test, because they may miss a recent infection. Other starting tests include chlamydia, gonorrhea and syphilis, plus kidney function and hepatitis B before pills.
After you start:
- Daily pills. HIV antigen/antibody and RNA tests at least every 3 months. CDC says each prescription covers no more than 90 days, until the next test.
- Apretude. HIV tests 1 month after the first shot, then at least every 2 months.
- Yeztugo. Its label calls for an HIV test before each injection.
For STIs on pills, CDC recommends syphilis and gonorrhea screening for everyone at least every 6 months, and chlamydia too for gay and bisexual men. Gay and bisexual men with risk factors, such as an earlier STI or several partners, are tested every 3 months with throat, rectal and urine samples and blood.
What these tests cost
With most insurance, CDC says, you can't be charged for the lab tests that keep your prescription going. If you're between plans or want to know your status before an appointment, here's the cheapest current price on each route for an HIV test and a common 4 panel (chlamydia, gonorrhea, syphilis and HIV):
The lowest current price on each route among the providers we track. Results times are what each provider states.
| Test | Cheapest offer | Price | Results time | Order |
|---|---|---|---|---|
| HIVSee all HIV prices | Lab visitSTDcheck.comSingle testHIV-1/2 4th-generation antigen/antibody blood test. A $6 physician fee is added per order at checkout; orders at New York labs add a 35% New York compliance fee. | $49 | 1 to 2 days | Order (opens in a new tab) |
| Home kitEverlywellSingle testOraQuick oral-swab rapid antibody test, read at home in about 20 minutes; a positive result needs a follow-up test. Free shipping. | $49 | Same day | Order (opens in a new tab) | |
| Common 4See all Common 4 prices | Lab visitEverlywellIncluded in STD Screening Panel - Basic4 tests as the provider counts themSample collected at a Quest location; all fees included; results in about 1–2 days. | $119 | 1 to 2 days | Order (opens in a new tab) |
HIV
- $49
- Results time
- 1 to 2 days
- $49
- Results time
- Same day
Common 4
- $119
- Results time
- 1 to 2 days
The lowest and highest price for each test, with the date we checked:
Each provider counts once, at its lowest current price for the test, whether sold alone or in a panel that includes it. Tests that cover only part of an infection, such as an HSV-2-only herpes test, aren't counted. Each range shows the older of its two verified dates.
| Test | Price range | Providers | Lowest price at | Order |
|---|---|---|---|---|
| HIV | $49 to $99 | 8 providers | EverlywellHome kit · Single testOraQuick oral-swab rapid antibody test, read at home in about 20 minutes; a positive result needs a follow-up test. Free shipping. | Order (opens in a new tab) |
| Syphilis | $39 to $149 | 9 providers | Labcorp OnDemandHome kit · Single testFirst To Know rapid antibody self-test (finger prick), read at home in about 15 minutes; no lab or physician service. Shipping cost is shown at checkout. All sales final. | Order (opens in a new tab) |
| Chlamydia | $59 to $189 | 10 providers | STDcheck.comLab visit · Single testUrine test. A $6 physician fee is added per order at checkout; orders at New York labs add a 35% New York compliance fee. | Order (opens in a new tab) |
| Gonorrhea | $59 to $189 | 10 providers | STDcheck.comLab visit · Single testUrine test. A $6 physician fee is added per order at checkout; orders at New York labs add a 35% New York compliance fee. | Order (opens in a new tab) |
| Hepatitis B | $24 to $489 | 9 providers | STDcheck.comLab visit · Single testA $6 physician fee is added per order at checkout; orders at New York labs add a 35% New York compliance fee. | Order (opens in a new tab) |
HIV
$49 to $998 providers- Lowest price at
- EverlywellHome kit · Single testOraQuick oral-swab rapid antibody test, read at home in about 20 minutes; a positive result needs a follow-up test. Free shipping.
Syphilis
$39 to $1499 providers- Lowest price at
- Labcorp OnDemandHome kit · Single testFirst To Know rapid antibody self-test (finger prick), read at home in about 15 minutes; no lab or physician service. Shipping cost is shown at checkout. All sales final.
Chlamydia
$59 to $18910 providers- Lowest price at
- STDcheck.comLab visit · Single testUrine test. A $6 physician fee is added per order at checkout; orders at New York labs add a 35% New York compliance fee.
Gonorrhea
$59 to $18910 providers- Lowest price at
- STDcheck.comLab visit · Single testUrine test. A $6 physician fee is added per order at checkout; orders at New York labs add a 35% New York compliance fee.
Hepatitis B
$24 to $4899 providers- Lowest price at
- STDcheck.comLab visit · Single testA $6 physician fee is added per order at checkout; orders at New York labs add a 35% New York compliance fee.
Ask your prescriber whether they accept outside lab results. Our HIV test types guide explains antigen/antibody and RNA tests, our HIV test page lists every offer, and our HIV home test guide covers self-tests.
Free option: public clinics
Free and low-cost testing is available at health department clinics and Title X family planning clinics. CDC's GetTested site finds confidential, free or low-cost testing near you by ZIP code.
What to expect
- Clinics usually test for chlamydia, gonorrhea, syphilis and HIV, and often hepatitis B and C, following CDC screening advice for your age, anatomy and the kind of sex you have.
- A clinician can examine you, swab sores and often treat you in the same visit.
- Some tests sold in private panels are usually not offered without symptoms, such as herpes blood tests and HPV tests for men, because CDC doesn't recommend them as screening tests.
- Hours can be limited, and you may wait for an appointment or a walk-in slot.
- Free testing usually isn't anonymous either (some publicly funded sites offer anonymous HIV testing). Positive results for reportable infections are reported to the health department, confidentially.
How to get PrEP
CDC says any health care provider licensed to write prescriptions can prescribe PrEP. HIV.gov says pharmacists can too in Arkansas, California, Colorado, Illinois, Maine, Nevada, Oregon, Utah and Virginia. Places to ask:
- your primary care provider
- a Planned Parenthood health center or health department, where Planned Parenthood says staff can also help you apply for insurance or assistance
- a community health center, which HIV.gov says charges on a sliding scale
- a telehealth service, since CDC says clinicians can start and follow PrEP by phone or video with lab-only visits
CDC's PrEP page has a locator for PrEP providers, and our local testing pages list free and low-cost clinics.
Two telehealth examples, from their own pages: MISTR says its consultation, required labs and STI testing are free in all 50 states, DC and Puerto Rico, and it bills insurance for the medicine. Q Care Plus serves adults 18 and older in the states it lists and says its PrEP services are free for nearly all its patients.
Paying for PrEP: insurance and free PrEP
HealthCare.gov lists PrEP among the preventive services that Marketplace plans and many other plans must cover with no copay or coinsurance at an in-network provider, even before you meet your deductible. Your plan may require prior authorization, CDC says. HIV.gov says Medicare covers PrEP under Part B with no cost-sharing.
Without insurance, or with a copay you can't afford:
- Gilead Advancing Access says uninsured people who qualify may get their prescribed Gilead PrEP medicine free, and it runs a co-pay program for people with commercial insurance.
- CDC says ViiVConnect has a medication assistance program for Apretude shots.
- Some states run PrEP assistance programs, listed in NASTAD's directory. CDC says some cover the medicine, some cover visits and lab tests, and some cover both.
PrEP side effects
CDC says PrEP is safe. Some people get diarrhea, nausea, headache, tiredness or stomach pain, or pain where a shot was given, and these usually go away. Talk to your provider about any side effect that is severe or doesn't go away.
Injection site reactions are common with Apretude and usually mild or moderate, CDC says, and Yeztugo's label lists injection site reactions, headache and nausea as its most common side effects. With pills, tenofovir can lower kidney function slightly, so your provider checks your kidneys. CDC says there are no known interactions with hormonal birth control or hormone therapy. Before you stop PrEP, CDC suggests talking to your provider about how to stop safely.
Frequently asked questions
- What is PrEP?
- PrEP, short for pre-exposure prophylaxis, is medicine that lowers the chance of getting HIV from sex or injection drug use. It's for people who don't have HIV, and it comes as a daily pill or as a shot every 2 or 6 months. CDC says that, taken as prescribed, it reduces the risk of getting HIV from sex by about 99%.
- How do I get PrEP?
- Ask any health care provider who can write prescriptions; CDC says you don't need an HIV specialist. Sexual health clinics, Planned Parenthood health centers, health departments and community health centers offer it, as do telehealth services. In some states a pharmacist can prescribe it. You'll need an HIV test before you start.
- Can I get PrEP for free?
- Often, yes. CDC says that under the Affordable Care Act almost all health plans must cover PrEP, the visits and the lab tests with no out-of-pocket cost. Without insurance, Gilead says eligible people may get its PrEP medicines free through its Medication Assistance Program, and some states run PrEP assistance programs.
- What is the difference between Descovy and Truvada for PrEP?
- Both are daily pills that combine emtricitabine with a form of tenofovir. CDC says Truvada, or its generic, is approved for everyone at risk through sex or injection drug use. Descovy is approved for sex, except for people who could get HIV through receptive vaginal sex, because it hasn't been studied for them. Descovy users also get cholesterol checks.
- What are the side effects of PrEP?
- CDC says PrEP is safe. Some people get diarrhea, nausea, headache, tiredness or stomach pain, or pain where a shot was given, and these usually go away over time. Pills can slightly lower kidney function, so your provider checks it. Tell your provider about any side effect that is severe or doesn't go away.
- How often do you need an HIV test on PrEP?
- Before you start, then at least every 3 months on daily pills, CDC says. On Apretude shots you're tested 1 month after the first shot and then at least every 2 months, and Yeztugo's label calls for a test before each shot. CDC also recommends regular syphilis, gonorrhea and chlamydia tests while you take PrEP.