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Repair Windows errors before they cause bigger problemsFix Now →Scan for outdated or missing drivers - takes under a minuteDriver Scan →Clear out junk files and repair common Windows errorsFree Scan →Before starting HIV pre-exposure prophylaxis (PrEP), ask about the option that fits your health and routine, the tests needed to confirm you do not have HIV, and the follow-up plan. You can open with: “I’d like to talk about PrEP. Can we review which option could fit me, what tests I need, and what follow-up would involve?”
PrEP is medicine taken as pills or injections to reduce the chance of getting HIV. CDC says clinicians should prescribe it to people who ask, including sexually active adults and adolescents who do not report risk factors. You do not need to arrive with a particular identity or risk label to start the conversation. CDC clinical guidance
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Ask whether PrEP fits your circumstances
Describe recent and anticipated exposures, your preferences, and what you want prevention to do for you. Ask whether PrEP could be useful even if you do not fit a risk checklist. CDC advises prescribing PrEP to anyone who asks. If you have a partner living with HIV, you can discuss their treatment and viral-load status, but a clinician should not deny a requested prevention option solely because the partner is reportedly undetectable. CDC clinical guidance
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Compare the available options with your health and routine
Ask which currently indicated option matches your exposure route, health history, and ability to follow its schedule. The options differ in route, eligibility, testing, and follow-up; no single option is best for everyone. Verify current labeling and your individual eligibility with the prescriber.
| Option | What to discuss |
|---|---|
| Oral F/TDF | Daily pill routine; kidney-function assessment and hepatitis B screening; whether it fits your exposure route and health history. CDC and USPSTF guidance describe it as an option for sexually acquired HIV prevention. CDC; USPSTF |
| Oral F/TAF | Daily pill routine; kidney-function and hepatitis B assessment, plus baseline cholesterol and triglycerides. It is not indicated for people at risk through receptive vaginal sex. CDC; USPSTF |
| Injectable cabotegravir | Scheduled injections and visits, the plan if an appointment is missed, and how this fits your routine. It does not require kidney-function monitoring. USPSTF describes it as an option for sexually acquired HIV prevention. CDC; USPSTF |
Tell the provider if attending injection visits or obtaining regular refills could be difficult, and discuss privacy, likely adherence, and preferences alongside medical considerations.
Ask which HIV tests you need before starting
PrEP is for people without HIV, so a provider must assess your HIV status before prescribing. Ask which test is planned and whether recent exposure, symptoms, or previous PrEP or PEP changes the testing plan.
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- Recent oral PrEP or PEP use within the past three months, or cabotegravir injection within the past 12 months, can change the testing algorithm. In relevant recent-use situations, CDC guidance calls for both an antigen/antibody test and an HIV-1 RNA test.
- A recent possible exposure or symptoms that could indicate acute HIV may warrant additional evaluation. You can ask: “If the test is negative but I have symptoms or a recent exposure, do we need an RNA test or a repeat test?”
- If results are unclear or discordant, CDC says to repeat testing and not prescribe until HIV status is confirmed. Oral rapid tests can miss recent infection and should not be assumed adequate for routine PrEP initiation.
Ask about other baseline tests and health checks
Ask which tests apply to the option you are considering and what screening sites are appropriate for the kinds of sex you have.
- CDC recommends screening sexually active adults for chlamydia, gonorrhea, and syphilis before oral or injectable PrEP.
- For oral F/TDF or F/TAF, ask about kidney-function testing and hepatitis B serology.
- For F/TAF, ask about baseline cholesterol and triglycerides.
- Ask whether pregnancy testing is appropriate for you.
CDC clinical guidance; USPSTF recommendation
Explain your medical history, medicines, and pregnancy plans
Tell the provider about kidney or liver disease, hepatitis B, pregnancy or plans to become pregnant, breastfeeding, all medicines and supplements, and any recent PrEP or PEP use. Ask how these factors affect the choice and monitoring plan.
Active hepatitis B is not itself a reason to rule out oral PrEP, but stopping tenofovir-containing medication can lead to hepatitis B rebound and liver damage. Arrange clinical follow-up before stopping. CDC says there are no known conflicts between PrEP and hormone therapy or hormonal birth control. CDC clinical guidance; CDC: Preventing HIV with PrEP
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CDC describes F/TDF as generally safe during pregnancy and says PrEP can help prevent HIV during conception, pregnancy, and breastfeeding. Ask the clinician to discuss the evidence and considerations for the specific formulation rather than assuming every option has identical evidence. CDC clinical guidance; CDC: Preventing HIV with PrEP
Ask about side effects and when to call
CDC lists diarrhea, nausea, headache, fatigue, stomach pain, and injection-site pain among possible side effects; these usually go away over time. Ask which effects are expected with your option and what symptoms should prompt a call. CDC: Preventing HIV with PrEP
CDC says kidney-function decreases with tenofovir PrEP are generally small and often return toward earlier levels after stopping, although rare acute kidney failure has occurred. The USPSTF evidence review reported increased kidney adverse events in trials of oral TDF/FTC or tenofovir disoproxil fumarate alone (12 trials; 18,170 participants; relative risk 1.43, 95% CI 1.18–1.75; absolute risk difference 0.56%, 95% CI 0.09%–1.04%); kidney abnormalities generally resolved after PrEP cessation. These are findings across trial populations, not a prediction of your individual risk. CDC clinical guidance; USPSTF evidence review
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Get the testing and follow-up schedule in writing
PrEP care includes repeat HIV testing, regimen-specific monitoring, refills or injection visits, adherence support, and STI screening. Ask the clinic to write down the schedule and explain how you will get required lab work.
- Oral PrEP: CDC generally calls for HIV antigen/antibody and HIV-1 RNA testing at least every three months, with refills limited to 90 days until the next test.
- Cabotegravir injections: CDC describes a visit and testing at month one, then at least every two months beginning in month three.
- Kidney monitoring: Oral users need periodic assessment, with additional intervals for some groups; cabotegravir does not require kidney assessment.
- STI screening: Timing varies with the regimen and patient.
Ask whether telehealth can cover some visits and where required lab tests can be completed. CDC says telehealth can support screening, initiation, or follow-up while regular HIV testing continues. CDC clinical guidance; CDC: Preventing HIV with PrEP
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Ask when protection begins and what to use meanwhile
Ask the prescriber to explain timing for your exact medication and exposure route, including any additional starting steps for injections. Do not assume protection is immediate: CDC gives daily-pill timing estimates for some routes, while injection timing varies by shot. USPSTF notes that time to protection is not known overall and discusses pharmacokinetic estimates from studies. Use the clinician’s advice for your situation rather than applying one estimate to every route. CDC: Preventing HIV with PrEP; USPSTF recommendation
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PrEP prevents HIV, not other sexually transmitted infections or pregnancy. Condoms can help prevent certain other STIs and pregnancy; they are not a substitute for PrEP. CDC: Preventing HIV with PrEP
Ask what care will cost and whether assistance is available
Request an estimate that includes medication, clinic visits, laboratory tests, and injection charges. Ask the insurer and clinic to confirm coverage for your specific plan rather than relying on a general estimate. CDC says most insurance plans and state Medicaid programs cover some form of PrEP and describes medication-assistance and state programs for people without insurance; coverage and eligibility vary. CDC: Preventing HIV with PrEP
Make a plan for missed doses, missed visits, or stopping
Ask what to do if you miss a pill or injection, how to restart, what HIV testing is needed, and what to do after a recent exposure. Do not stop or restart on your own without discussing the circumstances with your clinician.
Stopping tenofovir-based oral PrEP in someone with active hepatitis B can cause viral rebound and liver damage, so arrange clinical follow-up. After cabotegravir is discontinued, drug levels decline over time; USPSTF highlights potential resistance if HIV is acquired during that period. If exposure risk continues, CDC recommends another effective prevention method. CDC clinical guidance; USPSTF recommendation
Questions to take into the appointment
- Could PrEP be useful for me based on my circumstances and preferences?
- Which option is indicated for my exposure route and health history, and what schedule would it require?
- Which HIV tests and other baseline checks do I need, given any recent exposure, symptoms, PrEP, or PEP use?
- How do my medicines, supplements, kidney or liver health, hepatitis B status, or pregnancy plans affect the choice?
- When should I expect protection, and what should I use in the meantime?
- How often will I need tests, visits, refills, or injections, and what is the plan if I miss one?
- What will the full cost be, and are assistance programs available to me?
- How should I safely stop or change PrEP if my circumstances or preferences change?
Guidance, product labeling, coverage, and assistance programs can change. Confirm current individual eligibility and local access with a licensed prescriber.
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