It’s important to take oral PrEP consistently for it to be most effective. Taking it with food can help alleviate some of the side effects you may feel. Try taking your pill at the same time every day, such as after you brush your teeth or with your breakfast, so that it becomes a part of your daily routine. If your phone allows you to set a daily alarm, that may be helpful too! If you think you might have trouble remembering to take a daily pill, other options are available. Other options may be a better fit for you if you prefer not to take a pill every day.

You may miss a dose occasionally, but that only means you’re not as protected as you may want to be. You should use condoms in these cases. For the most protection, it's important to use PrEP consistently and on schedule. For oral PrEP, if you miss a dose, take it as soon as you remember, but don’t double up. If you’ve missed many doses, contact your provider to get tested for HIV again. For CAB PrEP, if you miss an appointment, don’t worry. Just contact your provider as soon as possible to reschedule your appointment. They can guide you on your nextstep!

Some people experience mild side effects such as nausea and headaches when they first start taking oral PrEP. Taking food with oral PrEP can help, but it can be taken without food. CAB PrEP may cause some injection site reactions. But these side effects usually go away after a few weeks. If they persist, it’s important to talk to me or your provider. We can help you manage any discomfort you might have.

PrEP can only protect you against HIV.

You should also continue using condoms while on PrEP to protect yourself and your partner against other STI as well as unintended pregnancy. PrEP does not increase your risk of STIs.

All PrEP (oral PrEP, CAB PrEP), options are still available for you if you use any contraceptives! If you ever consider getting pregnant, talk to your provider to explore the best options. Remember, PrEP does not protect against unintended pregnancy.

Oral PrEP is considered safe for use during pregnancy and breastfeeding. For CAB PrEP, there is evidence that suggest that it is safe for HIV prevention during pregrancy (https://www.nih.gov/news-events/news-releases/long-acting-injectable-cabotegravir-hiv-prevention-safe-pregnancy).

All PrEP options (oral PrEP, CAB PrEP, are available to you! Based on what we know so far, the use of gender-affirming hormones does not reduce the effectiveness of CAB PrEP, and no interactions are expected between gender-affirming hormones and the PrEP ring. However, you should talk to your provider to explore the best option for you!

Oral PrEP, CAB PrEP, can all be taken effectively and safely with alcohol or recreational drugs such as heroin and other opioids, cocaine, or meth. However, alcohol consumption, opiods, or other substances may make you forget to take the pills or miss an appointment. Importantly, only oral PrEP is protective against HIV exposure through injection.

NB: It is not advisable to take any medication while using alcohol or drugs, as this may affect its effectiveness and your overall health.

PrEP 2-1-1 can prevent HIV transmission during anal sex. PrEP medication absorbs slower into vaginal tissue than anal tissue, so PrEP 2-1-1 is not an effective option for vaginal sex. PrEP 2-1-1 can be an option for people who have less frequent anal sex or for people who are unable or prefer not to take daily PrEP.

Absolutely! There are different PrEP modalities to fit different lifestyles. Besides the oral pill, there is also the PrEP ring, which is a discreet, flexible ring that you insert in your vagina and replace once a month. There is also an injectable option, CAB PrEP. For this, you only need an injection every 2 months.

The PrEP ring is effective when used correctly, keeping it in the vagina the whole month and replacing it every month. It releases a steady dose of medication over the month, providing continuous protection against exposure through vaginal sex. It would not protect you for anal sex. The efficacy is slightly lower than with other methods, but it provides extra protection in case you don’t or can’t use a condom or it breaks. It is also very discreet and cannot be felt during sex. It is a great option if you are concerned about privacy.

Forgetting to replace the PrEP ring occasionally isn’t the end of the world. But it’s important to replace the ring as quickly as possible to make sure it continues to work well. If you forget, just replace it as soon as you remember. If you forget to replace it for a long time, talk to you provider to discuss the best way forward.

Oral PrEP is the recommended option for people who inject drugs, which is protective against both sexual and injection exposures. CAB PrEP is also an option for you for sexual exposure and may be effective for injection exposure, but there is less available evidence on injection exposure through clinical trials at this time. Other PrEP options have not been studied yet for people who inject drugs.

Great question! I’m glad you’ve heard of “2-1-1 dosing.” This is the oral PrEP dosing regimen for people assigned male at birth who are not taking gender-affirming hormones, and it’s protective against sexual exposure, but not for injection exposures. If you use injection drugs, your oral PrEP dosing regimen would be different.

This is an important question! Yes, you have the option to use either condoms or CAB PrEP for sexual exposure even if you are on OAT. Let your OAT provider know when discussing CAB PrEP. This is very important for your OAT provider to know so they can adjust your dose as needed. You should also let them know of any other medications and therapies you may be taking.