PrEP with PlushCare - Frequently Asked Questions
Most Common PrEP Questions
Can PlushCare prescribe PrEP?
Yes. All PlushCare doctors can prescribe you PrEP (pre-exposure prophylaxis). If you think you might want to take PrEP, book an appointment with one of our doctors today. They can answer all of your questions about PrEP and advise on a treatment plan that is best for you.
Who can take PrEP?
PrEP is for people who are HIV negative, are over 18 years of age, and meet one or more of the following criteria:
- Don’t use condoms every time
- Have sex with multiple partners
- Have had STDs before, once or multiple times
- Have a partner who is HIV positive or is of unknown status
- Inject recreational drugs
- Are trying to get pregnant with an HIV positive partner.
PrEP isn’t for everyone, but for those at risk it is a safe and effective way to prevent HIV. Don’t take PrEP unless you were prescribed it by a physician. Speak with our doctors today if you have questions.
Who shouldn’t take PrEP?
PrEP is not for people who are HIV positive or have recent symptoms of a new HIV infection. If you think you have symptoms of HIV, or are unsure, book an appointment with one of our doctors, or see another doctor, to get treatment immediately. PrEP is more risky or not recommended for people who have severe kidney disease, osteoporosis, chronic hepatitis B, or pregnant women. Talk to one of our doctors about getting on PrEP or finding another treatment plan that is appropriate for you.
My regular doctor won’t prescribe PrEP, what should I do?
PrEP is relatively new, and not everyone knows about it (both patients AND doctors). We are here to help. You can get PrEP from PlushCare because all of our doctors are trained on prescribing and monitoring PrEP, so that everyone who needs it can get it.
How well does PrEP work?
PrEP, when taken every day, is 99% effective in preventing HIV. You can learn about the Centers for Disease Control (CDC) review of the clinical trials and studies that enabled FDA approval of PrEP.
Why should I take a pill every day to prevent HIV?
For someone who is at risk for getting HIV, taking a pill a day is a small price to pay for preventing HIV. Just like women preventing pregnancy by taking a birth control pill, you can prevent HIV by taking PrEP every day.
Does PrEP prevent other STDs?
PrEP does NOT prevent other STDs. Wearing condoms every time is the most effective way of preventing most STDs.
Besides the pill, what else do I have to do to get PrEP? Taking the pill daily, getting tested for HIV and other blood work once every 3 months, and seeing a doctor regularly are all necessary parts of PrEP.
Does PrEP work if I think I was just exposed to HIV?
PrEP is preventative. It is NOT for taking after you are exposed to HIV. Rather, PrEP is taken daily in order to prevent HIV before you are exposed. Another medicine regimen, called PEP (post-exposure prophylaxis), can be prescribed and works if you take it within 72 hours of an exposure, so act fast. Get an appointment with one of our doctors to get PEP, or get to an ER immediately if you have been exposed and ask about PEP.
Can PlushCare prescribe PEP (post exposure prophylaxis)?
Yes! If you were exposed to HIV, our doctors can prescribe PEP. Our doctors can order HIV testing, prescribe PEP, and order a repeat test to make sure you stay negative.
How old must I be to enroll in PlushCare's PrEP treatment program?
You must be over 18 to sign up for PlushCare. However, we have pediatricians on staff for children and teenagers, and they may see a doctor about PrEP under their parents' accounts. You can get PrEP paid for by your insurance whether you are the primary subscriber or if you are on your parent's/guardian's or spouse's insurance plan.
What lab tests are needed to be on PrEP?
In order to get and stay on PrEP, lab tests are needed very 90 days to ensure patients are HIV-negative, STD-free, and maintain normal metabolic panel results. The following labs are needed:
- HIV 1 (RNA test)
- HSV 1 / 2
- Chlamydia & Gonorrhoea
- Hep B (immunity & vaccine)
- Hep C (RNA test)
- Basic Metabolic Panel
Paying for PrEP (with or without insurance)
I have private health insurance. Will my health insurance plan cover PrEP?
If you have health insurance, they will almost certainly cover PrEP. They may require some paperwork before you can get the medicine, but that is something we take care of for you. You will pay your normal drug co-pay for PrEP. Email us at [email protected] if you have any questions about insurance coverage. Visit our blog for more information about insurance coverage and copay assistance.
I have government-funded insurance (e.g. Medicaid, Medicare). Will my health insurance plan cover PrEP?
Yes, these plans cover PrEP! However, there is not a one-size-fits-all answer to how this precisely works. All plans should cover the medicaiton cost, but some may not cover the initial doctor's visit. Please contact us at [email protected] to inquire about your plan and how it works with PlushCare.
Additionally, copay or deductible assistance is available through private non-profit organizations for individuals with government-funded insurance. Read more on our blog about paying for PrEP with or without insurance.
I have a high deductible plan or my co-pay is too high, what can I do?
The drug maker of Truvada, Gilead, has set up a co-pay assistance program to help cover the cost. You can find out more info here. If you live in San Francisco, Healthy San Francisco covers PrEP costs if you meet the coverage criteria. Learn more here. Email us at [email protected] if you have any questions about insurance coverage.
I don’t have private health insurance and PrEP is too expensive. Can I get Truvada for PrEP for free or discounted?
The drug maker of Truvada, Gilead, has set up an assistance program for the uninsured to help cover the cost if you meet the income criteria. You can find out more info here. There are many places to get low cost PrEP and many government and nonprofit organizations provide assistance. However, this greatly varies by the city and state you reside in. You can find more information on how to find organizations here. If you live in San Francisco, Healthy San Francisco covers PrEP costs if you meet the coverage criteria. Learn more here
About Truvada - The PrEP Medicine
What medicine is PrEP?
Truvada is the only PrEP medicine that is FDA approved for adults. It is one pill (two drugs in one: emtricitabine and tenofovir) that you take every day. You may have heard about other forms of PrEP (e.g. shot, other pills), but all of these have years of clinical trials before FDA approval for the public.
Do I take PrEP forever?
PrEP only needs to be taken while you are at high risk of HIV. As your life and sexual habits change, you may or may not need to continue PrEP - this is a question you and your doctor should discuss regularly. With PlushCare, you can book an appointment to speak with a doctor from anywhere at your convenience as your needs change.
How quickly does PrEP work?
PrEP takes about 7 days before it is fully effective in rectal tissue, which is the most common need. For the first week you are on PrEP, you should continue to use condoms every time you have sex in order to prevent HIV. If you are concerned about other STDs (e.g. gonorrhea, chlamydia, herpes, etc.), condom use is encouraged as PrEP is only effective for preventing HIV. It may take longer for PrEP to be effective in vaginal tissue, oral tissue, or for injection drug users, so it is best to talk with your doctor about your specific needs.
What happens if I miss a dose?
PrEP is most effective when taken every single day. When taken less than 4 days per week, the effectiveness drops dramatically. If you miss a dose, make sure to take the next one - there is no need to double up. If you take 7 PrEP pills per week, the level of protection is about 99%. If you take 4 PrEP pills per week, the level of protection is about 96%.
What are the side effects of Truvada?
Nausea, vomiting, fatigue, and dizziness, are usually minor symptoms that get better after about a month. Changes in your kidney function are possible, and this is why you need blood tests every 3 months to catch anything as early as possible. Some people have bone demineralization when taking Truvada. The effect was minor and went away after stopping, but it is important to be aware of.
Can I still get HIV while on PrEP?
Yes, it is possible to get HIV while on PrEP - if you miss a dose or are frequently exposed to the virus, there is a chance the drug may not work. You get tested for HIV every 3 months while on the medicine, and it is important to know early and talk to a doctor immediately after you find out.
Is PrEP safe with other prescriptions drugs?
For the most part, yes, but this is important to bring up with your PlushCare doctor - always let them know what drugs you are taking!
Is it safe to drink alcohol or use other recreational drugs while on Truvada for PrEP?
Yes - there are no known interactions with recreational drugs and Truvada.
Read more from our PrEP and HIV Prevention Series: