PrEP in NYC: HIV Prevention (FAQs)
PrEP (Pre-Exposure Prophylaxis) is one of the most effective tools we have to prevent HIV. It is safe, evidence-based, and widely used. Many patients are curious about PrEP but are unsure whether they qualify, what testing is required, or what the process looks like.
Below are answers to the most common questions we receive about PrEP at Atrium Medical Primary Care in Midtown Manhattan.
What is PrEP?
PrEP stands for Pre-Exposure Prophylaxis. It is a medication that HIV-negative people can take to significantly reduce their risk of acquiring HIV.
PrEP is taken before exposure and is intended to prevent infection from occurring.
How effective is PrEP?
PrEP is extremely effective when taken as prescribed.
When taken consistently, PrEP reduces the risk of HIV from sex by around 99%
It also reduces risk for people exposed through injection drug use
The most important factor in PrEP effectiveness is adherence (taking it consistently).
Who should consider PrEP?
PrEP may be appropriate for adults who are HIV-negative and have ongoing or potential exposure risk. Common examples include:
Sex without condoms with partners of unknown HIV status
Multiple sexual partners
A recent sexually transmitted infection (STI)
A partner living with HIV (especially if viral suppression is unknown)
Situations where partner status and risk are uncertain
If you are unsure whether you qualify, that is common. A short visit can help assess your risk and discuss whether PrEP makes sense for you.
What is the difference between PrEP and PEP?
This is a very common question.
PrEP is taken before exposure, as ongoing prevention
PEP (Post-Exposure Prophylaxis) is taken after a possible exposure, ideally within 72 hours, and continued for 28 days
If you believe you had a recent high-risk exposure, do not wait. Contact a clinician immediately.
What medications are used for PrEP?
The most commonly used oral PrEP medications include:
Truvada (emtricitabine + tenofovir disoproxil fumarate)
Descovy (emtricitabine + tenofovir alafenamide)
Your clinician will help choose the best option based on your exposure type, kidney function, and overall medical profile.
What is the difference between Truvada and Descovy?
Both are effective PrEP medications, but they differ in meaningful ways.
The main difference is the type of tenofovir:
Truvada contains TDF
Descovy contains TAF
This difference affects where the medication concentrates in the body and influences the safety profile.
In general:
Descovy tends to have more favorable kidney and bone laboratory markers compared with Truvada in comparative studies
Truvada has a longer track record and broader use, and may have slightly more favorable lipid effects in some patients
Important note:
Descovy is not indicated for PrEP for people at risk through receptive vaginal sex, because effectiveness has not been established for that exposure type
The best choice is individualized, and we review the pros/cons in the context of your health history and risk.
What tests do I need before starting PrEP?
Before starting PrEP, we confirm that you are HIV-negative and that the medication is safe for you.
Typical baseline testing includes:
HIV test
Kidney function test (creatinine/eGFR)
Hepatitis B testing
STI screening (often gonorrhea, chlamydia, syphilis)
Sometimes: hepatitis C screening or additional tests depending on history
How often do I need follow-ups while on PrEP?
Most patients should follow up every 3 months while taking PrEP.
These follow-ups typically include:
repeat HIV testing
STI screening as appropriate
prescription refills
periodic kidney function testing
Regular follow-up is part of using PrEP safely and effectively.
Does PrEP protect against other STIs?
No. PrEP prevents HIV, but it does not protect against other sexually transmitted infections such as:
gonorrhea
chlamydia
syphilis
herpes
HPV
Depending on your situation, condoms and routine STI screening remain important.
How quickly does PrEP start working?
PrEP does not provide instant protection.
Protection depends on the type of exposure and how consistently the medication is taken. Your clinician will advise you on when PrEP becomes protective for your specific situation.
What if I miss a dose?
Missing a dose occasionally happens. What matters most is the overall pattern.
If missed doses become frequent, protective benefit can decrease. If adherence is difficult, discuss it with your clinician so we can adjust strategy or consider alternatives.
What are the side effects of PrEP?
Most people tolerate PrEP well.
Possible side effects can include:
mild nausea or stomach upset
headache
fatigue
temporary changes in appetite
Rarely, PrEP can affect kidney function, which is why we monitor labs. If you have side effects, we can often troubleshoot without stopping treatment.
Can I take PrEP if I have kidney issues?
PrEP options depend on kidney function.
Some patients with reduced kidney function can still take PrEP, but the medication choice and monitoring plan may differ. This is one reason baseline kidney testing and follow-up labs are required.
Is PrEP confidential?
PrEP care is treated like any other medical care. We prioritize privacy and confidentiality.
If you have concerns about:
insurance billing
explanation of benefits (EOBs)
confidentiality
please bring this up at your visit. These are common and important questions.
Can I start PrEP and do STI testing at the same visit?
Yes. Many patients combine PrEP evaluation with routine STI screening, and this is often the best approach.
How do I prepare for a PrEP appointment?
To make your visit efficient, please bring:
a list of current medications (including supplements)
any relevant medical history
your insurance card (if using insurance)
Fasting is generally not required unless instructed otherwise.
How do I start PrEP at Atrium Medical Primary Care?
To schedule a PrEP appointment:
Phone: Call our office
Online: Book through our Appointments Page and choose the appropriate sexual health / PrEP visit type
We aim to make PrEP care straightforward: evidence-based counseling, appropriate testing, and discreet follow-up.
