Before starting HIV pre-exposure prophylaxis (PrEP), ask your provider which option fits your health and routine, what tests you need, and how follow-up will work. PrEP is medicine taken as pills or injections to reduce the chance of getting HIV. You do not need to fit a particular risk profile to ask about it: CDC guidance says to prescribe PrEP to anyone who asks, including sexually active adults and adolescents who do not report risk factors.
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?”
Is PrEP appropriate for me?
Ask whether your recent or anticipated HIV exposures, preferences, and health goals make PrEP useful. The conversation should not assume your identity or require you to disclose more than is needed for care. CDC encourages clinicians to prescribe PrEP to people who ask, even when they do not report risk factors. A partner’s reported undetectable viral load may be relevant context, but should not by itself prevent you from discussing a requested prevention option.
The USPSTF’s patient discussion guide is intended to support a conversation with a clinician; it is not a risk assessment tool or decision aid.
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Which PrEP option could fit my health, exposure route, and routine?
Ask the provider to compare options against your circumstances rather than naming a universally best choice. In the United States, the options discussed in CDC and USPSTF guidance include daily oral medicines and injectable cabotegravir. Their indications and monitoring differ; confirm current eligibility and product labeling with the prescriber.
- Route and indication: Ask which option is indicated for your exposure route. Oral F/TAF is not indicated for people at risk through receptive vaginal sex.
- Routine: Compare taking a daily pill with keeping scheduled injection appointments. Ask what to do if you miss a pill, refill, or injection visit.
- Health checks: Oral tenofovir-containing PrEP requires kidney assessment and hepatitis B screening. Cabotegravir does not require kidney monitoring.
- Practical fit: Discuss privacy, likely adherence, access to refills or injection visits, side effects, and cost.
The CDC clinical guidance and USPSTF recommendation describe the options and their different eligibility and monitoring considerations.
What HIV tests do I need before starting?
PrEP is for people who do not have HIV, so ask which test the provider will use to confirm your status and whether your recent history changes the testing plan. Recent oral PrEP or post-exposure prophylaxis (PEP) use within three months, or cabotegravir injection within 12 months, can affect the testing algorithm. In relevant recent-use situations, CDC guidance calls for both an antigen/antibody test and an HIV-1 RNA test.
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Tell the clinician about a possible recent exposure or symptoms that could reflect acute HIV, such as a flu-like illness. 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 discordant or unclear, CDC advises repeating testing and not prescribing until HIV status is confirmed. Oral rapid tests can miss recent infection and should not be treated as sufficient for routine PrEP initiation.
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What other baseline tests or checks apply to my option?
Ask which tests are appropriate for your health and the kind of sex you have. CDC recommends screening sexually active adults for chlamydia, gonorrhea, and syphilis before oral or injectable PrEP; the sites tested should reflect exposure.
- Oral F/TDF or F/TAF: Ask about kidney-function testing and hepatitis B serology.
- Oral F/TAF: Ask about baseline cholesterol and triglycerides.
- Pregnancy: Ask whether a pregnancy test is appropriate to your situation.
How could my medical history, pregnancy plans, or other medicines affect PrEP?
Share any kidney or liver disease, hepatitis B, pregnancy or plans to become pregnant, breastfeeding, recent PrEP or PEP use, and all medicines and supplements. Ask the clinician to review interactions and which formulation’s evidence applies to you.
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CDC says active hepatitis B is not itself a reason to rule out oral PrEP, but stopping tenofovir-containing medicine can allow hepatitis B to rebound and may damage the liver. If you have hepatitis B, do not stop without arranging clinical follow-up. CDC describes F/TDF as generally safe during pregnancy and says PrEP can help prevent HIV during conception, pregnancy, and breastfeeding; ask how that applies to your circumstances and option. CDC also reports no known conflicts with hormone therapy or hormonal birth control.
What side effects should I expect, and when should I call?
Ask which effects are expected with the option you are considering and which should prompt a call. CDC lists diarrhea, nausea, headache, fatigue, stomach pain, and injection-site pain among possible effects; these usually go away over time.
For tenofovir-based oral PrEP, CDC says kidney-function decreases are generally small and often return toward earlier levels after stopping, although rare acute kidney failure has occurred. The USPSTF evidence review found an increased risk of 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%). The review says kidney abnormalities generally resolved after PrEP cessation; these group-level results are not an individual prediction.
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How often will I need tests, visits, and refills or injections?
Ask for your schedule in writing. Under CDC guidance, people taking oral PrEP generally need HIV antigen/antibody and HIV-1 RNA testing at least every three months, with refills limited to 90 days until the next test. For injectable cabotegravir, CDC describes a visit and testing at month one, then at least every two months beginning in month three.
Kidney monitoring depends on the regimen and patient: oral PrEP users need periodic assessment, with additional intervals specified for some groups; cabotegravir does not require kidney assessment. STI-screening intervals also vary by regimen and patient. Ask whether some visits can be done by telehealth and where required lab work can be completed; CDC says telehealth can support screening, initiation, or follow-up while regular HIV testing continues.
When will PrEP protect me, and what should I use in the meantime?
Ask the prescriber when protection is expected for the specific medicine and exposure route, and whether injections involve extra starting steps. Do not assume protection is immediate or apply one timing estimate to every route: USPSTF notes that the time from starting PrEP to protection is unknown overall, while estimates from studies vary. CDC’s patient information gives timing estimates for some daily-pill routes but says injection timing varies by shot. If you may be exposed before the option is expected to protect you, ask about an interim prevention plan.
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What will PrEP cost, and can I get help paying?
Ask about the total expected cost of medication, clinic visits, lab tests, and injections, along with insurance coverage and assistance programs. 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, so ask the clinic or insurer to confirm your own costs. The CDC PrEP information page outlines access and assistance resources.
What if I miss doses or decide to stop?
Before starting, ask how to handle missed doses, restart safely, and get evaluated after a recent possible exposure. Do not stop tenofovir-based oral PrEP without medical advice if you have active hepatitis B, because viral rebound can damage the liver.
If you discontinue cabotegravir, ask how to maintain prevention if exposure risk continues. Drug levels decline over time after the last injection; the USPSTF highlights potential resistance if HIV is acquired during this period, and CDC recommends another effective prevention method when risk continues. Ask the provider what testing and follow-up are needed during the transition.
How should I weigh the options?
There is no single best option for everyone. Consider the route and schedule alongside your exposure route, kidney and hepatitis B considerations, ability to attend injection visits or obtain refills, side effects, cost, and personal preference. In the USPSTF evidence review, injectable cabotegravir was associated with lower HIV acquisition risk than oral TDF/FTC at median follow-up of 1.4 years (0.6% versus 1.7%; relative risk 0.33, 95% CI 0.18–0.62). This is a result for the studied populations, not a prediction of your individual risk.
PrEP prevents HIV; it does not prevent other sexually transmitted infections or pregnancy. Condoms can help prevent certain STIs and pregnancy, but they are not a substitute for PrEP. For current U.S. clinical recommendations, see the CDC clinical guidance for PrEP and the USPSTF recommendation, accessed October 4, 2026; ask your clinician to check current local guidance and product labeling.
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