Oral PrEP in New York

HIV PrEP evaluation and prevention care

PrEP is medication for people without HIV who want to reduce their chance of acquiring it. A prevention visit helps choose a product that fits exposure, kidney health, other medicines and daily life. Options include daily oral emtricitabine/tenofovir and long-acting injections. The products have different eligibility and follow-up requirements. PrEP does not replace testing for other STIs, condoms when useful, or pregnancy prevention.

How HIV PrEP evaluation and prevention care works

PrEP medicines act before infection becomes established. They work only when enough drug is present for the relevant exposure. Starting, stopping, missed doses and switching therefore need an agreed plan. Recent HIV exposure calls for a PEP assessment, because PrEP is not the emergency treatment course used after an exposure.

Eligibility: HIV PrEP evaluation and prevention care

PrEP can be discussed with anyone who requests it, without having to disclose a particular identity or partner history. For oral PrEP, the indicated adult/adolescent weight threshold is 35 kg. Daily F/TDF, including generic Truvada, is used for sexual or injection-related risk in CDC guidance. Descovy, F/TAF, is for sexual risk excluding receptive vaginal sex; that limitation concerns the exposure, not simply someone’s gender identity. Injectable Apretude and Yeztugo are approved for sexual HIV prevention. Each requires confirmed HIV-negative status.

What to expect: HIV PrEP evaluation and prevention care

Review exposure and current protection

Discuss sexual and injection exposures, prior PrEP/PEP, recent missed doses and symptoms. If a potential HIV exposure was within 72 hours, get urgent PEP advice before a routine prevention appointment.

Select tests and a suitable product

Oral PrEP requires kidney assessment and hepatitis B screening. CDC uses estimated creatinine clearance above 60 mL/min for F/TDF initiation and at least 30 mL/min for F/TAF. Descovy also involves lipid and weight monitoring. Injectables have their own HIV testing and interaction checks.

Write the start or switch plan

Agree on the first dose, when protection is expected for your exposure and what to use during a transition. An optional Apretude oral lead-in differs from Yeztugo’s required initiation tablets. Do not transfer one product’s schedule to another.

Arrange follow-up and access

Oral prescriptions are connected to HIV testing at least every three months. Injection follow-up uses the relevant product calendar. Build in STI screening, refills, symptom contact and a backup plan for travel or coverage problems.

Preparing for your appointment

Bring medication and supplement lists, kidney and hepatitis B records, recent HIV tests and dates of prior prevention doses. Ask how results will be reviewed, how long a refill lasts and where injections are administered. Testing may still be needed even if you recently tested elsewhere, because the date, assay and intervening exposures matter. A negative home oral-fluid test alone may be inadequate when recent infection is a concern.

Risks and when to seek help

Both oral formulations carry warnings about resistance during undetected HIV and hepatitis B worsening after stopping in someone with HBV. Hepatitis B does not automatically rule out oral PrEP, but stopping requires coordinated monitoring or treatment. F/TDF can affect kidney function and bone health. Report new symptoms or intolerance rather than abandoning protection without a plan. Your clinician reviews pregnancy and breastfeeding separately for the chosen product.

Follow-up and treatment review

Follow-up assesses HIV status, adherence, exposure, side effects and ongoing preferences. Kidney testing occurs at intervals based on age, baseline function and other risks, with at least annual monitoring for oral PrEP. A missed dose does not have one universal answer across pills and injections. Contact the team if exposure occurred during an interruption, and do not wait for a later HIV test when PEP may still be timely.

Appointments, costs and coverage

Compare total care costs: medication, visits, labs and injection administration. Ask about the exact plan and formulation, authorization, pharmacy and assistance eligibility. Some assistance pays for medication but not all visit or testing costs. Confirm the exact plan terms, medication supply and administration charges with the service. Request a product-specific access assessment and keep the current prevention plan while it is arranged.

Medical sources

• CDC clinical guidance for PrEP
• Descovy US prescribing information
• Truvada US prescribing information
• Yeztugo US prescribing information
• CDC injectable lenacapavir PrEP recommendation
• Apretude US prescribing and patient information
• CDC PEP clinical guidance
• CDC HIV testing
• Gilead investigational once-yearly lenacapavir status
• Gilead weekly oral lenacapavir application status
• Cabenuva US prescribing and patient information