Compare injectable HIV PrEP options

Possible HIV exposure is time-sensitive. Seek PEP assessment as soon as possible, ideally within 24 hours and no later than 72 hours after a qualifying exposure. PEP is a 28-day course of antiretroviral medication used after exposure; it is different from ongoing PrEP. Do not wait for symptoms, a partner’s results, insurance approval or a routine appointment. If a clinic cannot assess you promptly, go to an emergency department or another service able to start PEP.

Tell the service the exact date and time, what happened, any prior PrEP doses and what is known about the source. If sexual assault occurred, urgent care can also address injuries, pregnancy prevention, other infections and support; PEP decisions should not wait for reporting or paperwork.

A baseline HIV test and renal, hepatic, hepatitis, STI or pregnancy testing may be needed. When PEP is indicated, the first dose should not be delayed waiting for laboratory results that are unavailable immediately.

Confirm where the medication will be dispensed, how the full 28-day supply will be obtained and whom to call for side effects or a missed dose. The regimen is selected for age, pregnancy, organ function and interactions.

CDC recommends early contact around 24 hours to check access and tolerance, with clinical/laboratory follow-up at 4–6 and 12 weeks after exposure. Your clinician specifies the HIV antigen/antibody and nucleic-acid tests and any timing adjustments.

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.

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.

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.

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.

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.

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.

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.

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.

CDC describes maximum protective drug levels after about seven days of daily oral PrEP for receptive anal sex and up to about 21 days for receptive vaginal sex and injection-drug exposure. Data are insufficient to assign the same onset for insertive sex. These are not an individual guarantee. Injections have their own initiation requirements and no universal immediate-protection promise; agree on additional prevention during a start or switch.

Lenacapavir blocks HIV capsid function, disrupting several steps the virus needs to replicate. It is a prescription antiviral, not an HIV vaccine. Approved products have different purposes. Yeztugo is PrEP for HIV-negative adults and adolescents weighing at least 35 kg at risk through sex. Sunlenca injections with other antiretrovirals treat heavily treatment-experienced adults with multidrug-resistant HIV whose current regimen is failing. The current Sunlenca label also permits its tablets for the two-day oral loading phase when adults start Bixlenvo, a separate complete daily HIV treatment regimen. That switch requires suppression on a stable regimen and no known or suspected resistance to Bixlenvo’s components. These treatment uses do not turn Sunlenca into PrEP or replace Yeztugo’s instructions.

Start with a clinician who can establish whether you need HIV prevention or treatment and identify the exact product. Yeztugo requires HIV-negative testing and a PrEP plan. Sunlenca treatment and Bixlenvo initiation require an HIV clinician’s eligibility and regimen review. Confirm the prescription, dispensing route, coverage, medication receipt and professional injection site when injections are planned. FDA approval does not establish local stock, Nao prescribing readiness or an available appointment. Keep current prevention or HIV treatment while access is arranged, and seek urgent PEP assessment for a qualifying exposure within 72 hours.

The effect depends on the product and task. In the Yeztugo prevention label, PURPOSE 1 recorded zero HIV infections among 2,134 participants assigned Yeztugo, versus 16 among 1,068 assigned Truvada. PURPOSE 2 recorded two among 2,179 assigned Yeztugo, versus nine among 1,086 assigned Truvada. Zero cases in one trial does not promise zero risk for every patient. Sunlenca’s CAPELLA treatment cohort measured viral suppression with an optimized background regimen. Of 36 participants, 81% had HIV RNA below 50 copies/mL at week 26 and 83% at week 52. These populations and endpoints cannot be combined into one efficacy percentage.

The exact product and treatment purpose determine the regimen. Yeztugo PrEP starts with professional subcutaneous injections plus tablets on initiation day one and tablets on day two. Maintenance injections are every 26 weeks with a two-week permitted window. Sunlenca’s injection treatment pathway has two labeled initiation options and the same 26-week maintenance interval, while other prescribed antiretrovirals continue. Sunlenca tablets used to start Bixlenvo instead accompany its two-day initiation. Maintenance is Bixlenvo daily, not ongoing Sunlenca injections. Contact the prescriber before a delayed injection for the exact bridge or restart plan. Do not self-inject depot lenacapavir or substitute one product’s tablets or schedule for another.