The Los Angeles LGBT Center and our Center-WeHo offer PEP. Based on your income, you may even qualify for free treatment. To learn more, please call us at 323-860-5855 (option 4), Monday through Friday from 11 a.m. - 6 p.m.

Note: If you believe you were exposed on Friday night or on Saturday, you should consider going to the emergency room of a hospital to access PEP.

PEP contains some of the same medicines that people with HIV take to stay healthy. If you are exposed to HIV, it takes a few days for an HIV infection to take hold in your body. As soon as you start PEP, these medicines begin to stop the virus from multiplying. As you continue taking PEP for the full 28–days, cells with HIV die and the virus stops spreading to the rest of your body.

PEP’s effectiveness varies depending on when it is initiated; according to the CDC it can be up to 80% effective. However, it is not effective in all cases.

PEP can be used to treat people who may have been exposed to HIV during a single event (e.g., during episodes of unprotected sex, needle-sharing injection drug use, or sexual assault).

PEP should only be used in uncommon situations right after a potential HIV exposure. It is not a substitute for other proven HIV prevention methods, such as PrEP, correct and consistent condom use, or use of sterile injection equipment.

Because PEP is not 100% effective, you should continue to use condoms with sex partners while taking PEP and should not use injection equipment that has been used by others. This will help avoid spreading the virus to others if you become infected.

To be effective, PEP must begin as soon as possible, but always within 72 hours of exposure. Your healthcare provider will consider whether PEP is right for you based on how you might have been exposed and whether you know if the person whose fluids you were exposed to might be HIV-positive. You will be asked to return for more HIV testing at 4 to 6 weeks, 3 months, and 6 months after the potential exposure to HIV.

For more information, see the Center for Disease Control and Prevention's (CDC's) PEP Basics page: http://www.cdc.gov/hiv/basics/pep.html

When used correctly, PrEP provides 92%–99% reduction in HIV risk for HIV-negative individuals who take the pills every day as directed. PrEP is even more effective when it is combined with other prevention methods, such as condoms.

Some people will keep using condoms while on PrEP and others will decide to stop using them. If you are already using condoms consistently, and doing so makes you feel comfortable and protected, then keep doing what feels right to you. Many people struggle with using condoms consistently, which is one reason why PrEP was developed. You have to decide for yourself what level of protection feels right and gives you the peace of mind to lead a sexually fulfilling life.

PrEP does not prevent you from contracting sexually transmitted diseases (STDs) such as gonorrhea, chlamydia, or syphilis. Consistent and correct use of condoms can reduce your risk of contracting or transmitting STIs. It is important for you to be regularly tested for these infections and to be treated promptly if you find out that you are infected.

The use of daily PrEP is highly effective if taken every day, less effective if pills are not taken daily. Before starting PrEP, it’s important for you to determine if you are comfortable and confident in your ability to take a daily pill to prevent HIV. PrEP only works if you take it!

NOTICE: When starting PrEP, it is estimated that 7 days of daily dosing is needed to achieve protective concentrations for receptive anal sex.

PrEP is not the right fit for everyone but may be useful for HIV-negative individuals who have substantial and ongoing risk for HIV infection, through either sex and/or injection drug use.

If you can answer yes to any of the questions below, then PrEP may be one HIV prevention strategy to consider.

• Do you use condoms sometimes or not at all?
• Do you often get STIs in your butt?
• Do you often get STIs in your vagina?
• Have you taken post-exposure prophylaxis (PEP) more than once in the past year?
• Are you in a serodiscordant relationship, where your sexual partner is HIV positive and you are HIV negative?
• Are you in an open relationship or having anal and/or vaginal sex with multiple partners?
• Are you having sex with someone whose HIV status you don’t know?
• Are you having sex with someone in a city or region where the HIV prevalence is high—that is, where there are large numbers of people living with HIV?

Note: PrEP is not just about taking a pill every day. If you decide to take PrEP, you’ll need to see your provider at least every three months for routine care and HIV testing.

We can help you determine whether PrEP is right for you and if so, issue and fill a prescription on-site. We can even help you qualify for financial assistance programs if PrEP isn’t covered by your insurance or you are uninsured. Call us at 323-993-8990, option 4 and let our staff know you’d like to talk about getting PrEP.

Your primary care provider can also prescribe PrEP for you. Before discussing it with your doctor, we suggest you make a list of the reasons you think PrEP would be a good choice for you. Be as honest as possible so your provider can help you make the best decision. If your sex life is a hard topic to talk about, say that to your provider. It will help to start the conversation.

Some providers may not know about PrEP or may not be knowledgeable or comfortable discussing PrEP or your sexual health. If you do not have a provider, or if your medical provider does not feel comfortable helping you make this decision and prescribing PrEP, you're welcome to get your medical care from the Los Angeles LGBT Center.

If you and your provider agree that PrEP is right for you, your provider will conduct a general physical and test you for HIV and other STDs. Your blood will also be tested to see if your kidneys and liver are working well.

NOTICE: Be sure to inform your provider about any current medications that you are taking (including vitamin supplements, work out supplements, herbs, etc.). Example: Creatine supplements can throw off the blood test that measures kidney function.

PrEP is generally safe and well tolerated.

Some people in clinical studies of PrEP had early side effects such as nausea, upset stomach, diarrhea, mild headache, or dizziness, but these were mild and usually went away in the first month. PrEP may also cause decreases in kidney function and bone density, however, research suggests that side effects while using PrEP are generally mild and uncommon. No serious side effects were observed. You should tell your health care provider if these or other symptoms become severe or do not go away.

PrEP is covered by most private insurance programs and Medi-Cal, but the amount of coverage varies by insurance plan.

If you have private healthcare insurance, you can expect to pay your normal co-pay associated with brand-name drugs. The co-pay will vary from plan to plan. Some insurance companies will, however, require certain pre-authorization requirements to determine if you are eligible to have PrEP covered.

In some cases, even with insurance, the co-pay may make PrEP unaffordable. The Gilead Co-Pay Assistance Program is specifically set-up for those eligible to have the cost of co-pays covered.

Without insurance, out-of-pocket costs can be as high as $13,000 per year. Luckily, there are medication programs available for the uninsured.

The Los Angeles LGBT Center has a team of Linkage to Care Navigators who work one-on-one with patients to answer questions about PrEP, offer guidance with navigating health insurance plans, assist with benefit enrollments (including medication assistance programs), and scheduling appointments.

Please call us at 323-993-8990 option 4 to schedule an appointment.