Getting a PrEP prescription is straightforward: you need an HIV-negative test result, a basic blood panel, and a willing prescriber. The whole process, from first appointment to picking up your medication, typically takes one to two weeks. Any licensed healthcare provider can prescribe PrEP, not just infectious disease specialists, and telehealth services have made the process even faster.
Who Can Get PrEP
PrEP is approved for anyone who is HIV-negative and at risk of exposure. There’s no checklist of specific behaviors you need to disclose or prove. If you have a reason to want protection, whether that’s a sexual partner whose HIV status you’re unsure of, inconsistent condom use, injection drug use, or simply peace of mind, you’re a candidate. The only hard requirement is that you test negative for HIV before starting.
Kidney function matters too. The daily pill forms of PrEP are processed through your kidneys, so your provider will check that yours are working well enough. One formulation (Truvada and its generics) requires stronger kidney function than the other (Descovy). If you have mild kidney concerns, Descovy may still be an option. The injectable form, Apretude, doesn’t require kidney screening at all.
Where to Get a Prescription
You have several options for finding a prescriber:
- Your primary care doctor. Any general practitioner can prescribe PrEP. If yours seems unfamiliar with the process, it’s reasonable to ask them to look into current CDC guidelines or to seek another provider.
- Sexual health or STI clinics. Many public health clinics and community health centers prescribe PrEP routinely and are experienced with the lab work and follow-up involved.
- Telehealth services. Several online platforms now specialize in PrEP. You create a profile, schedule a video visit, get lab orders sent to a local lab, and once results confirm you’re eligible, the prescription is sent directly to a pharmacy or delivered to your home.
Telehealth is especially useful if you live in an area without convenient sexual health services or prefer not to discuss PrEP with a provider you see for other care. The process is the same: consultation, lab work, prescription if eligible.
What Happens at Your First Appointment
The appointment itself is usually quick. Your provider will ask about your sexual health, any current medications, and your reasons for wanting PrEP. Then they’ll order a set of baseline labs. Here’s what to expect:
- HIV test. This must be a blood-based test, not an oral rapid test, because blood tests are more sensitive at detecting recent infections.
- Kidney function test. A simple blood draw measuring creatinine levels. Required for the pill forms of PrEP, not needed for the injectable.
- Hepatitis B screening. Having hepatitis B doesn’t disqualify you from PrEP, but your provider needs to know about it because stopping certain PrEP medications can cause a hepatitis B flare if you have the virus.
- STI screening. Tests for chlamydia, gonorrhea, and syphilis are recommended before starting.
If you’re prescribed Descovy specifically, your provider will also check your cholesterol and triglyceride levels at baseline. Most of these tests can be done with a single blood draw and a urine sample, so the lab visit is quick. Results usually come back within a few days, and your provider can write the prescription as soon as everything looks clear.
Three Types of PrEP Available
There are now three FDA-approved PrEP options, and which one you get depends on your preferences, lifestyle, and health profile.
Truvada (and generic equivalents) is a daily pill containing two antivirals. It’s been available the longest, is approved for all adults regardless of sex, and now has cheaper generic versions. The main consideration is that it can slightly reduce bone density and affect kidney markers over time, though serious kidney problems are rare (about 1% of users or fewer). Younger users may see more noticeable bone density changes.
Descovy is also a daily pill with two antivirals but uses a newer formulation that delivers the active drug more efficiently. This means lower drug levels circulating through your body, which translates to less impact on kidneys and bones. In a 48-week comparison study, people on Descovy had fewer kidney-related side effects and small increases in bone density at the hip and spine, while those on Truvada experienced slight declines. However, Descovy is currently only approved for people assigned male at birth or transgender women who have sex. It is not yet approved for people exposed to HIV through receptive vaginal sex.
Apretude is an injectable option for people who prefer not to take a daily pill. It’s approved for all adults. You get two starter injections one month apart, then one injection every two months after that. Each injection has a seven-day flexibility window on either side of your scheduled date. Apretude doesn’t require kidney monitoring, which simplifies the lab work.
On-Demand Dosing
If your risk of exposure is infrequent and predictable, you may hear about “2-1-1” or on-demand dosing. This schedule uses Truvada (or its generics) taken around sexual activity rather than every day: two pills taken 2 to 24 hours before sex, one pill 24 hours after that first dose, and one more pill 24 hours later. This approach has been studied primarily in men who have sex with men and is not currently recommended for other populations. Your provider can help you decide if this schedule fits your situation.
Follow-Up Visits and Refills
PrEP isn’t a one-time prescription. You’ll need to check in with your provider every three months for repeat HIV testing and STI screening, plus periodic kidney function checks if you’re on a pill form. These follow-up visits are what keep your prescription active. For telehealth users, the process works the same way: your provider contacts you every three months, orders lab work at a local facility, reviews results, and sends a refill to your pharmacy.
These visits are genuinely important. Taking PrEP while unknowingly HIV-positive can lead to drug resistance, making future HIV treatment harder. The quarterly HIV test protects you from that scenario.
Paying for PrEP
Cost is one of the biggest concerns people have, but several programs exist to make PrEP affordable or free.
Most private insurance plans cover PrEP with no cost-sharing under the Affordable Care Act’s preventive services mandate, meaning zero copay for the medication and associated lab work. If your plan does have a copay, Gilead (the manufacturer of Descovy) offers a co-pay savings card that covers up to $7,200 per year in out-of-pocket costs for commercially insured patients. You need to be 18 or older, have a valid prescription, and live in the U.S. This card doesn’t apply if you’re on Medicare, Medicaid, TRICARE, or VA coverage.
If you’re uninsured, the federal Ready, Set, PrEP program provides PrEP medication at no cost. To qualify, you need to lack prescription drug insurance coverage, have a negative HIV test, have a valid PrEP prescription, and live in the United States (including territories and tribal lands). The program covers the medication itself. Lab work costs may be covered separately through local health departments or community health centers that offer sliding-scale fees.
Generic Truvada is also now widely available, which has significantly reduced costs. Even without assistance programs, generic versions can run a fraction of what brand-name options cost, making them the most affordable daily pill choice.