What is PrEP?
PrEP is an anti-HIV medication, short for pre-exposure prophylaxis. Taken daily, it can reduce the the risk of getting HIV from sex by up to 99%. Among those who inject drugs it can reduce the risk of getting HIV by more than 70%. A combination of two HIV medicines (tenofovir and emtricitabine), sold under the name Truvada®, is approved for daily use as PrEP to help prevent an HIV-negative person from getting HIV from a sexual or injection-drug-using partner who’s positive. Studies have shown that PrEP is highly effective for preventing HIV if it is used as prescribed. PrEP is much less effective when it is not taken consistently.
Is PrEP a vaccine?
No. PrEP does not work the same way as a vaccine. A vaccine teaches your body to fight off infection for several years. For PrEP, you take a pill every day by mouth. If you take PrEP daily, the presence of the medicine in your bloodstream can often stop HIV from taking hold and spreading in your body. If you do not take PrEP every day, there may not be enough medicine in your bloodstream to block the virus.
Should I consider taking PrEP?
PrEP is for people without HIV who are at very high risk for getting it from sex or injection drug use. The federal guidelines recommend that PrEP be considered for people who:
- are in an ongoing sexual relationship with an HIV-positive partner
- inject drugs, have shared needles, or have been in drug treatment in the past 6 months
- isn’t in a mutually monogamous relationship with a partner who recently tested HIV-negative, and are
- gay or bisexual men who have had anal sex without using a condom or been diagnosed with an STD in the past 6 months, or
- heterosexual men or women who do not regularly use condoms during sex with partners of unknown HIV status who are at substantial risk of HIV infection
If you have an HIV-positive partner and are considering getting pregnant, talk to your doctor about PrEP if you’re not already taking it. PrEP may be an option to help protect you and your baby from getting HIV infection while you try to get pregnant, during pregnancy, or while breastfeeding.
Where can I get PrEP?
We’re glad that you’re interested in PrEP! Currently, PrEP is free to eligible Virginia residents through our clinic. However, becoming part of our PrEP Program requires some commitments from the applicant – you! This guide gives you an overview of what to expect from our PrEP Program at Richmond City Health District.
Fatimah Craighead is currently the PrEP Coordinator at RCHD. For any additional information regarding PrEP or the application process, please contact her by phone or email. If contacting by phone, please leave a voicemail and your call will be returned.
If you’re interested in PrEP, you’ll need to come to Richmond City Health District during our STI clinic. RCHD is located at 400 E. Cary Street, Richmond, VA 23219. A limited amount of free parking (labeled “visitor parking”) is available in the parking lot at our Cary Street Entrance.
Please be advised that our clinic operates on a first-come, first-serve basis. Individuals may not be able to register if the cap for the day has already been met, so we advise you to come at the beginning of each registration time to ensure you are able to be seen. The STI clinic operates three days a week at the following times:
- A.M. clinic on Mon/Wed/Fri – Registration: 8:00-10:00AM (doors open at 7:30AM)
- P.M. clinic on Mon/Wed/Fri – Registration: 12:30-3:00PM
- On the FOURTH Friday of every month, only A.M. clinic will be available.
- On the FIFTH Friday of a month, both A.M. and P.M. clinic will be CLOSED.
Initial screening for PrEP is NOT appointment based. When you decide to come in, please plan to be here anywhere from one hour to three hours, depending on how many individuals are registered before you. This is why we advise you to come at the beginning of each registration time to ensure you are able to be seen.
RCHD currently does financial screening at registration for everyone regardless of their reasons for coming to the clinic. It is advised that you bring:
- A photo ID
- Proof of income (having no income does not disqualify you from any service offered by RCHD)
- Insurance info (being uninsured does not disqualify you from any service offered by RCHD)
For your initial visit, please follow the process below:
- Let registration know that you are interested in routing screening/ STI screening.
- Do NOT say you are here for PrEP at registration. This will not move you through clinic faster, and it will delay your visit and slow down the flow of clinic.
- When you have been called to speak with a nurse about why you have come to clinic, please inform the nurse that you have come in to apply for the PrEP Program.
- The nurse will contact the PrEP Coordinator and they will orient you to the PrEP Program and assist in the application process. Please keep in mind that established patients may already be ahead of you to see the PrEP Coordinator or may have arrived before you, so we like to reiterate that you should come early and plan for up to three hours of time for your initial visit.
Once your application has been approved for the PrEP Program, there are some expectations placed on you as an individual when you begin to have medication prescribed to you.
- Once a month, you will have to come to RCHD to pick up your PrEP Medication during STI clinic.
- Every three months you will undergo a routine screening. You will be required to complete an HIV test as well as general STI screening during this routine process. Periodic kidney screening to ensure kidney health will also be included. At this time, these cost of routine screening is covered under the PrEP Program. Please be reminded that our clinic operates on a first-come first-serve basis, and so we urge individuals to come as soon as registration starts for STI clinic. Established patients may miss the opportunity to be seen if RCHD has already registered the maximum number of patients for the day.
- Along with STI screening, other lab tests will also be performed. Screening for creatinine will be conducted every six months to ensure the health of your kidneys. Screening for Hepatitis C will be done on a yearly basis.
PrEP is a pill that is to be taken daily. When starting PrEP medication, you are not immediately protected from the transmission of HIV. It takes about three weeks PrEP medication to be fully effective, and if the pill is not taken daily you may not be fully protected from HIV. Missing daily doses, especially multiple days in a row, or frequently throughout the month, may disqualify you from the PrEP Program. It can do more harm than good to frequently alter the levels of the medication in your bloodstream. Communication is key, so keep in contact with your PrEP Coordinator if you have any questions, concerns, or are experiencing challenges with adherence.
PrEP is just one way to reduce your risk to HIV, and PrEP does not prevent you from getting other STIs such as Chlamydia, Gonorrhea, or Syphilis. Other forms of risk reduction should be practiced in addition to PrEP. To learn more about different ways to reduce your risk, check out our page on getting protected.