At Osra Medical, we’re committed to offering cutting-edge HIV prevention solutions tailored to our patients’ unique needs. That’s why we offer options for Pre-Exposure Prophylaxis (PrEP) medications that can significantly reduce the risk of HIV infection.

In this guide, we’ll break down everything you need to know about PrEP, including the different options available, how they work, and how to choose the right one for you.

PrEP (Pre-Exposure Prophylaxis) is a medication taken by HIV-negative individuals to prevent HIV infection.

PrEP is a powerful tool for anyone at higher risk of HIV exposure, including those with an HIV-positive partner, individuals who engage in condomless sex, or people who share needles.

When taken as prescribed, PrEP is over 99% effective at preventing HIV transmission through sexual contact and at least 74% effective for people who use intravenous drugs.

PrEP does not protect against other sexually transmitted infections (STIs) or pregnancy, so it’s important to use additional prevention methods like condoms or birth control.

PrEP is a game-changer in HIV prevention, empowering individuals to take control of their sexual health. It’s not just about protecting yourself—it’s also about reducing the overall spread of HIV in your community. By taking PrEP, you’re contributing to a healthier future for everyone.

At Osra Medical, we offer a full suite of oral and injectable PrEP options, each designed to fit different patients’ lifestyles and preferences. Below, we’ll explore the most common options, for oral PrEP and injectable alternatives.

Oral PrEP medications are taken as daily pills or, in some cases, on an as-needed basis. These are the most widely used forms of PrEP.

Effective for HIV prevention in those assigned male at birth, Descovy is not yet approved for people assigned female at birth who are at risk through vaginal sex. Do not take Descovy if you are HIV-positive or if you are a person with Hepatitis B (HVB), as it may worsen your symptoms or infection.

Administration: One pill taken daily with or without food.

Active Ingredients: Emtricitabine and tenofovir alafenamide

Key Benefits:

• Smaller pill size, making it easier to swallow.
• May have fewer side effects on bone density and kidney function compared to Truvada.
• Best for individuals who prefer a daily pill with potentially fewer side effects.

Side Effects:

• Diarrhea
• Nausea
• Headache
• Fatigue or tiredness
• Gastrointestinal distress or stomach discomfort
• Occasionally, more serious side effects like
  • lactic acidosis, a build-up of lactic acid in the blood
  • kidney problems, including kidney failure
  • severe liver problems

Truvada is approved for all populations at risk of HIV, including through vaginal sex and those who use intravenous drugs.

Administration: One pill taken daily or as on-demand PrEP

Active Ingredients: Emtricitabine and tenofovir disoproxil fumarate

Key Benefits:

• The first FDA-approved PrEP medication with a long track record of safety and effectiveness.
• Flexible dosing options, including daily use or on-demand use with 2-1-1 dosing.
• Best for those who want a well-established option with flexible dosing.

Side Effects:

• Diarrhea
• Nausea
• Headache
• Fatigue or tiredness
• Dizziness
• Gastrointestinal distress or stomach discomfort
• Occasionally, more serious side effects like
  • lactic acidosis, a build-up of lactic acid in the blood
  • kidney problems, including kidney failure
  • weaker bones
  • difficult-to-treat HIV
  • hepatitis B (HBV) flare-ups after stopping Truvada

The 2-1-1 dosing strategy is an on-demand option for Truvada, primarily recommended for those who take the active role while having sex with men. Here’s how it works:

– Take 2 pills 2-24 hours before potential HIV exposure.

– Take 1 pill 24 hours after the first dose.

– Take 1 pill 24 hours after the second dose.

This method is not currently recommended for other populations, such as those who are on the receiving end of vaginal or anal intercourse or those at risk through injection drug use.

For those who prefer not to take a daily pill, injectable PrEP offers long-lasting protection with fewer doses.

Approved for use in 2021, Apretude is the first of several new exciting injectable PrEP options coming to the market. A great option for cisgender and transgender individuals and a range of ages, Apretude is given every 2 months after an initial loading dose. Do not take Apretude if you are HIV-positive.

Administration: An intramuscular injection (into the muscle)

Active Ingredient: Cabotegravir

Key Benefits:

• Eliminates the need for daily pills, making it easier to adhere to for some people.
• Highly effective, with studies showing it may be even more effective than oral PrEP in some populations.
• Only 6 injections per year after the initial dosing phase.
• Best for individuals who struggle with taking daily pills or for those who prefer a long-acting option.

Side Effects:

• Pain, redness, or swelling at the injection site
• Muscle pains
• Diarrhea
• Nausea
• Headache
• Fever
• Fatigue or tiredness
• Dizziness
• Gastrointestinal distress or stomach discomfort
• Occasionally, more serious side effects like
  • Allergic reactions. Do not take if you are allergic to cabotegravir. If you experience fever, tiredness, trouble breathing, or blisters, redness, or swelling near the eyes or mouth, please stop taking Apretude and seek medical attention.
  • Depression or mood changes.
  • Liver problems.

Lenacapavir is currently under investigation in two large Phase III clinical trials and three smaller Phase II clinical trials for use in several different gender identities and age groups. In December 2024, the maker of Lenacapavir, Gilead, submitted an application to the United States Food and Drug Administration (FDA) for the approval of Lenacapavir for use as PrEP. Approval may be granted as soon as summer 2025.

Administration: A subcutaneous injection (under the skin) given every 6 months.

Active Ingredient: Lenacapavir.

Key Benefits:

• The longest-acting PrEP option in development, requiring only 2 subcutaneous injections per year.
• Potential game-changer for those who want the least frequent dosing schedule.
• Best for individuals seeking the most convenient, infrequent dosing option.
• Studies show a high rate of effectiveness in a wide population of diverse ages and gender identities.

Note: The U.S. Food and Drug Administration, the agency responsible for ensuring the safety and effectiveness of medications, has not yet approved Lenacapavir for PrEP, but this drug is in advanced clinical trials. Ask your healthcare provider about availability.

Choosing the right PrEP option depends on your lifestyle, medical history, and personal preferences. Here are some factors to consider:

• Do you prefer a daily routine or a medication you can take only when needed?
• Are you comfortable with taking pills, or would you prefer a long-acting injection?
• Check with your insurance provider to see which options are covered, as costs can vary.

Your Osra Medical team is here to discuss your needs and any potential side effects to help you find the best PrEP option that aligns with your healthcare needs.

At Osra Medical, LGBTQ+-friendly medical team is here to help you navigate your PrEP options and find the best solution for your lifestyle.

Whether you’re considering oral PrEP, injectable options, or just want to learn more about HIV prevention, Dr. Nasser Mohamed and our experienced healthcare providers are ready to guide you.

Don’t wait to take control of your health. Schedule a consultation today to discuss your PrEP options and start your journey toward effective HIV prevention.