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Guides / PrEP and PEP

How do you get PrEP? Steps, costs and where to go

By Bud

Not medical advice. This guide is written from CDC and public health guidance and hasn’t been reviewed by a clinician yet. Sources checked . For advice about your own health, talk to a doctor or clinic. How we write guides · Health disclaimer

A bottle of Descovy PrEP tablets with a small pile of blue pills on a wooden table.
Licensed under CC BY 2.0. Photo by Tony Webster.

The short answer: get an HIV test, then get a prescription from a doctor, sexual health clinic, health department or telehealth PrEP service. Most US insurance plans must cover PrEP and its lab tests at no cost to you, and there are free programs if you don’t have insurance.

PrEP is the closest thing we have to a cheat code. The CDC says it lowers your chance of getting HIV from sex by about 99% when you take it as prescribed. Getting it is mostly paperwork, and the paperwork is easier than it looks.

Pick the kind of PrEP that fits your life

There are now pills and shots. They all work. The best one is the one you’ll actually keep up with.

PrEP options in the US
OptionHow you take itGood if you
Daily pill (generic Truvada, or Descovy)1 pill every dayLike a routine and want the cheapest option
On-demand pills (2-1-1)2 pills 2 to 24 hours before sex, then 1 pill 24 and 48 hours laterHave sex now and then, and can plan ahead
Cabotegravir shot (Apretude)A shot every 2 months after 2 starter shotsHate pills or keep forgetting them
Lenacapavir shot (Yeztugo)A shot every 6 months after a starter doseWant to think about it twice a year
Based on CDC PrEP guidance, including its 2025 recommendation of twice-yearly lenacapavir. On-demand 2-1-1 is off-label in the US and only works with generic Truvada pills, so ask your provider.

If you bottom, daily pills take about 7 days to reach full protection in your ass, according to the CDC. With 2-1-1, the double dose before sex is what does the work, so don’t skip it.

What happens at your first PrEP visit

You don’t need to explain your sex life in detail. You do need to be honest enough that they test the right things.

  • HIV test: you need a negative result before starting, because PrEP alone isn’t enough to treat HIV.
  • Kidney test: a blood test for the pills, since they’re cleared through your kidneys.
  • Hepatitis B test: some PrEP pills also act on hep B, so they’ll check before you start.
  • STI tests: syphilis, plus chlamydia and gonorrhea from your throat, ass and dick. Ask for swabs (“a rectal swab and a throat swab”) if you suck or bottom.

After that, you go back every 3 months for pills, or every 2 months for the cabotegravir shot. Each visit includes an HIV test, and it’s a good moment to test for STIs too.

Where to get a PrEP prescription

Free and covered options come first.

  1. A sexual health clinic or health departmentMany prescribe PrEP for free or on a sliding scale, and they won’t blink at anything you tell them.
    Free
  2. Your regular doctorAny doctor or nurse practitioner can prescribe PrEP. Covered by most insurance.
    Often covered
  3. An online PrEP clinicAn online visit, a home lab kit or a quick lab stop, and pills by mail. Good if you’d rather not see anyone local. Examples below.
    Often free
  4. A pharmacyIn some states, pharmacists can prescribe PrEP themselves. Ask yours.
    Varies by state

Online PrEP clinics

These are some of the better-known US services. Bud doesn’t get paid for listing them. Check that they serve your state and what they charge before you sign up, since prices and coverage change.

  • Mistr: built for gay and bi men. Says it can get PrEP, labs and visits covered at $0, using insurance or assistance programs if you don’t have it.
  • Q Care Plus: online PrEP and sexual health care. Accepts insurance, and visits and labs are often free.
  • PlushCare: a general telehealth service that prescribes PrEP. Accepts insurance and charges a monthly membership.

If you’re not out to your family doctor or you share an insurance plan with someone, a clinic or telehealth service keeps it off the family radar more easily.

How to pay for PrEP

PrEP shouldn’t cost you much, and often costs nothing.

  • Private insurance: under the Affordable Care Act, most plans must cover PrEP, the visits and the lab tests with no copay. The Supreme Court left that rule in place in 2025. If you get a bill, push back, and ask the clinic to recode the visit as preventive.
  • Medicaid: covers PrEP in every state.
  • No insurance: generic daily pills are cheap with a pharmacy discount card. Drug makers run patient assistance programs for the brand-name pills and shots, and many health departments pay for the visits and labs.

What PrEP doesn’t do

PrEP protects against HIV and nothing else. Syphilis, gonorrhea and chlamydia still get passed around, which is why you test every 3 months. Condoms help, and so does doxyPEP.

Frequently asked questions

How long does it take for PrEP to work?
For bottoming, daily PrEP pills take about 7 days to reach full protection, according to the CDC. Ask your provider how this works for the shot you choose.

Can I get PrEP without insurance?
Yes. Health department clinics, patient assistance programs and cheap generic pills mean most people can get PrEP for free or close to it.

Does PrEP have side effects?
Some people get an upset stomach or headaches in the first few weeks, and it usually passes. Your provider checks your kidneys with regular blood tests.

Can I stop taking PrEP?
Yes, but talk to your provider first. How long to keep taking pills after your last sex depends on how you were taking them.

Sources: CDC: Preventing HIV with PrEP, CDC recommends new injectable HIV PrEP (2025).

This guide is general information, not medical advice. Talk to a doctor or clinic about your own situation. Health disclaimer

Not sure when to test? The STI test window calculator works out when each test can pick up an infection after sex.