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PrEP

Pre-exposure prophylaxis (PrEP)

PrEP is a highly effective HIV prevention method that can be used to reduce the risk of getting HIV through sex or sharing needles. PrEP is for people of all genders. Unlike PEP, PrEP is a medication taken before a possible exposure to HIV and on an ongoing basis if there is continued possibility of exposure. PrEP can be taken even if drinking alcohol, using recreational drugs, or taking hormones or birth control. PrEP does not prevent other sexually transmitted infections (STIs), only doxy-PEP and/or condoms can do that. Learn more about PrEP.

PrEP Options

PrEP is now available in two pill formulations: 1) TDF/FTC (brand name Truvada, available as either a brand-name or a generic medication), or 2) TAF/FTC (brand name Descovy, only available as a brand-name medication). For patients receiving PrEP at SF City Clinic, our providers will recommend one of these two formulations based on your medical history.

PrEP is also available in the form of a long-acting injection (a shot) of a medication called cabotegravir (brand name Apretude, only available as a brand-name medication), that can only be administered by a medical provider in-clinic. Cabotegravir (or CAB for short) requires injections (shots) approximately every 2 months. SF City Clinic currently prescribes both pill formulations of PrEP and is working to begin administering CAB. Please check back here for more updates regarding CAB.

For more information about the different PrEP medication options available, see this guide.

What schedule should I follow when taking oral PrEP?

Taking a pill of PrEP once per day is the most studied regimen PrEP regimen, and it works for all genders and body parts used for sex, as well as protection during injection drug use. The schedule is simple: take once per day at around the same time; and if you miss a dose, take it as soon as you can, or if it’s almost time for the next dose, just take that next dose.

There is also another regimen called 2-1-1 that is available using TDF/FTC. 2-1-1 involves taking pills only around the days when you have sex, following a specific schedule, and requires planning ahead since the first dose is always before sex. 2-1-1 is not any better at preventing HIV than daily dosing, so its main advantage is in providing an option for people who prefer not to, or cannot, take a pill every day. 2-1-1 has been studied for protection during anal sex. It is not known if 2-1-1 PrEP is effective at preventing HIV if someone is exposed while having vaginal/front-hole sex, or while using injection drugs. Therefore, it is recommended for protection against HIV during anal sex. It is NOT recommended for HIV prevention for people who use their vagina or front-hole for sex, or for protection while injecting drugs. Daily oral TDF/FTC works to prevent HIV for all genders, body parts, and during all activities, including sex and injection drug use.

Where can I get PrEP?

We can help you get PrEP or find out where you can get it. If you would like to start PrEP at our clinic, please call us at 628-217-6692 to get started.

Please note, San Francisco City Clinic is unable to prescribe PrEP to patients who have these insurance types: Kaiser, Veterans Administration (VA). However, we can see patients with those plans for HIV and STI testing, and we are happy to help you figure out how to get PrEP through your plan.

  • Visit pleaseprepme.org for a national directory of PrEP providers and answers to many PrEP questions.
  • PrEP is also available via telehealth, with medication shipped directly to your door. Check out https://pleaseprepme.org/online-providers.
  • Kaiser patients can contact 415-833-7737 for the Kaiser SF PrEP program, or 510-752-6848 for the Kaiser Oakland PrEP program.

Can I get doxy-PEP along with my PrEP?

Yes! It’s ideal for patient convenience that patients taking PrEP who are also eligible for doxy-PEP, receive both prescriptions from the same provider or clinic. City Clinic provides doxy-PEP prescriptions for patients in our PrEP program, and we do our best to synchronize the follow-up visits for both medications. For more information about doxy-PEP, visit page.

How can I pay for PrEP?

Our clinic and many others in San Francisco charge low or no fees for PrEP-related medical costs (e.g., the clinic visit and laboratory tests). Most insurance plans cover the cost of PrEP medication, including Medi-Cal, and many forms of financial assistance are available to cover the cost of medication copays. Most uninsured people qualify for a program that covers the full cost of the medication! We’ll help you navigate the system.

Additionally, since generic TDF/FTC came to market in the U.S. in late 2020, most patients can access PrEP medication for $0/monthly supply. And while some patients have to pay a co-pay, this should never exceed approximately $35/monthly supply, as this is the cash price for the medication.

How can I sign up for PrEP coverage?

If you are uninsured or have insurance that won’t cover the full cost of the medication, we can help you apply for a program that covers the cost of PrEP. Just call us at 628-217-6692.

Want to sign up for insurance? Contact Covered California for information at 800-300-1506 or coveredca.com. California residents with an annual income of less than $18,754, or who have lost their job and income can sign up for Medi-Cal any time. Find out how at sfhsa.org (or if you live outside SF, search your county here).

PrEP Resources for Healthcare Providers