PrEP

The CDC's clinical guidance frames PrEP as one of the most effective HIV-prevention tools currently available: when taken as prescribed, the agency reports it reduces the risk of acquiring HIV from sex by about 99% and from injection drug use by at least 74%. CDC clinical guidance for PrEP documents both oral pill regimens — Truvada (FDA-approved 2012) and Descovy (approved October 2019) — and the longer-acting injectable options that have since joined them, including cabotegravir (Apretude, every two months) and lenacapavir (Yeztugo, every six months).

Dosing flexibility matters in lifestyle contexts. The standard regimen is a daily oral pill, but for cisgender men who have sex with men there is also an event-driven 2+1+1 protocol using Truvada — two pills 2 to 24 hours before sex, one pill 24 hours later, and one pill 48 hours after the initial dose — described in Wikipedia's overview of PrEP. Descovy is not currently approved for people assigned female at birth who are at risk through receptive vaginal sex, since the relevant trials excluded that population.

The repeated caveat across CDC and clinical literature is that PrEP addresses HIV only. It provides no protection against gonorrhoea, chlamydia, syphilis, herpes, or any other STI, which is why current standards pair PrEP with quarterly STI screening and continued condom use for participants whose play patterns warrant it. Doxy-PEP — doxycycline taken after exposure to reduce bacterial-STI risk — is sometimes layered on top in higher-risk patterns, but it is a separate tool with its own indications and is not a substitute for PrEP.