A conversation about sexual health needs to consider your life as it is: your questions, relationships and what you can maintain in your routine. That information helps choose an approach to prevention and also supports care for people already living with HIV.
PrEP: prevention before exposure
Pre-exposure prophylaxis, or PrEP, is medication taken by people without HIV to prevent infection. The indication considers sexual practices, exposures and your interest in using it; it is not determined by sexual orientation or gender identity alone.
Before starting, it is necessary to test for HIV and assess recent exposures or symptoms of infection. Other sexually transmitted infections (STIs), hepatitis, vaccinations and the need to check kidney function are also part of the assessment.
When PrEP is indicated, guidance includes how to take it, when protection begins and what to do about missed doses or side effects. HIV testing continues at follow-up appointments. As PrEP does not prevent other STIs, condoms, vaccines and other precautions also belong in the conversation.
For people living with HIV
I care for people living with HIV, considering treatment, tests and other health needs. Difficulties taking medication consistently, possible interactions and issues such as sleep, mental health and chronic conditions need space in the appointment. When needed, care is coordinated with the healthcare network and an infectious disease specialist.
One fact deserves to be more widely known: people on treatment who maintain an undetectable viral load do not transmit HIV through sex. This is the principle of undetectable = untransmittable. It depends on continuing treatment and follow-up.
If an exposure has already happened
PEP may be needed: an urgent intervention that differs from PrEP. Seek a service offering post-exposure prophylaxis immediately. When indicated, it must begin as soon as possible, no later than 72 hours after exposure. Do not wait for a scheduled appointment. Even after that period, seek care to assess testing and other needs.