Daily, On-Demand, or Injectable: The Many Forms of PrEP Explained

by Dr. Anu Hazra (Howard Brown Health), with thanks to the BLUPrint and PrEP4Teens teams

TaskForce Prevention and Community Services/buzz McBride

You might’ve heard of PrEP — short for pre-exposure prophylaxis — but not realized just how many options there are today. PrEP refers to safe, effective prescription medications that people who are HIV-negative can take to prevent HIV infection. When taken as prescribed, each of the different forms of PrEP reduces the risk of getting HIV through sex by up to 99%.

PrEP is available for people of all genders and sexualities, and it’s approved for young people under 18. What’s exciting is that there are now multiple ways to take it — from daily pills to long-acting shots — giving people more choice and flexibility than ever before.

As a provider serving primarily folks across Chicago, from adolescents to elders, I love helping people choose what will work best for their lives, PrEP or otherwise. I let them know that all the forms of currently available PrEP reduce your chances of getting HIV by up to 99%. I also remind that internal and external condoms are great choices, and all people have the right to make informed and empowered health and wellness decisions for themselves.

We don’t push prescriptions, we push information and empowerment!

Just a couple of months ago a new form of PrEP – an injection (shot) called Yeztugo – was approved by the U.S. Food and Drug Administration. Before I tell you more about Yeztugo (also called “lenacapavir”), let’s quickly revisit the other PrEP choices currently available. 

Daily Oral PrEP

This is the OG PrEP. People who choose this option take one pill once a day to protect against HIV. If you have experience taking multi-vitamin daily, you got this. The good news is that you don’t need to be absolutely perfect. If you miss a dose here and there, you will still have very high protection. However, if you find yourself missing multiple doses, you may want to think about other PrEP options. 

Oral PrEP Before/After Sex

This way to dose PrEP requires a little bit of planning and is meant for people who have anal intercourse (are penetrated anally.) People who choose this option take 2 PrEP pills at least 2 hours before they have sex. Then they take 1 pill 24 hours after sex, and another pill 48 hours after sex. Some people call this 2-1-1 PrEP or On-Demand PrEP. This dosing option may be attractive to people who have sex once a week or less. Dosing for people who have vaginal intercourse may require a different strategy according to a new study. 

Types of Oral PrEP
Oral PrEP comes in a few forms: brand names like Truvada and Descovy, plus generic versions that work the same but cost much less. Generics have the same active ingredients and are just as safe and effective, without the brand-name price tag.

Oral PrEP Side Effects
Most people feel great on oral PrEP. Some may notice mild headaches, fatigue, or an upset stomach at first, but these usually go away quickly. Your provider will help you choose the option that fits your lifestyle, check in on how things are going, and support you if any side effects come up.

2-month Injectable PrEP

Apretude (also known as cabotegravir) is a name-brand PrEP option given by a healthcare provider as a shot in your butt (gluteal muscle) every two months. When starting, you’ll get your first shot, another one a month later, and then continue with shots every two months. Common side effects include mild soreness, redness, or swelling at the injection site, which usually goes away within a week.

6-month Injectable PrEP

Yeztugo (also called lenacapavir) is the newest form of PrEP, approved by the FDA in June 2025. It’s given by a healthcare provider as two small injections under the skin of your belly or thigh every six months. When starting, you’ll also take two pills on the day of your first injection and two more the next day. Some people may feel a small lump at the injection site, which can last for a few months but usually isn’t visible or painful.

Drug Interaction Notes on Yeztugo
People taking Yeztugo who also use erectile dysfunction (ED) medications such as Viagra, Cialis, or Levitra may need to adjust their dosing to avoid side effects like dizziness or fainting. Whether you get these medications from your doctor or elsewhere, it’s important to be honest with your PrEP provider about all the drugs you take so they can recommend safe dosing adjustments.

Yeztugo can also interact with ketamine, which is used both medically and recreationally. This combination can intensify ketamine’s effects, including changes in breathing and perception. Your PrEP provider can help you navigate these interactions and keep your care safe and effective.

PrEP4Teens

PrEPwork is Teamwork

PrEP is not a DIY situation. Please be sure to tap into the expertise of your healthcare provider, other clinic staff, and resources like PrEP4Teens. There are all kinds of people like me out here who are ready to help you on your path, including connecting you to other things you may need beyond HIV prevention.

How to Access PrEP

PrEP prescriptions and medical visits are covered by most insurance plans and Medicaid, and there are assistance programs like PrEP4Illinois and others that can help people who are uninsured or under-insured. And remember – there are a lot of teen-friendly PrEP providers in Chicago. Be sure to check out the PrEP4Teens provide list.

Take a look, ask questions, stay curious — we’re here to help you figure it out.

Post author Dr. Anu Hazra presenting at the Illinois PrEP Summit.