Pre-exposure prophylaxis for HIV prevention, commonly known as PrEP (pronounced as prep, ), is the use of antiviral drugs as a strategy for the prevention of HIV/AIDS by people that do not have HIV/AIDS. PrEP is one of a number of HIV prevention strategies for people who are HIV-negative but who have a higher risk of acquiring HIV, including sexually active adults who are at increased risk of contracting HIV, people who engage in intravenous drug use (see drug injection), and serodiscordant sexually active couples.
The first form of PrEP for HIV prevention—emtricitabine and tenofovir disoproxil (FTC/TDF; Truvada)—was approved in 2012. In October 2019, the US Food and Drug Administration (FDA) approved the combination of emtricitabine and tenofovir alafenamide (FTC/TAF; Descovy) to be used as PrEP in addition to Truvada, which provides similar levels of protection. Descovy, however, is currently approved only for cisgender males and transgender women as the efficacy has not been assessed in people at risk for HIV through receptive vaginal sex.
In December 2021, the US FDA approved cabotegravir (Apretude), which is an injectable form of PrEP manufactured by Viiv Healthcare. Regulators believe it will improve medication adherence because it has to be taken just once every two months, and it will also widen adoption as it eliminates the need to hide pills or pharmacy visits for discretion.
In its 2021 guidelines, the World Health Organization (WHO) recommends several options for PrEP, tailored to different populations and circumstances:
Oral PrEP using TDF-containing compounds for anyone at substantial risk of HIV infection;
Event-driven PrEP for men who have sex with men (MSM); and
The dapivirine vaginal ring (DPV-VR) for women at substantial risk of HIV infection who do not have access to oral PrEP.
On 18 June 2025, the FDA approved the long-acting HIV prevention antiretroviral lenacapavir in the United States. The drug is branded as Yeztugo by Gilead Sciences and requires only two doses a year demonstrating high efficacy in clinical trials by offering nearly complete protection against HIV infection. As the second PrEP extended-release option following cabotegravir, lenacapavir's simplified dosing schedule could significantly improve patient access and adherence, especially for populations at higher risk of HIV. However, the global rollout may be challenged by recent funding reductions by the Trump Administration in global health funding by the United States that were expected to support lenacapavir access in lower-income countries across sub-Saharan Africa by PEPFAR. In September 2025, global partnerships set lenacapavir's HIV prevention price at US$40 per patient annually in 120 low- and middle-income countries. The WHO is planning to adopt lenacapavir in global guidelines for resource-limited settings as well as for WHO pre-qualification regulatory approval.
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