Over the years, we have made great progress in having conversations about HIV prevention as access to pre-exposure prophylaxis, commonly known as PrEP, has increased. There are more options for pills and injectables and more programs for managing cost. And more people know that this prevention tool, which can be up to 99 percent effective when taken correctly, exists and is available to them.
But while the conversations have grown, HIV prevention is often discussed through a narrow lens focusing on men, while women, especially cisgender women, remain significantly impacted by HIV.
For many women, HIV risk is not about individual behavior alone; it’s shaped by relationships, access to healthcare and social factors. Women may not always be able to control whether a partner uses condoms, may not know their partner’s HIV status or may be in relationships where negotiating safer sex is difficult. PrEP gives women control over their own protection, independent of a partner’s choices.
Many women who could benefit from PrEP are never offered it or don’t realize it’s an option to include in their plan for sexual health and wellness. That’s why it’s so important for women to talk openly with their healthcare providers about PrEP.
So, how do you know if you or a friend is at higher risk of infection? It’s essential to remember that evaluating risk is not about judgement. It’s about biology, exposure and opportunity for prevention.
While any sexually active woman can benefit from learning about PrEP, certain groups are at higher risk and may benefit the most. These include:
- Women with sexual partners who are HIV-positive, especially if the partner is not consistently undetectable.
- Women with partners of unknown HIV status, particularly in communities with higher HIV prevalence.
- Women who have multiple sexual partners or whose partners have multiple partners.
- Women who do not consistently use condoms, whether by choice or circumstance.
- Women with a recent sexually transmitted infection (STI), which increases susceptibility to HIV.
- Women who inject drugs or have partners who inject drugs.
- Black and Latina women, who are disproportionately affected by HIV due to structural and healthcare inequities.
If you think PrEP might be right for you and your sexual health, there are several options to consider with different levels of commitment and time needed, much like with birth control.
PrEP is not one-size-fits-all. Current options include Truvada, which is a daily oral PrEP pill, and Yeztugo, which is a long-acting injectable PrEP given every eight weeks by your provider that can be a great option for women who prefer not to take a daily pill.
A healthcare provider can help determine which option fits best based on lifestyle, medical history and personal preference.
Many women wait for their provider to bring up PrEP, but that doesn’t always happen, especially if your provider doesn’t realize it may be right for you. Asking directly about PrEP is a powerful step toward protecting your health. Asking is not a sign of risky behavior or something to be afraid of; it’s a sign of self-advocacy, planning and prevention.
HIV prevention works best when folks are informed, supported and given choices. Women should feel empowered to think about HIV prevention as part of their sexual health and wellness plan, just like other STI testing and prevention methods, birth control or cancer screenings. Talking to a provider about PrEP can be the start of taking control of your sexual health on your own terms.
Dr. Saleh Musleh, D.O., is a primary care provider at Prism Health North Texas’ Worth Street Health Center. You can make an appointment to talk about PrEP with an affirming, informed provider at Prism Health North Texas by visiting us at PHNTX.org.