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PEP is a medication you can take within 72 hours of potential exposure to HIV to lower your chances of contracting the virus. Read on to learn more about who is eligible for it and when to use it.

What to Know About Using PEP to Prevent HIV Infection

PEP, or post exposure prophylaxis, is a medication you can take within 72 hours of potential exposure to HIV to lower your chances of contracting the virus. While some research indicates that this groundbreaking medication may be able to lower your risk of HIV infection by up to 80%, it is only effective when taken as prescribed and is not intended to be a method of ongoing, recurring HIV prevention (see our article on PrEP to learn more about long-term preventative options).

Read on to learn more about what PEP is (and what it isn’t), who is eligible for it, and when to use it.

PEP is a medication regimen that you begin taking as soon as possible after potential exposure to HIV and continue with for at least 28 days. It typically consists of three medications: Truvada® (emtricitabine/tenofovir) with either Tivicay® (dolutegravir) or Isentress® (raltegravir). Your healthcare provider will recommend the best medication regimen for your health needs during your consultation.

These medications are antiretrovirals, a type of medication that blocks various stages of a virus’ life cycle. In this case, PEP prevents HIV from spreading throughout your body. Taking PEP medications as prescribed throughout the entire 28-day duration is critical to its effectiveness.

It’s important to reach out to a healthcare provider or pharmacist to start PEP as soon as possible if you believe you were exposed to HIV. The virus spreads very quickly — typically within 24 to 36 hours of exposure — and it is recommended to begin taking PEP within 72 hours, or three days, of potential exposure. 

And the sooner you begin your PEP regimen within that 72-hour window, the more effective the medication is at blocking the virus. If your potential exposure to HIV falls outside of that 72-hour window, you should still seek medical attention as soon as possible for further evaluation.

PEP may cause some side effects such as nausea, vomiting, diarrhea, and fatigue, however these are mild in most cases. Be sure to inform your healthcare provider of any other medications you currently take, as these may interact with PEP.

If you experience a rash or fever while taking PEP, you should contact your doctor as soon as possible, as these may indicate the early stages of HIV.

PEP works most effectively for people who may have been exposed to HIV within the last three days. That primarily includes anyone who had unprotected sex with or who shared needles or other drug paraphernalia with someone who may have HIV. It is also recommended in instances of sexual assault or if you used a condom that broke while having sex with someone who may have HIV.

PEP baseline testing and ongoing monitoring

Recommended baseline screening for PEP includes a rapid HIV test, kidney and liver function tests, a pregnancy test for women of reproductive age who aren’t using birth control, and screening for sexually transmitted infections (STIs). However, if baseline screening isn’t available when you reach out to a healthcare provider or pharmacist to start PEP, they will likely advise you to take your first dose before you complete the tests, in the interest of starting PEP as soon as possible. Additional HIV testing is recommended at 30 days and 90 days after the potential exposure to confirm your HIV status.

In all states, any licensed doctor or nurse can prescribe PEP. And in a growing number of states, including California, Colorado, and Nevada, pharmacists are also allowed to prescribe PEP. 

Since the medication should be taken as soon as possible after exposure, PEP is commonly prescribed by emergency room doctors. It is also available at many sexual health clinics and community-based health centers, but if you have been exposed to HIV after standard working hours, you should visit your nearest hospital’s emergency department as soon as possible.

PEP isn’t an ongoing method of HIV prevention

PEP is only for emergencies and infrequent exposures, as it is not 100% effective in preventing HIV even when taken as prescribed. It should not be considered a substitute for proven methods of long-term HIV prevention, including condoms and/or taking PrEP, a medication that can lower your risk of sexual transmission of HIV by 99% when taken daily. It is also important to continue using condoms during your 28-day course of PEP.

If you have had several potential exposures to HIV, speak with your doctor about potentially taking PrEP to prevent HIV infection in the long term.

Alto can help you navigate PEP or PrEP access

Alto pharmacists will work with your insurance (if applicable) and any third party savings programs so that you can get PEP at the lowest possible price. 

There are several patient assistance programs designed to reduce the cost of PEP for individuals without insurance, including Gilead’s Advancing Access Program and ViivConnect. If you’re eligible, we’ll automatically enroll you in these programs as soon as we receive your prescription.

We can also help you get started with PrEP if you and your doctor decide that it’s right for you. In addition to support with navigating insurance and patient assistance programs, you can expect:

Discrete, private packaging and free, same-day delivery

Med syncing support to eliminate extra deliveries each month and in-app reminders to stay on track

Pharmacists directly available through phone or within the Alto app seven days a week

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

Editor’s Note: This post was originally published in September 2021 and has been updated for accuracy and completeness.

Reproductive endocrinologist Dr. Guy Ringler — a former faculty member at UCLA and an advisory board member at Men Having Babies — was one of the first doctors in the world to help gay men have children through assisted reprodutive technology.

Spotlight on Men Having Babies & Dr. Guy Ringler

There are many ways to start a family and raise a child. And as recent decades have brought forth milestones in marriage equality and the fight for LGBTQ+ rights, the options for LGBTQ+ family building have also expanded.

According to 2019 data from the Williams Institute, almost 29% of people who identify as members of the LGBTQ+ community are raising children, up from 16.2% between 2014 - 2016. That includes a growing number of gay men who’ve had children through surrogacy, a process in which a woman who is not related to the child — a gestational surrogate — carries a baby who is biologically related to one of the fathers and an egg donor.

Breaking down barriers to LGBTQ+ family building

Reproductive endocrinologist Dr. Guy Ringler — a former faculty member at UCLA and an advisory board member at Men Having Babies — was one of the first doctors in the world to help gay men have children through assisted reprodutive technology. Throughout the twenty-five years that he’s been in practice, he’s seen how scientific advances and cultural changes have broken down barriers for gay men interested in parenthood.

“Over two decades ago, when I began my career, people barely understood the concept of surrogacy for gay men,” he says. “It wasn’t as easy to find women who wanted to become surrogates for gay couples. There was still fear about HIV, and there were questions about the impact of surrogacy on a child’s development.”

The landscape looks a lot different today. Thanks to cultural shifts and greater understanding of the science behind surrogacy — and to awareness-raising organizations like Men Having Babies — there are now more options than ever to become a parent regardless of your sexual orientation or gender identity.

“Greater acceptance of the LGBTQ+ community and marriage equality has opened people’s minds and allowed them to see that gay families can thrive, just like any family,” Dr. Ringler says. “Gay men are now able to plan for a future that we once didn’t know was possible.”

Getting to meet prospective fathers at Men Having Babies’ annual conferences is one of Dr. Ringler’s favorite things about working with the organization. He’s observed a greater number of gay men pursuing parenthood at an earlier age.

“I’m so inspired by the next generation of gay men, who are planning their families in their twenties. That simply wasn’t an option when I was their age.”

Men Having Babies and financial assistance for IVF and surrogacy

There are many steps on the road to parenthood for LGBTQ+ individuals and couples: fertility treatments, legal consultation, and financial planning are all required to start a family.

“Having a baby doesn’t just happen for gay men,” Dr. Ringler says. “It takes thoughtful planning and there are many decisions along the way.”

That’s why support from organizations like Men Having Babies is so critical. The organization started as a program at The Center (formerly the NYC LGBT Center) in 2005 and officially became a nonprofit in 2012. Today, Men Having Babies supports thousands of gay men and couples around the world in starting their families through surrogacy, with monthly workshops, annual conferences and financial resources. 

Determining how to pay for IVF and surrogacy is an important part of planning your family. As part of the process, Dr. Ringler suggests mapping out a vision for your family. Knowing how many children you want can help you prepare for the cost: “When you’re making the commitment to start a family as a gay man, think about how you will financially support the decision. It may feel overwhelming, but it’s similar to the process of buying a house. If it’s really important to you, you can find a way to make it work.”

There are many resources to help alleviate the cost, including Men Having Babies’ Gay Parenting Assistance Program (GPAP) . The program offers different forms of financial support, including:

Discounted and free services donated by more than one hundred leading IVF, surrogacy, egg donation, and legal service providers to prospective parents (Stage I support)

Discounted and donated ancillary services, including fertility medication, escrow services, and insurance resource services (Stage I support)

Cash grants for approved prospective parents based on income eligibility (Stage II support)

Learn more about the criteria for applying to Stage I or Stage II support from the GPAP.

You must be a member of Men Having Babies to receive financial assistance. You can become a member by making an annual donation of $150 or more. Learn more about the membership process.

In addition, EMD Serono offers financial assistance for fertility medications and Family Equality has a list of family-building grants that help LGBTQ+ families afford fertility treatment. Be sure to also ask your fertility clinic or pharmacy about available financial assistance programs and payment plans.

The importance of researching your options

As Dr. Ringler emphasized, gay men building a family through IVF and surrogacy have many decisions to make throughout the process. For that reason, it’s important to thoroughly research your options and to work with a medical team that you trust. Here are some additional considerations to be mindful of as you plan your family.

Understanding the process of IVF and surrogacy

In IVF, eggs and sperm are combined in a laboratory. When gay men conceive through IVF, the sperm will come from one of the fathers and the eggs will come from a donor. Then the fertilized eggs, or embryos, are placed into the uterus of a gestational carrier who will carry the baby to term.

Not only is this an exciting time for expectant dads, as Dr. Ringler notes, but surrogates can play a big role in raising awareness of LGBTQ+ families.

“In my experience, surrogates who are asked when their baby is due while out in public may feel comfortable sharing that they’re having a baby for a gay couple. This helps open up more people’s minds to the possibilities for LGBTQ+ parenthood.”

Understanding your goals for your relationship with your surrogate is one of many key decisions, and there is a spectrum of options. Some couples cultivate intimate relationships with the surrogates while others prefer to remain more detached. There’s no one right choice — it’s all about understanding what’s best for you.

“If your surrogate wants a little distance, that does not mean that they are any less committed to the process,” Dr. Ringler says, adding that it’s important to discuss your preferences in an open discussion with your surrogacy agency.

Deciding who will be biologically related to the child

Another important decision for same-sex male couples is deciding which parent will be genetically related to the child. When heterosexual couples have babies through IVF, both parents can contribute their genetic material, so that the baby is biologically related to both, even when using a gestational carrier. 

But with gay men, only one father can contribute his sperm per pregnancy, so it’s important to discuss this decision with your partner if having a child as a couple. Some fathers fertilize multiple eggs so that both can have a biological connection with one of their children. Taking time to identify your family building goals will allow you and your partner to plan for the financial cost of more than one round of IVF, if you choose to pursue that option.

Keep in mind that you can establish a legal paternal relationship with your child even if you are not biologically related to them. It’s critical to research your state’s laws about legal parentage procedures once your baby is born. Movement Advancement Project’s interactive map on parental recognition laws is a good starting point. 

Be sure to speak with an experienced LGBTQ+ family lawyer in your state before starting the IVF and surrogacy process. There are many forms of financial support to help alleviate the cost of these legal services, like Men Having Babies’ Gay Parenting Assistance Program.

There's a wide selection of available egg donors, and one of the factors to consider as you choose yours is whether they will be anonymous or open. With an open donor, you can more easily answer any questions your child may have about their genetic background. However, some families prefer anonymous donors, and sometimes an anonymous donor’s physical or personality traits better fit your goals. Both paths are viable options, and it all comes down to what’s right for your family.

Regardless of which option you choose, Dr. Ringler notes that you should be prepared to share information with your child about how they were conceived. You can even get creative with how you share their journey: some of Dr. Ringler’s patients have created story books for the whole family to read together, which helps children understand their background and feel proud of who they are.

Seeking support for your family building journey

While there are many paths to take, and many decisions to make, as you build your family, all will lead to the same destination of parenthood.

“I personally had a very close relationship with my mother growing up, and as gay men, we can’t guarantee our children that same experience,” Dr. Ringler says. He notes that if you have an open donor, your child’s biological mother may be able to have a presence in their life, which is another important factor to consider when planning your family.

But regardless of your chosen family structure, “I’ve seen again and again throughout my career that all you need to start a happy, healthy family is love and fun.”

One thing that’s certain: family building as a gay man is much easier to navigate with support from organizations like Men Having Babies. If you’re feeling overwhelmed while planning for a family, remember that you don’t have to go through this journey alone. Men Having Babies understands the challenges specific to building a family as a gay man, and their resources can help you fulfill your dreams of becoming a parent.

Learn how to become a member of Men Having Babies.

At Alto, we’re proud to support Men Having Babies, and we’re happy to be a part of your family building journey if fertility prescription medications become part of your plan. Reach out any time to get started though the Alto app  or phone at 1-800-874-5881.

For many transgender men and women, hormone replacement therapy is an important component of their transitioning process. Here is an overview of hormone replacement therapy medications and side effects.

What to Know About Transgender Hormone Therapy Side Effects

For many transgender men and women, hormone replacement therapy is an important component of their transitioning process, allowing them to develop physical traits aligned with their gender identity. Taking this step to feel more comfortable in your body is a big decision, and there are many factors to consider as you determine if gender-affirming hormone replacement therapy is right for you. 

Below is an overview of hormone replacement therapy medications and side effects to help you learn more about the process.

Hormone replacement therapy for transgender women

Estrogen and testosterone-blocking medications help transgender women develop a more feminized appearance in line with their gender identity while transitioning. It reduces the discomfort of gender dysphoria, the distress caused by having a gender identity that differs from the sex you were assigned at birth. Many transgender women experience less emotional distress, improved personal relationships, and a better overall quality of life as a result of hormone replacement therapy.

Feminizing hormone replacement therapy causes a variety of physical changes like breast development and facial and body hair reduction. You may also experience a loss of muscle tone and changes in your body shape as the body redistributes fat cells.

Feminizing hormone replacement therapy medication and timing

While your healthcare provider will help you develop an individualized treatment plan, feminizing hormone therapy often begins by taking 100 to 200 milligrams daily of a diuretic called spironolactone to begin blocking male hormone receptors and suppress testosterone production. Some individuals begin taking estrogen immediately, in tandem with spironolactone, to further reduce testosterone production and develop more feminine characteristics. In other cases, estrogen is introduced after several weeks of spironolactone use. Your doctor will recommend the best plan for your needs.

There are various methods for administering estrogen, including orally, by injection, or as a cream, gel, spray, or patch. Commonly used forms of estrogen during a male-to-female transition include:

Oral: Estradiol tablets. 
Note that your doctor may advise you to let the tablets dissolve under your tongue rather than swallowing them. This is called sublingual administration, which may lower your risk for blood clots since it bypasses the liver.

Injections: Estradiol valerate (branded options include Delestrogen®) and estradiol cypionate (branded options include DEPO®-Estradiol)

Feminizing hormone replacement therapy side effects

You may experience one or more of the following hormone replacement therapy side effects. Your doctor can advise you about the potential risks and benefits prior to starting hormones.

A blood clot in a deep vein (also known as deep vein thrombosis) or in your lungs

High levels of triglycerides, a type of fat found in the blood

Feminizing hormone replacement therapy may also increase your risk for some chronic health conditions. Since estrogen affects how your body responds to insulin, it can lead to changes in your blood sugar levels and a greater risk for type 2 diabetes. Research into the impact of estrogen on your cardiovascular system is ongoing, and some studies have found a connection between estrogen therapy and a greater risk for heart disease and stroke. You may also face a greater risk of breast cancer after starting hormone replacement therapy.

Certain underlying health conditions may increase your risk of health complications related to the use of estrogen and testosterone-blocking hormones. It’s important to share your full medical history with your doctor, especially if you’ve had a hormone-related cancer, like prostate cancer, or a history of blood clots.

Gender-affirming hormone replacement therapy may affect your fertility, as it impacts sperm production. While some transgender women can produce sperm again after stopping hormone treatment, research indicates that this may not be the case universally, and there is a risk of permanent infertility with long-term use of hormones. If you would like to have biological children, ask your doctor about your options with freezing your sperm before starting hormones.

Hormone replacement therapy for transgender men

Hormone replacement therapy for transgender men during a female-to-male transition also combats gender dysphoria, leading to reduced emotional discomfort and better overall mental health.

During the process, you will take testosterone, which decreases estrogen production and suppresses menstruation. Testosterone is typically administered by injection (branded options include Delatestryl® and Tesamone®) or as a gel applied to the skin (branded options include AndroGel®, Testim®, Fortesta®, and Axiron®). In some cases, it may be applied as a patch or pellets positioned under the skin. If you have a persistent menstrual flow, your doctor might recommend taking progesterone to control it.

You may observe some of the following physical changes within several months of starting hormones, though individual responses to treatment varies:

Masculinizing hormone replacement therapy side effects

There are several potential side effects that transgender men may experience as a result of hormone replacement therapy, including the following:

Masculinizing hormone replacement therapy may also increase your risk for type 2 diabetes and cardiovascular disease.

You are more likely to experience one or more of these health complications if you have had breast cancer or have a history of blood clots. It may be unsafe to continue with hormone treatment if you are pregnant or breastfeeding. Be sure to discuss the potential risks and benefits of hormone replacement therapy with your doctor, and make sure they are aware of your full medical history.

Masculinizing hormone therapy and fertility

While some transgender men have sucessfully undergone egg freezing or IVF after starting hormone therapy, long-term use of hormones may lead to permanent infertility. If you want to leave open the possibility of starting a family by having children biologically, consult your doctor about your options for egg freezing before starting treatment.

Given that individual responses to testosterone treatment vary, you have a chance of becoming pregnant even while taking hormones. Your doctor can advise you about your options for birth control.

Baseline and follow-up testing for hormone replacement therapy

Before you begin hormone replacement therapy, your doctor will order tests to measure your baseline lipid, blood sugar, liver enzyme, and electrolyte levels, which may change throughout the course of your treatment. Your doctor will also evaluate your medical history to identify any health conditions that may affect treatment. This is also a good opportunity to discuss reproductive health and fertility considerations, including potential contraception options if you are a transgender man.

Throughout hormone therapy, you will have regular follow-up appointments with your healthcare provider to document physical changes in your appearance and monitor the impact of hormones on your lipids, blood sugar, and liver enzymes.

Hormone replacement therapy affects you emotionally as well as physically. In the long term, gender-affirming treatment, including both hormone therapy and surgery, can lead to better mental health, reducing the need for depression and anxiety-related treatment. 

Your doctor will likely ask questions related to your mental health during your initial consultation — including any symptoms of gender dysphoria that you have experienced and how they impact you at work, school, or home — and continue the conversation throughout your treatment.

It’s important to be honest with your doctor about how you are feeling — your mental health matters as much as your physical health. Don’t be afraid to ask for mental health-related resources if you need extra support, and remember that your doctor is here to help you without judgment.

View the National Institute of Mental Health’s suggestions for finding mental health treatment, and the Human Rights Campaign’s list of LGBTQ mental health resources.

Alto is here to support your journey with hormone replacement therapy. Our team of patient care pharmacists has experience working with the LGBTQ+ community and is available to answer any questions you have about the process.

We also make it as simple as possible to stay on top of your medications, with same-day delivery and mediation management tools like reminders and auto refills in our app. Reach out any time to get started by phone at 1-800-874-5881 or download the app for secure messaging with our care team. 

Many states have patient assistance programs to help people with a variety of insurance statuses access PrEP and related medical services at little to no cost. Here’s a breakdown of how to apply.

What to Know About State-Funded PrEP-DAP Programs

Cost is often a barrier to starting PrEP, a medication that can lower your risk of sexual transmission of HIV by 99% when taken daily. Fortunately, the HIV prevention landscape is rapidly evolving, and PrEP is now more accessible than ever.

As of this January, most private insurance plans must cover PrEP for HIV prevention without charging any out-of-pocket costs. In addition, many states have patient assistance programs to help people with a variety of insurance statuses access PrEP and related medical services at little to no cost. Here’s a breakdown of how to apply for state-funded PrEP drug assistance programs — also referred to as PrEP-DAP or PrEP-AP programs —  in four of the states that Alto serves.

The State of California’s PrEP Assistance Program (PrEP-AP) helps cover PrEP-related medical expenses, with different benefits for individuals without insurance, those with private insurance, and those with Medicare.

You can receive Truvada®, one of the two FDA-approved PrEP medications, free of charge through Gilead’s Advancing Access® Program. California’s PrEP-AP will also provide financial assistance with all other medications on the PrEP-AP formulary for HIV prevention and treatment of sexually transmitted infections (STIs) and the following PrEP-related medical services:

To be eligible for the assistance, you must receive all PrEP-related medical services at approved locations within the California Department of Public Health’s Office of AIDS PrEP-AP Provider Network. Search for a California PrEP-AP provider or enrollment site near you. 

Gilead’s Co-Payment Assistance Program covers up to $7,200 of Truvada® copays per calendar year. Once you’ve met this threshold, California’s PrEP-AP will cover any remaining PrEP copays for the rest of the calendar year, in addition to assistance for out-of-pocket costs for PrEP-related medical services and all other medication on the PrEP-AP formulary for HIV prevention and STI treatment. To be eligible for assistance with PrEP-related medical services, you must see a provider in your insurance plan’s network.

If you have prescription medication coverage through Medicare, you are not eligible for financial assistance from Gilead, but California’s PrEP-AP offers financial assistance with copays for all medications on the PrEP-AP formulary including Truvada®.

If you do not have prescription medication coverage through Medicare, you are eligible to enroll in Gilead’s Patient Assistance Program and receive Truvada® free of charge. In addition, California’s PrEP-AP will provide assistance with all other medications on the PrEP-AP formulary.

Anyone who has outpatient coverage through Medicare is also eligible to receive assistance from California’s PrEP-AP for PrEP-related medical services. However, you must see a provider in your plan’s network.

To be eligible for California’s PrEP-AP, you must:

Have a negative HIV test dated within six months of the PrEP-AP application

Have an annual Modified Adjusted Gross Income (MAGI) that does not exceed 500% of the Federal Poverty Level based on family size and household income

Not be fully covered by Medi-Cal or other third party payers

Be enrolled in the manufacturer's assistance program, if eligible

Colorado’s Public Health Intervention Program (PHIP) helps cover PrEP expenses for anyone living in Colorado who has an income less than 500% of the Federal Poverty Level.

If you have insurance, you must apply for the Gilead copay card to receive the assistance. If you do not have insurance, you must apply for Gilead’s Advancing Access program and see an approved PHIP-PrEP medical provider.

You can apply online or by mail. You must provide the following documents:

Proof of income (one month's worth of paystubs, award letter, etc.)

Gilead Co-Pay Card, if you have insurance

PHIP is not eligible for those with Colorado Medicaid. However, if you have Colorado Medicaid, your PrEP costs should be covered at a $1-3 copay for both medication and related medical services.

The New York State Department of Health’s AIDS Institute has a PrEP assistance program for individuals without insurance. The program covers the cost of PrEP-related medical services including HIV testing, counseling, STI testing, and primary care services. The cost of PrEP itself will be covered through manufacturer-sponsored patient assistance programs, to which healthcare providers affiliated with the program can help you apply.

Eligibility is based on financial and medical need. Learn more about how to apply and search for a New York State PrEP-AP provider near you.

Washington State’s PrEP Drug Assistance Program (PrEP-DAP) provides financial assistance with  PrEP and related medical services.

The program covers the cost of Truvada®. The Washington Department of Public Health contracts with Ramsell Corp® to provide pharmacy benefits for program participants. You must use a pharmacy contracted with Ramsell for PrEP-DAP to receive the financial assistance (Alto is contracted with Ramsell).

In addition, Washington’s PrEP-DAP also covers many of the PrEP-related lab and medical services including baseline and monitoring tests for STIs, kidney function, and Hepatitis B. If you have insurance, the program covers your portion of insurance deductibles, copays, and coinsurance up to a certain limit. To confirm the current maximum amount of financial assistance for individuals with insurance, call 360-236-3412 or 877-376-9316 (toll free) or email PrEPDAP@doh.wa.gov.

If you do not have insurance, the program will cover all of the costs up to the maximum amount of covered services.

To be eligible for Washington’s PrEP-DAP, you must live in Washington State, test negative for HIV, and meet one of several defined risk factors, described in more detail here.

There are several FDA-approved medication options for PrEP: Truvada®, Descovy®, and Emtricitabine 200 mg/Tenofovir 300 mg (generic Truvada, which became available in October 2020). PrEP may be right for you if you have a partner who is HIV-positive or unsure of their HIV status, or if you have multiple partners. It also reduces the risk of getting HIV from intravenous drug use by about 74%. Consult with a healthcare professional if you have any questions about whether PrEP is the right choice for you.

A negative HIV test is required before starting PrEP. Your doctor or pharmacist may also recommend additional tests to ensure that it’s safe for you to use PrEP. Initial baseline testing may include:

You will also have to visit a healthcare provider while taking PrEP for follow-up testing including:

Pregnancy testing and discussion of pregnancy plans every 3 months

HBV DNA testing every 6 to 12 months while taking PrEP if you have hepatitis B

We’ll help you get PrEP at the most affordable price

Alto will coordinate with your doctor and your insurance provider to ensure you’re receiving the best PrEP option for your needs at the most affordable price. We offer discrete, private packaging and free, same-day delivery along with in-app reminders to stay on track. And our pharmacists — who have deep expertise in many clinical areas, including HIV treatment and prevention — are directly available through phone or within the Alto app to answer any questions.

Reach out any time to get started by phone at 1-800-874-5881 or download the app for secure messaging! 

Practicing preventative health is critical to detecting health issues early on, when they are more treatable, and lowering your risk of developing conditions that are otherwise avoidable.

Prioritize Your Health with Preventative Care

If you’ve ever waited until you’re sick to see a doctor, you’re not alone. Many adults in the U.S. put off routine doctor’s appointments — sometimes even when they don’t feel well. 

These delays can be serious: according to the Centers for Disease Control and Prevention, up to 40% of all fatalities linked to the five leading causes of death in the U.S. — heart disease, cancer, chronic lower respiratory diseases, stroke, and unintentional injuries — could have been prevented. Untreated blood pressure or cholesterol and unhealthy lifestyle habits factors heavily into many of these cases.

Practicing preventative health is critical to detecting health issues early on, when they are more treatable, and lowering your risk of developing conditions that are otherwise avoidable. Preventative care involves a combination of annual check-ups, vaccinations, screenings, and healthy lifestyle habits. 

If you haven’t been to the doctor in a while, don’t get discouraged. The important thing is to get back in the habit. Below is an overview of preventative care for both men and women, with recommendations from our pharmacists for how to ensure you’re prioritizing your health.

There are several important numbers that help your doctor understand your risk for health conditions such as heart disease and diabetes: your body mass index (BMI), blood pressure, cholesterol, and glucose levels.

Being overweight or obese increases your risk for many different health conditions, including high blood pressure, unhealthy cholesterol levels, type 2 diabetes, heart disease, and stroke. 

Body mass index (BMI) is a screening tool that doctors use for obesity. A healthy BMI is typically between 18.5 to 24.9, while a BMI between 25 to 29.9 is considered overweight and a BMI of 30 or higher is obese.

Keep in mind that while a BMI does help doctors understand your general risk for the chronic conditions mentioned above, it is merely a snapshot of your health and doesn’t account for other important health factors including age and genetics. Your healthcare provider can help you understand your overall priorities with preventative care beyond any single number, which is another important reason to stay up to date with doctor’s appointments.

Your blood pressure numbers are one of several factors that can help your doctor predict your risk for heart disease and cardiac events like a heart attack or stroke. There are five different blood pressure ranges recognized by the American Heart Association:

If your blood pressure is in the normal range, you should get screened at least once per year. If your blood pressure is in a higher range, consult with your doctor about recommended screening frequency.

Read our previous blog to learn more about managing blood pressure.

A cholesterol blood test, also called a lipid profile or lipid panel, gives results for several different readings: HDL (good) cholesterol, LDL (bad) cholesterol, triglycerides, and total blood (or serum) cholesterol. Your total cholesterol and HDL cholesterol levels are particularly important in helping your doctor identify if you are at risk for a heart attack or stroke.

A healthy range for total cholesterol is considered to be less than 200 mg/dL

A healthy range for HDL cholesterol is considered to be higher than 40 mg/dL for men and higher than 50 mg/dL for women

A healthy range for LDL cholesterol is considered to be less than 100 mg/dL

These targets are intended to be general guidelines, and each individual’s health needs are different. Having type 2 diabetes, smoking, being overweight, and not getting enough physical activity can affect your cholesterol levels. Your healthcare provider can help you determine your personal targets.

If your total cholesterol is under 200 mg/dL, you can have your cholesterol checked every 4-6 years. If you are at higher risk for heart disease and stroke, consult your doctor about recommended screening frequency.

Your blood glucose numbers can help your doctor determine if you have diabetes or are at risk for developing it. A blood sugar level under 140 mg/dL (7.8 mmol/L) is typical considered healthy, while a reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) may indicate prediabetes and a reading over 200 mg/dL may indicate diabetes. A discussion of these numbers with your healthcare provider is required for an official diagnosis of diabetes.

Generally speaking, if your blood glucose numbers are under 140 mg/dL, you should get screened at least every three years. If you have prediabetes you will need more frequent screening.

If you have diabetes, your healthcare provider can help you develop individualized targets for healthy blood sugar levels, which may be different from the numbers above. Try not to worry about what “normal” looks like for other people, and focus instead on taking simple actions to control your diabetes and live your healthiest life, like staying active and quitting unhealthy habits.

You should have an annual check-up once per calendar year. This appointment is the foundation of preventative care: since each individual’s risk for specific preventable health conditions may vary, discussing your personal health history and vital signs with your doctor will help you determine which preventative measures to prioritize.

In addition to checking with your physician about which vaccines, screenings, and medical tests you need, ask if your family history indicates an increased risk for any health conditions.

Prevention and screening become more important as you age. Regular colorectal cancer screening is recommended for everyone 50 and over. If you have risk factors like an immediate family member with colorectal cancer, your doctor may suggest earlier screening.

The American Cancer Society recommends annual mammograms for all women between 45 and 54. Some women begin screening for breast cancer as early as age 40 depending on their risk and family history. Women 55 and older can continue with yearly mammograms or switch to every two years. Your doctor can help you determine the right screening frequency for your individual needs. 

Preventative health doesn’t just happen in your doctor’s office. Everyday choices like what you eat and how often you exercise can protect your health for years to come.

Staying active is one of the most important things you can do to prevent cardiovascular disease and maintain a healthy weight. If you’re just starting to figure out your ideal exercise routine, know that you don’t have to exert yourself too hard to reap the benefits of physical activity. Even just 30 minutes of moderate exercise most days of the week can help strengthen your heart.

Everyone should do their best to limit their intake of the following foods, but it’s especially important if you face a greater risk for heart disease or diabetes:

Saturated and trans fats, which can raise your cholesterol

Sodium, which may increase your blood pressure

Sweets and sugar-sweetened beverages, which have been linked to both type 2 diabetes and an increased risk for heart disease

Other things you can do to stay healthy? Chronic stress can elevate your blood pressure, putting you at a greater risk for heart attack and stroke, so try to manage stress in heart-healthy ways like getting enough sleep, maintaining a fulfilling social life, and practicing mindfulness and gratitude. And it’s never a bad time to cut back on your alcohol consumption and quit smoking, if you currently smoke.

Prioritizing your physical and mental well-being today can help you prevent health issues in the future. We’re here to help make that as simple as possible.

At Alto, a pharmacist is your partner in health. If you take medication, we will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to make your medications as affordable as possible. And our team of patient care pharmacists is available to chat whenever questions come up. Reach out through our in-app messaging or by phone at 1-800-874-5881.

The U.S. Centers for Disease Control and Prevention (CDC) has updated its guidelines for PrEP, a medication that can lower risk of sexual transmission of HIV by 99% when taken daily. The new guidelines — which will inform local healthcare policies and doctors’ decision-making processes — recommend that healthcare providers share information about PrEP with any patient who is sexually active, and that they prescribe PrEP for any patient who requests it. Here’s what to expect from the changes.

How Updated CDC Guidelines Can Expand PrEP Access

PrEP usage has historically been low despite the medication’s effectiveness. In 2020, just 25% of those who could benefit from PrEP were taking it.

Under the former guidelines, many doctors only shared information about PrEP with patients who presently have multiple partners or a partner who is HIV-positive or unsure of their HIV status. In reality, more people could benefit from PrEP, including those who are single and sexually active.

Under the new guidelines, anyone who is sexually active should receive PrEP information from their healthcare provider, including adolescents. Given that many traditional sex education programs in schools throughout the U.S. aren’t providing LGBTQIA+ youth with the resources they need to stay safe and healthy, the new guidelines are also an important step toward more inclusive sexual education.

Opening up the conversation about HIV prevention to more individuals aligns with what Dr. Lisa Sterman, MD, MPH, shared during a conversation with Alto in October 2020.

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What to Know About Using PEP to Prevent HIV Infection

Spotlight on Men Having Babies & Dr. Guy Ringler

What to Know About Transgender Hormone Therapy Side Effects

What to Know About State-Funded PrEP-DAP Programs

Prioritize Your Health with Preventative Care

How Updated CDC Guidelines Can Expand PrEP Access

Expanded PrEP Access at Pharmacies: What to Know

What a USPSTF “A” Recommendation Means for PrEP Access

Getting PrEP for HIV Prevention at an Affordable Cost

What the COVID-19 Vaccine Means for Those With HIV

What We Know about Injectable PrEP for HIV Prevention

An HIV Prevention Milestone: Truvada Goes Generic

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