Advocates Benjamin Warren and Michael Scott, gay men’s sexual health coordinator and gay men’s sexual health worker at ACCKWA, respectively, talk through the nuances of disclosing that you’re taking PrEP.

Warren and Scott offer their perspective on the decision to disclose and suggest ways to share if you decide that’s the right path for you.

This interview has been edited for brevity, length, and clarity.

Preexposure prophylaxis (PrEP) is a prescription medication that comes in two forms: a daily oral medication or a long-acting injection. PrEP prevents HIV from establishing itself in the body after exposure, primarily through condomless anal or vaginal sex.

The medication interferes with HIV’s ability to copy itself in the first few days after exposure. This prevents HIV from spreading through the body, and the virus will die. Remember that PrEP only protects against the transmission of HIV, not other STIs [sexually transmitted infections]. That’s why routine STI testing is a part of PrEP care.

PrEP is 99% effective [against getting HIV from sexual contact] when it is taken as prescribed. The HIV-negative person taking PrEP will need to follow the dosing schedule they have arranged with their medical PrEP professional. This could be a daily pill or injected PrEP every 2 months after the initial adherence period and monitoring.

[While the World Health Organization (WHO) has adopted guidelines for on-demand PrEP, it is not yet recommended by the Centers for Disease Control and Prevention (CDC).] There is some evidence for men who have sex with men that utilizing a “2-1-1 (PrEP-On-Demand)” approach is up to 86% effective [in avoiding HIV compared to a placebo]. This involves taking two pills 2–24 hours (24 hours is recommended) before having condomless anal sex, one pill 24 hours after the first dose, and another pill 24 hours after the second dose.

Stigma affects PrEP use in a few ways. Individuals experience barriers to accessing PrEP initially because of HIV stigma, homophobia, and sex negativity. Many people have shared with us that health professionals themselves have made individuals feel shameful about their desire to take PrEP.

In other cases, an individual’s request for PrEP [may be] dismissed because of what the medical professional assumed about their sexual activity or orientation. The health professional did not ask questions or create a safe space for the individual to disclose.

Another way that stigma affects PrEP use is that people on PrEP are often shamed by their peers for “being promiscuous” or “putting themselves at risk” for HIV. Instead, they should be celebrated for taking care of their sexual health and the health of their sexual partners!

While PrEP is a revolutionary step forward for HIV-negative people to prevent transmission of the virus, it can also be stigmatizing for those living with HIV, as they are seen as “vectors of disease” from whom others need protection.

So, we must raise awareness of and increase access to PrEP for all individuals who could get HIV, while also emphasizing and respecting the dignity of those living with HIV and their right to have healthy and active sex lives, too!

A person may decide to disclose they are taking PrEP for different reasons.

They may be at the beginning of their adherence stage, when the medication is not fully effective, and choose to disclose this to a sexual partner(s) so they can negotiate condom use or other safer sex practices in the interim.

Disclosing that they’re taking PrEP is a way to open the door to further conversations about sexual health and safer sex practices with their sexual partner(s). This is a great way to care for one another, no matter the relationship structure. Talking about PrEP can also include talking about condom use, the benefits of routine HIV and STI testing, and your interests and boundaries when it comes to sex.

It’s important to remember that how and when a person decides to disclose that they take PrEP is entirely up to them.

Telling someone you’re taking PrEP is not mandatory. It is private health information that you have every right to keep to yourself if that is what you feel is best for you.

Some individuals may not want to disclose they are on PrEP because they have had negative experiences doing this in the past. Others may feel that they do not want to have the conversation because the sexual partner is a casual one and not someone who will be in their life for long.

Trust your instinct and approach it in a way that works for you.

You could start the conversation by asking the other person what they know about PrEP and HIV. This will give you a better understanding of their knowledge base and allow you to gauge their reaction. Some individuals have negative experiences when disclosing they take PrEP, so we want you to be prepared.

From there, you can share your knowledge of PrEP and maybe teach them a thing or two about the current landscape of HIV prevention.

We always encourage individuals to be open and honest about their sexual health with a partner(s). Asking about each other’s HIV/STI status, the date of their last full-screening tests, their condom use, their sexual positioning preferences, and whether or not they’re taking PrEP are all ways to ensure you have all the information you need to feel safe and confident in the interaction.

Knowledge is power, and this will also provide you the opportunity to set any boundaries and expectations.

We know that talking about anything related to sexual health with anyone can be an awkward and uncomfortable experience for most people. Don’t hesitate to reach out to an HIV/AIDS service organization or sexual health clinic near you. There will always be someone available to help build your capacity and confidence to have these conversations.

PrEP is an incredibly effective HIV prevention tool and one that has been well-documented and studied over the past two decades. To learn more about it, see:

Note that PrEP can be taken for a short or long period of time — it is completely up to you and your medical team! Even if you are someone who is not highly likely to get HIV, taking PrEP can be a great way to ease your mind and anxiety when it comes to HIV and allow you to have the sex you want to have.

Remember: PrEP only protects against HIV transmission, not other STIs. Routine testing and condom/barrier use is still encouraged while taking PrEP.

If you have questions or concerns about PrEP, reach out to knowledgeable organizations for support and information. We will always make time for you and ensure you have all of the resources you need to make the best and most informed decisions for yourself when it comes to HIV prevention.

Michael Scott (left) is a gay men’s sexual health worker at the AIDS Committee of Cambridge, Kitchener, Waterloo and Area (ACCKWA). He is a passionate sexual health advocate and navigates the intersection of personal experience and academic achievement as he approaches the completion of his public health degree. His unique perspective as a gay man propels him to bridge the gap between academia and community outreach, fostering collaborative relationships and ensuring health standards are met. With a vision to translate his skills into a role as a public health inspector, he emerges as a force ready to contribute significantly to community health standards and overall well-being.

Benjamin Warren (right) is the Gay Men’s Sexual Health Coordinator at ACCKWA. He is a registered social service worker supporting gay, bisexual, and other men who have sex with men in Waterloo Region, Ontario to prevent HIV and other sexually transmitted infections (STIs). He is a gay man and is committed to providing comprehensive and holistic sexual health services to his community members.