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5 Reasons Straight People Should Talk About PrEP

Medically reviewed by Marie Dorsey, Pharm.D., BCPS, AAHIVP
Written by Anika Brahmbhatt
Posted on May 16, 2024

If you or a loved one has human immunodeficiency virus (HIV), you might have heard about preexposure prophylaxis (PrEP). This medication is prescribed to HIV-negative people to prevent them from contracting HIV.

When the U.S. Food and Drug Administration (FDA) first approved PrEP for HIV in 2012, the preventive treatment was mainly marketed toward the LGBTQ+ community. Because of this, PrEP has mostly been talked about among members of the queer community. However, it’s important to note that people of all genders and sexual orientations, including people who are heterosexual (straight), can be affected by HIV and might benefit from PrEP use.

You might consider starting the medication for many reasons, such as if you:

  • Sometimes have sex without a condom
  • Have multiple partners
  • Have a sexual partner who has multiple partners
  • Don’t know whether your partner has HIV
  • Are having sex with someone who is HIV-positive and aren’t sure if their viral load has been undetectable for at least six months in a row
  • Have had a sexually transmitted infection (STI) in the past six months
  • Sometimes have unprotected sex with a partner who injects drugs
  • Are trying to get pregnant and your partner is HIV-positive

If you’re unsure about your risk factors and whether PrEP might be helpful for you, you should talk with a health care provider. Being open and honest about your questions, concerns, and lifestyle factors is the best way to get the most helpful guidance.

Even if you identify with a group that isn’t usually thought of as high risk for HIV, your questions and concerns are valid. Read on to learn more about why straight people can and should talk about PrEP.

1. Lack of Awareness Can Keep People From Getting Tested

Increasing awareness is the first step toward getting rid of the stigma around PrEP, HIV, and AIDS.

Believing that heterosexual people aren’t at risk of HIV infection can be dangerous. This misconception may cause people to think they don’t need to get tested when they might have been exposed to the virus.

A 2022 report from England found that heterosexual people were much more likely to be diagnosed with later-stage HIV than gay or bisexual men, meaning their immune system had already started to be compromised by the time they got their diagnosis.

Open discussions about HIV transmission and testing can help ensure everyone knows their HIV status sooner rather than later. This can help encourage people who have heterosexual sexual partners to openly discuss HIV prevention and PrEP.

If you test positive for HIV, treatments are available. Antiretroviral therapy (ART) — a type of HIV treatment — can keep someone’s viral load “undetectable.” This means that the amount of HIV in your body is too low to transmit to an HIV-negative partner through sex. HIV-positive people who get these treatments can live long, healthy lives with fulfilling partnerships and intimate relationships.

2. It’s a Myth That Straight People Don’t Get HIV

Although HIV still disproportionately affects men who have sex with men, more heterosexual people have been reporting diagnoses in recent years. For example, the report from England found that 49 percent of new HIV diagnoses were among straight people, as opposed to 45 percent among gay and bisexual men.

In 2021, more than one-fifth of new HIV cases involved people who had reported heterosexual contact, according to the Centers for Disease Control and Prevention (CDC). Women made up 16 percent of these cases, and men made up 6 percent.

Even if you don’t think you’re part of a high-risk population, you should be aware of the factors that can increase your chances of getting HIV. If you want more information about your potential risk, you can start by accessing the CDC’s HIV Risk Reduction Tool. Keep in mind that only a medical provider familiar with your case can offer advice specific to your own life circumstances.

3. Preexposure Prophylaxis Is Safe and Effective for Preventing HIV

PrEP is extremely effective at preventing sexually transmitted HIV infection. When taken as prescribed, PrEP reduces the risk of infection in these cases by 99 percent. PrEP also reduces the risk of getting HIV from injecting drugs by at least 74 percent. Like any medication, PrEP is less effective if you don’t follow your doctor’s instructions, such as if you skip doses.

The amount of time that passes between starting PrEP and when the medication becomes most effective depends on the kinds of activities you engage in. For receptive anal sex (bottoming), protection usually reaches its peak efficacy after seven days of consistently taking PrEP. For receptive vaginal sex and use of injection drugs, maximum protection usually takes 21 days.

PrEP can sometimes cause side effects, including:

  • Diarrhea
  • Nausea
  • Headache
  • Fatigue
  • Stomach pain

Side effects typically go away after regular use of the medication. Make sure to talk to your doctor if you have long-lasting or severe side effects, and bring up any concerns you have about your treatment.

The FDA has approved three PrEP medications. Emtricitabine/tenofovir disoproxil fumarate (Truvada) and emtricitabine/tenofovir alafenamide (Descovy) are pills. Cabotegravir (Apretude) is a shot. Your doctor can help you understand which option is right for you.

4. Preexposure Prophylaxis Can Be Taken During Pregnancy and Breastfeeding

Using PrEP can help protect a baby against HIV infection before birth. If the pregnant person has HIV, they can take ART medication to prevent passing HIV to their child. If the pregnant person is a partner of someone who has HIV, they can keep taking PrEP and continue while breastfeeding at little to no risk to the baby.

Doctors recommend that people continue with PrEP if they’re having receptive vaginal sex with an HIV-positive partner. If you’re pregnant, don’t stop taking PrEP before talking to your doctor.

Also, it’s important to note that there’s no evidence that PrEP affects fertility. If you’re on PrEP and you or your partner is trying to get pregnant, talk with your doctor.

5. Talking About HIV Status Encourages Open Communication

Talking about STIs, especially HIV, can be difficult when you’re dating or starting a new relationship. However, it’s important to talk openly with a partner about your HIV status and how you both plan to stay safe.

It’s normal to feel nervous during these conversations, especially if you’re with an HIV-negative partner who hadn’t thought they could be part of an at-risk group. Even if it’s an unexpected topic, talking about your status and STI testing can help your partner learn more about HIV and their risk as a straight person.

Your status is your information to share when you feel ready, but keep in mind that certain states and countries require HIV disclosure. Make sure you have a strong support system in place, whether that aspect of self-care means talking about your concerns with trusted loved ones, others who know what you’re going through, or a mental health specialist.

Talk With Others Who Understand

On myHIVteam, the social network for people with HIV and their loved ones, more than 41,000 members come together to ask questions, give advice, and share their stories with others who understand life with HIV.

Are you a straight person living with HIV, and have you encountered myths about who can or can’t get HIV? What information about HIV testing, HIV prevention, and overall sexual health do you wish more people knew? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on May 16, 2024
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Marie Dorsey, Pharm.D., BCPS, AAHIVP is currently a clinical pharmacist at Bridgewell Medical, specializing in medication therapy management and holds a certification as an HIV pharmacist through the American Academy of HIV Medicine. Learn more about her here.
Anika Brahmbhatt is an undergraduate student at Boston University, where she is pursuing a dual degree in media science and psychology. Learn more about her here.

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