PrEP is primary care

PrEP (pre-exposure prophylaxis) is medication that keeps HIV-negative people from getting HIV. Taken as prescribed, it is one of the most effective prevention tools in all of medicine. Today there are four FDA-approved options, from a daily pill to an injection just twice a year.

At Aristos Internal Medicine in Spokane, we treat PrEP the way we treat blood pressure, cholesterol, or vaccines: as routine preventive care. You don’t need a specialty clinic, a referral, or a long explanation. You need a doctor who knows the options, orders the right labs, and follows up.

And you need to be able to talk openly. Your sex life, your partners, and your history are medical information, and nobody here will judge you for them. Whoever you are and whatever brings you in, you’ll get straightforward, patient-centered care.

Who should consider PrEP?

If you’re sexually active, you should know PrEP exists, and it’s reasonable to ask about it. You don’t have to “qualify” by fitting a stereotype. PrEP is worth a conversation if any of these apply:

• You have a partner who is living with HIV, especially if their viral load isn’t confirmed undetectable
• You have sex without condoms with partners whose HIV status you don’t know
• You’ve had a recent sexually transmitted infection (STI), such as syphilis or gonorrhea
• You’ve used PEP (post-exposure prophylaxis) more than once
• You inject drugs or share injection equipment
• You simply want extra peace of mind about HIV

The 4 PrEP options compared

All four options are highly effective when used as prescribed. The real differences are how often you take them, who they’re approved for, and what fits your life.

	Generic Truvada (TDF/FTC)	Descovy (TAF/FTC)	Apretude (cabotegravir)	Yeztugo (lenacapavir)
How it’s taken	Pill by mouth	Pill by mouth	Injection in the buttock	Injection under the skin of the belly
How often	Once daily	Once daily	Every 2 months (after 2 starter shots 1 month apart)	Every 6 months (after a short starter dose)
FDA approved for PrEP	2012	2019	2021	2025
Approved for	Adults and teens at risk through sex; also the option recommended for people who inject drugs	Adults and teens at risk through sex, except receptive vaginal sex	Adults and teens at risk through sex	Adults and teens at risk through sex
Biggest advantage	Low-cost generic; longest track record	Easier on kidneys and bones	No daily pill	Just two visits a year
Main trade-offs	Daily adherence; can affect kidneys and bone density	Daily adherence; may raise weight and cholesterol slightly	Visits every 2 months; injection-site soreness	Newest option; nodules or soreness at injection site; cost and insurance approval

Option 1: Generic Truvada (tenofovir disoproxil fumarate/emtricitabine)

The original PrEP pill, now available as an inexpensive generic. It has more than a decade of real-world safety data, and it’s the PrEP option CDC clinical guidance recommends for people who inject drugs. We check kidney function before you start and periodically while you take it. Some men who have sex with men use an off-label “on-demand” (2-1-1) schedule around sex instead of daily dosing. It isn’t right for everyone, so ask us if it interests you.

Option 2: Descovy (tenofovir alafenamide/emtricitabine)

A newer daily pill with less effect on kidney function and bone density. It’s a good choice if you have kidney concerns or osteoporosis risk. It is not approved for people whose risk comes from receptive vaginal sex, because it hasn’t been studied enough in that group.

Option 3: Apretude (injectable cabotegravir)

A shot every two months, given in our office. It removes the need to remember a daily pill, which is the most common reason oral PrEP fails. You’ll get two starter injections one month apart, then one every two months, with an HIV test at each visit.

Option 4: Yeztugo (injectable lenacapavir)

The newest option, approved by the FDA in June 2025. After a starter dose (injections plus tablets on days 1 and 2), you need just two injections a year. In its two large clinical trials, 99.9% of participants on Yeztugo stayed HIV-negative. For many people, twice-yearly PrEP is as close to “set it and forget it” as prevention gets.

How to choose the right PrEP for you

The best PrEP is the one you’ll actually stay on. A few quick rules of thumb:

• Want the lowest cost and a proven track record? Generic Truvada.
• Have kidney or bone health concerns? Descovy.
• Hate remembering a daily pill? Apretude or Yeztugo.
• Want the fewest appointments possible? Yeztugo.
• Have receptive vaginal sex? Generic Truvada, Apretude, or Yeztugo.
• Inject drugs? Generic Truvada.

We’ll walk through these with you, check what your insurance covers, and pick the option that fits your health and your schedule. You can switch later if your needs change.

What PrEP care looks like at Aristos Internal Medicine

PrEP care here is simple and private. It’s handled by a board-certified internal medicine physician who gets to know you and follows you over time.

1. A judgment-free first visit. We talk about your goals, your health history, and which option fits. No lectures.
2. Baseline labs. An HIV test (required before starting), kidney function, hepatitis B screening, and STI testing as appropriate.
3. Start your PrEP. A prescription for oral PrEP, or your first injection scheduled in the office.
4. Regular follow-up. HIV and STI testing every 2 to 3 months for pills and Apretude, or at each Yeztugo visit, plus routine kidney checks when needed.
5. Whole-person primary care. While you’re here, we can also handle vaccines (hepatitis A and B, HPV, mpox), blood pressure, weight, and everything else on your list.

Cost and coverage. Under federal preventive-care rules, most insurance plans cover PrEP medication and the related labs and visits with no out-of-pocket cost. Washington residents who need help paying may qualify for the state’s PrEP Drug Assistance Program (PrEP DAP), which helps pay for generic PrEP medication, PrEP-related visits, and PrEP labs for people who meet its income guidelines.

Privacy. Your sexual health is your business. If you’re on a Washington-regulated health plan, you can ask your plan to keep sensitive services confidential, so explanation-of-benefits notices go to you instead of the policyholder.

PrEP FAQs

Do I need to see an HIV specialist to get PrEP?

No. PrEP is routine preventive care, and primary care doctors prescribe it every day. You can start PrEP right here in Spokane.

How effective is PrEP?

When taken as prescribed, PrEP is extremely effective at preventing HIV from sex. Most PrEP failures come from missed doses, which is why long-acting injections appeal to many people.

Does PrEP protect against other STIs?

No. PrEP prevents HIV only. Condoms and regular STI testing still matter, and we include STI screening in your PrEP follow-up.

Is PrEP covered by insurance?

Most plans cover PrEP as preventive care with no copay. Coverage for injectable options can require prior authorization, which our office handles.

What if I’m already on PrEP somewhere else?

We’re happy to take over your PrEP prescription and follow-up. Bring your most recent lab results if you have them.

Will you judge me for asking?

No. Asking about PrEP means you’re taking your health seriously. That’s exactly what primary care is for.

Start PrEP in Spokane

Ready to talk about PrEP? Schedule a visit with Dr. Kyle Varner at Aristos Internal Medicine, 42 E. Rowan Ave, Suite B, Spokane, WA 99207, or call (509) 426-5425. We’ll help you choose the right option, handle the insurance paperwork, and keep you protected with care that’s straightforward and judgment-free.

Sources

• Gilead Sciences. Yeztugo (lenacapavir) FDA approval announcement. June 18, 2025.
• Washington State Department of Health. Pre-Exposure Prophylaxis Drug Assistance Program (PrEP DAP).
• Centers for Disease Control and Prevention. PrEP considerations for different patient populations.
• Washington State Office of the Insurance Commissioner. Health information and your privacy.
• Featured image: photo by cottonbro studio on Pexels.