PrEP Referral Form

The information collected in this form will only be made available to the HIV Prevention Team at the Utah AIDS Foundation. With your permission, this information can be used to facilitate referral services to qualified medical providers and financial assistance programs. All information is confidential and secured by HTTPS encryption.

Complete the PrEP Form

Educate Your Doctor

If you already have a doctor, download this letter and give it to your doctor. It contains links for Continuing Medical Education and scholarly articles about PrEP designed for healthcare professionals.

pdf Doctors Letter 

PrEP Strategy

Pre-exposure prophylaxis (PrEP) is a strategy used to reduce the risk of HIV infection. It involves taking a pill called Truvada, which contains drugs very similar to those used to treat HIV. Patients take a single pill every day and must schedule regular check ups with a health care provider every three months. A study has shown that PrEP, when used in combination with other prevention strategies and as prescribed, can reduce the risk of HIV infection by 92 percent. PrEP is not a “chemical condom,” it does not reduce the risk of other viral and bacterial infections, it does not prevent unwanted pregnancies, and it may not be widely available. PrEP should not be taken without a prescription; using HIV drugs prescribed to someone else may increase your risk of HIV infection and may negatively impact that person’s health.

What You Need to Know About PrEP

  • PrEP should not be used as the first and only line of defense against HIV. It is only partially effective when used in combination with regular HIV testing, condoms, and other proven prevention methods like reducing sexual partners, lubrication, and non-penetrative sex.
  • PrEP should only be used among individuals who have been confirmed to be HIV negative through an HIV test 3 to 6 months from the last time they had oral, vaginal, anal sex, and/or shared needles to inject any substance.
  • Anyone taking PrEP as part of a prevention plan should be tested every three to six months for HIV. Screening for STI’s should occur more often depending on risk behaviors, the presence of symptoms, and number of sexual partners.
  • PrEP must be obtained and used in close collaboration with a healthcare provider. Taking HIV medications without a prescription, in the wrong combination or dosage, and taking HIV medication belonging to someone else may pose a risk to your health.
  • Never use HIV medication prescribed to another person. Doing so can pose a health risk to you, may increase your risk for HIV, and can compromise the health of the person whose medication you are taking.
  • Taking PrEP daily is critical. The drug is most effective when taken as prescribed. Taking PrEP immediately before a sexual encounter will not protect against HIV infection.
  • PrEP is not for everyone; always consult a doctor before using it.
  • Your insurance provider may not cover the cost of PrEP, and the medication may cost upwards of $1200 for a 30-day supply. We encourage you to review your insurance plan before seeking a prescription for PrEP.
  • If you cannot afford PrEP, Gilead Pharmaceuticals offers a patient assistance program (PAP) which may reduce the cost of the medication. For information regarding the PAP contact the Utah AIDS Foundation or Gilead.

Who might benefit from PrEP?

PrEP has been tested with men who have sex with men, transgender women who have sex with men, and heterosexual women. PrEP may be a useful addition to an HIV reduction strategy for:

  • Is in an ongoing relationship with an HIV-infected partner;
  • Is not in a mutually monogamous relationship with a partner who recently tested HIV-negative; and is a gay or bisexual man who has had sex without a condom or been diagnosed with a sexually transmitted infection within the past six months;
  • Heterosexual man or woman who does not regularly use condoms when having sex with partners known to be at risk for HIV (e.g., injecting drug users or bisexual male partners of unknown HIV status); OR
  • Has, within the past six months, injected illicit drugs and shared equipment or been in a treatment program for injection drug use.

How else can I reduce my risk of HIV infection?

There are a number of ways that you can reduce or eliminate your risk of HIV/STI infection. These include, but are not limited to:

  • Regular use of condoms and lubricant
  • Reducing your number of sexual partners
  • Engaging in non-penetrative sex where fluids are not exchanged and do not enter your body
  • Using a clean needle if you inject substances; using the needle first and not sharing injecting equipment
  • Being the performing (topping) partner during anal sex
  • Being tested with a new sexual partner prior to having sex of any kind