This page is a companion to another page
This page is a companion to another page called "Clinical updates on HIV PrEP for SF providers." This page provides an accessible version of the PrEP regimen selection summary table from that page.Go to main pagePrEP regimen selection summary table
Published November 4, 2026
This table provides a summary of the use scenarios of each PrEP method.
This accessible table is a companion to another page called Clinical updates on HIV PrEP for SF providers.
Oral PrEP
| Use scenarios | Truvada daily | Truvada 2-1-1 | Descovy daily |
|---|---|---|---|
Insertive sex using the penis | Yes | Yes | Yes |
Receptive anal sex | Yes | Yes | Yes |
Receptive vaginal/front-hole sex | Yes | Unknown [1] | Yes |
Protection when sharing injection equipment [2] | Yes | Unknown [2] | Unknown [2] |
Initiate with a dose of two pills [4] | Yes | Yes | Unknown |
Pregnancy | Yes | No [5] | Unknown [6] |
Lactation-feeding | Yes | Yes | Yes |
Safe and effective for use with gender-affirming hormone therapy (no special dosing guidance needed) | Yes | Yes | Yes |
CrCl 30 to 60 [7] | No | No | Yes |
CrCl 15 to <30 [7] | No | No | No |
Osteopenia or osteoporosis | No | No | Yes |
Compatible with gluteal implants and fillers | Yes | Yes | Yes |
Associated with dyslipidemia and weight gain | No | No | Yes |
Drug-drug interactions with common recreational and ED drugs | No | No | No |
Injectable PrEP
| Use scenarios | Cabotegravir IM | Lenacapavir SC |
|---|---|---|
Insertive sex using the penis | Yes | Yes |
Receptive anal sex | Yes | Yes |
Receptive vaginal/front-hole sex | Yes | Yes |
Protection when sharing injection equipment [2] | Unknown [2,3] | Unknown [2,3] |
Initiate with a dose of two pills [4] | Not applicable | Not applicable |
Pregnancy | Yes | Yes |
Lactation-feeding | Yes | Yes |
Safe and effective for use with gender-affirming hormone therapy (no special dosing guidance needed) | Yes | Yes |
CrCl 30 to 60 [7] | Yes | Yes |
CrCl 15 to <30 [7] | Yes | Yes |
Osteopenia or osteoporosis | Yes | Yes |
Compatible with gluteal implants and fillers | Requires evaluation for suitable injection site [8] | Yes |
Associated with dyslipidemia and weight gain | No | No |
Drug-drug interactions with common recreational and ED drugs | No | Yes [9] |
Table footnotes
- 2-1-1 dosing has not been studied for protection during receptive vaginal/front-hole sex. For patients having condomless receptive vaginal/front-hole sex whose only acceptable or feasible PrEP regimen is 2-1-1 PrEP, it may be reasonable to prescribe 2-1-1 PrEP via shared decision-making with clear counseling that effectiveness data are unavailable. Adding one additional dose (2-1-1-1) may help better achieve protective medication levels for vaginal/front-hole protection.
- People who inject drugs may need protection against HIV when having sex, so this panel recommends prescribing the regimen that best fits the patient’s dosing and HIV protection needs. In some cases, this may mean prescribing a regimen proven to protect during sex even if not proven to protect when sharing injection equipment.
- CAB and LEN are currently being studied in people who inject drugs.
- The IAS-USA 2024 Panel recommends a dose of 2 pills of Truvada upon initiation of daily dosing for all, regardless of gender or body parts used for sex, to hasten onset of protection.
- Pregnancy lowers tenofovir levels which could compromise efficacy of 2-1-1 dosing. For this reason, 2-1-1 PrEP is not recommended during pregnancy, regardless of body parts used for sex.
- Stratified efficacy data in pregnancy are not available for Descovy, though PK data are encouraging. For pregnant patients whose only acceptable or feasible PrEP regimen is Descovy, it may be reasonable to prescribe Descovy via shared decision-making with clear counseling that effectiveness data are unavailable.
- CAB and LEN are preferred for patients with significant renal disease given their minimal renal clearance, lack of known nephrotoxicity, and no required dose adjustments for CrCl ≥15 mL/min.
- This clinical update provides more details on how to evaluate for suitable injection site in section “Injection site options (including considerations for patients with fillers or implants)”.
- This clinical update provides more details in section “Drug-drug interactions between LEN and certain common drugs”.
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