You have access to the most significant advances in the treatments of the human immunodeficiency virus (HIV) along with cutting-edge prevention strategies right here at Tufts Medicine. While there is no cure for HIV, we work with you so that you can get back to living a longer and healthier lifestyle, in some cases, without evidence of the disease.
Providing all the medical services you need
Our community is close-knit, welcoming and private. Whether you are recently diagnosed with HIV or AIDS, considering HIV prevention strategies, or have been living with HIV for some time, we treat you like family. We provide comprehensive resources, including HIV Primary Care to support you at every stage—from prevention to diagnosis to long-term care—helping you determine the best care plan for your needs, including timing and frequency.
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Understanding HIV risk and transmission
Some risk factors for HIV include unprotected sex, previous sexually transmitted infections (STI), or IV drug use, or transmission during birth from a mother with HIV. Regular STI screenings and education are essential for prevention and treatment, even if you have no symptoms.
It is essential to understand that HIV cannot be spread through casual contact such as kissing, hugging or sharing food. Only exposure to bodily fluids (blood, semen, vaginal fluid or breast milk) from an infected person puts you at risk.
Pre-exposure prophylaxis (PrEP): Preventing HIV before exposure
What is PrEP?
Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention strategy for people who do not have HIV but may be at risk of exposure. PrEP involves taking medication before potential exposure to HIV to significantly reduce your chances of becoming infected. When taken as prescribed, PrEP is extremely effective—reducing the risk of getting HIV from sex by about 99% and from injection drug use by at least 74%.
At Tufts Medicine, we provide comprehensive PrEP education, prescription and monitoring services as part of our commitment to ending the HIV epidemic. We have both oral and long acting injectable options for prevention. Our team will partner with you to determine if PrEP is right for you and support you throughout your journey.
Who should consider PrEP?
The CDC recommends that healthcare providers inform all sexually active adults and adolescents about PrEP and prescribe it to anyone who requests it. You may benefit from PrEP if you:
Have had anal or vaginal sex in the past 6 months and you:
- Have a sexual partner with HIV (especially if the partner has an unknown or detectable viral load)
- Have not consistently used a condom
- Have been diagnosed with a sexually transmitted infection (STI) in the past 6 months
Inject drugs and you:
- Have an injection partner with HIV
- Share needles, syringes or other drug injection equipment
Have been prescribed PEP (post-exposure prophylaxis) and you:
- Continue to have ongoing HIV risk
- Have used multiple courses of PEP
Are pregnant, planning pregnancy or breastfeeding and have any HIV risk factors
Important: You may choose to take PrEP even if the behaviors listed above don't apply to you. At Tufts Medicine, we respect your choice and will prescribe PrEP to anyone who asks for it.
PrEP medication options
There are several FDA-approved PrEP options available, and our team will help you choose the one that best fits your lifestyle and preferences:
Daily oral PrEP
Oral PrEP consists of a single pill taken once daily. These medications have been extensively studied and have established long-term safety profiles.
Long-acting injectable PrEP
Available in options including every 2 months option or every 6 months option.
Is PrEP safe?
PrEP is very safe. Studies show no significant health effects in people who are HIV-negative and have taken PrEP for up to 5 years.
Common side effects
Most people taking PrEP have no or minimal side effects. When side effects do occur, they are usually mild and temporary. Tell your doctor if you experience any side effect that bothers you or doesn't go away. We're here to support you and can adjust your treatment plan if needed.
HIV prevention (PrEP/PEP)
We provide comprehensive HIV prevention services including pre-exposure prophylaxis (PrEP) for ongoing prevention and post-exposure prophylaxis (PEP) for emergency situations. Our team will help you choose the right prevention strategy for your circumstances.
Conditions
HIV is a disease that requires a lifetime of care, and we will be with you every step of the way, providing for all your HIV-related medical needs. We also provide comprehensive prevention services including PrEP for you or your loved ones. We will partner with you to determine what care you need, when and how often.
HIV (human immunodeficiency virus)
HIV attacks the body's immune system and interferes with its ability to fight infections and diseases. You may not show symptoms, but getting tested is the only way to identify the infection. Early detection and treatment can help you live a long, healthy life.
AIDS (acquired immunodeficiency syndrome)
AIDS is the late stage of HIV infection that occurs when the body's immune system is badly damaged by the virus. With modern HIV treatment, progression to AIDS can often be prevented.
Testing
The only way to know if you have HIV is to get tested. You should get tested if you have certain risk factors, are sexually active, have a suppressed immune system or solid organ transplant, think you have had an exposure or have shared needles or drug equipment. Testing for HIV is easy and involves 3 simple steps:
- Antigen/antibody test: Blood test in a lab or finger prick for a rapid test that can detect HIV earlier than antibody tests alone
We offer confidential HIV testing at all our locations. Testing is quick, often with results available the same day for rapid tests. If you test positive, our team is here to support you immediately with treatment and care coordination.
Treatments
Living with HIV can be challenging, but there's hope. Thanks to significant advancements in treatments, patients with HIV can lead healthy lives with normal life expectancies. Our team understands the impact of this condition on your well-being, and we're here to support you every step of the way.
We'll work closely with you to determine the best care plan, taking into account your unique needs and any complications. Our goal is to provide you with the highest level of care, from prevention to diagnosis to treatment, no matter how complex your case may be.
Comprehensive HIV care services
Our specialists collaborate to make sure you receive all the necessary services at the right time. We'll be here for you, monitoring your response to treatment and providing extensive support in all areas, including:
- Antiretroviral therapy (ART): Modern HIV medications that can reduce the virus to undetectable levels
- Clinical nutrition: Nutrition counseling to support your overall health
- Infectious disease management: Expert care for HIV and related infections
- Behavioral health: Mental health support and counseling
- Dental care: Comprehensive oral health services
- Social work services: Help with insurance, housing, transportation and other social needs
- Integrative therapies: Complementary approaches including acupuncture
- Vaccinations: Immunizations to protect against preventable diseases
- Sexual health services: STI testing, treatment and prevention including PrEP
We also provide screening and treatment of anal precancerous lesions caused by human papillomavirus (HPV), a sexually transmitted infection that requires specialized care.
U=U: Undetectable = Untransmittable
When HIV treatment reduces the virus to undetectable levels in your blood, you cannot sexually transmit HIV to others. This is called U=U (Undetectable = Untransmittable). This groundbreaking finding means effective treatment protects both your health and prevents transmission to partners.
FAQs
What is some of the misinformation surrounding HIV + AIDS?
HIV can only be shared from infected blood, semen, vaginal fluid or breast milk. Important facts to know:
- You cannot tell if someone has HIV by just looking at them.
- HIV can affect anyone and not just people of certain sexual orientations.
- You cannot get HIV if you use the same utensil or drink from a water fountain, hug, kiss or shake hands, or even use exercise equipment at the gym.
- You cannot get HIV from insect bites.
- Even if you are on HIV treatments and have an undetectable viral load (U=U), you should still practice safe sex to protect against other STIs.
- PrEP does not cause HIV—it prevents HIV infection in people who do not have the virus.
Can women who have HIV still get pregnant?
Yes! With proper treatment and the guidance of a specialist, HIV-positive women can give birth without transmitting HIV to their babies. With appropriate antiretroviral therapy during pregnancy and childbirth, and sometimes for the newborn, the risk of mother-to-child transmission can be reduced to less than 1%. Our team works closely with obstetric specialists to ensure the best outcomes for both mother and baby.
What should I do if I think I've been exposed to HIV?
If you've had a possible exposure to HIV in the last 72 hours, go to the nearest emergency room to discuss PEP (post-exposure prophylaxis). PEP is most effective when started within 24 hours of exposure and must be started within 72 hours. Time is critical for PEP to work effectively.
PrEP FAQs
How quickly does PrEP start working?
For receptive anal sex, daily oral PrEP reaches maximum protection in about 7 days. For receptive vaginal sex and injection drug use, it takes about 21 days. Injectable PrEP provides protection 7 days after the first injection. Your doctor will discuss the specific timeline for your situation.
Do I still need to use condoms if I'm on PrEP?
PrEP is highly effective at preventing HIV, but it does not protect against other sexually transmitted infections (STIs) or pregnancy. We recommend using condoms along with PrEP for the most comprehensive protection. During your visits, we provide STI screening, treatment and condoms as part of your care.
What happens if I miss a dose of oral PrEP?
If you miss a dose, take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and continue with your regular schedule. Don't double up doses. Missing occasional doses may reduce protection, so discuss any adherence challenges with your doctor—we can help find solutions.
Can I stop PrEP if my risk changes?
Yes, PrEP is designed to be flexible. You can stop PrEP when you no longer need it, and you can restart it if your risk increases. It's important to discuss any changes with your doctor to ensure safe discontinuation and timing, especially if you have hepatitis B.
Can I take PrEP if I'm pregnant, planning pregnancy or breastfeeding?
Yes! PrEP can help protect both you and your baby from HIV. Oral PrEP has been safely used during pregnancy and breastfeeding. We'll work closely with you and, if needed, your OB/GYN to ensure the best care for you and your baby.
Will taking PrEP affect my ability to get pregnant or impact my sexual function?
No. PrEP does not affect fertility, sexual function or sexual desire in any way. It's simply a preventive medication that protects against HIV.
Is my PrEP care confidential?
Absolutely. All your medical care at Tufts Medicine, including PrEP services, is completely confidential and protected by HIPAA privacy laws. We respect your privacy and provide care in a welcoming, nonjudgmental environment.
How often do I need to be tested if I'm on PrEP?
You'll need HIV testing every 3 months while on oral PrEP, or on the day of each injection for injectable PrEP. Regular testing ensures PrEP is working and allows us to detect any issues early. We also recommend regular STI screening and kidney function monitoring as part of comprehensive PrEP care.
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