Can people who inject drugs use PrEP?

People who inject drugs are eligible for PrEP in many countries. For example, in the United States, the Centers for Disease Control and Prevention recommends PrEP if you have an injection partner living with HIV or you share needles, syringes, or other drug injection equipment. The most common form of PrEP is in pill form containing tenofovir disoproxil and emtricitabine. It’s also available as a long-acting injectable containing cabotegravir.

The only rigorous study testing PrEP efficacy among people who inject drugs took place in Bangkok and was published in 2013. Researchers found that once-daily oral PrEP containing tenofovir (on its own) was effective in preventing HIV among people who inject drugs. When used consistently, PrEP reduced the risk of HIV transmission by at least 74%.

If you are interested in taking PrEP, it is useful to know that it does not alter the pharmacological makeup of methadone, so methadone will still work. For more information on other interactions and possible side effects, visit our pages on PrEP.

Lastly, there may be barriers to PrEP uptake and adherence to consider. Some barriers you may face include concerns about PrEP side effects, other health needs that take priority, negative experiences of health care, HIV-related stigma, and a sometimes burdensome process to obtain PrEP. These vary for each individual and many PrEP providers can assist you with linking to care.