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Pre-Exposure Prophylaxis (PrEP) is a revolutionary HIV prevention strategy that has transformed the landscape of sexual health. By taking a daily pill containing antiretroviral medication, individuals at high risk of HIV infection can significantly reduce their chances of contracting the virus. 

While PrEP has been hailed as a breakthrough in HIV prevention, its use has raised questions about potential side effects, including its impact on mental health.

This article explores the relationship between PrEP and depression, shedding light on the available evidence and offering insights into the experiences of individuals who have used this prevention method. 

The Science Behind PrEP

PrEP works by blocking the HIV virus from entering and replicating in the body. There are two different medications that are used for PrEP: tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC). These medications are taken as a single pill once a day.

TDF and FTC work by blocking different enzymes that the HIV virus needs to replicate. TDF blocks an enzyme called reverse transcriptase, while FTC blocks an enzyme called integrase. Without these enzymes, the HIV virus cannot replicate and make more copies of itself.

When PrEP is taken orally, it is absorbed into the bloodstream through the digestive tract. The medications then travel to the body’s tissues, where they build up over time. When PrEP is at a high enough level in the tissues, it can block the HIV virus from entering and replicating.

PrEP is not immediately effective at preventing HIV infection. It takes about 7 to 20 days for the medications to build up to a high enough level in the tissues to be effective. This is why it is important to start taking PrEP before engaging in sexual activity that puts you at risk for HIV infection.

The Link Between PrEP and Depression: What Does the Research Say?

The short answer is that PrEP itself does not cause depression. PrEP is a medication designed to prevent HIV infection, and its primary function is to inhibit the replication of the virus in the body. However, it is possible for individuals to experience symptoms of depression while taking PrEP.

Depression is a multifaceted condition influenced by various factors, including genetics, life experiences, and other underlying medical conditions. While PrEP may not directly lead to depression, its use can intersect with these contributing factors.

Side Effects of PrEP That May Mimic Depression

Side effects of PrEP that resemble symptoms of depression can be distressing and confusing for individuals using this preventive medication. It’s essential to recognize these potential side effects and understand how they might manifest.

PrEP users may experience fatigue or a general sense of tiredness. This side effect can lead to a lack of motivation and decreased interest in daily activities, which are common symptoms of depression.

Concentration can also be impaired in both depression and due to some PrEP side effects. Individuals may struggle to focus, make decisions, or stay organized.

Anhedonia, or the loss of interest in activities that were once enjoyable, is also a hallmark symptom of depression. Some PrEP users might find themselves experiencing a decreased interest in hobbies or activities they used to relish.

Moreover, PrEP users might encounter disruptions in their sleep patterns or changes in appetite, which are also associated with depressive disorders. These changes can contribute to feelings of exhaustion and irritability.

It’s important to emphasize that experiencing depression while taking PrEP does not mean that PrEP is the direct cause of the condition. Rather, it underscores the need for a comprehensive and individualized approach to mental health. 

Individuals who experience symptoms of depression should seek support from mental health professionals who can assess their unique circumstances, provide guidance, and develop appropriate treatment plans if necessary.

Exploring the Psychological Impact of PrEP

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PrEP usage doesn’t just affect physical health; it has profound psychological implications. To understand this impact, we need to explore the multifaceted aspects of mental health, including emotions, attitudes, and experiences that individuals may encounter while using PrEP.

1. Anxiety and Empowerment 

For many individuals, the decision to start PrEP may be rooted in a genuine concern about HIV risk. This concern can manifest as anxiety or fear, especially among those who are sexually active with partners of unknown HIV status or engage in behaviors with higher transmission risks. 

However, PrEP also provides a sense of empowerment. Knowing that there’s a tool available to reduce HIV risk can alleviate anxiety and contribute to a more positive outlook on one’s sexual health.

2. Stigma and Disclosure

PrEP users often navigate the stigma associated with HIV and AIDS. Some individuals may experience discomfort or judgment from peers, partners, or even healthcare providers due to their PrEP use. 

The need to disclose PrEP use to sexual partners can also be challenging. This can involve discussions about sexual practices, perceived promiscuity, and potential misunderstandings about PrEP’s purpose. These conversations can be emotionally taxing, leading to feelings of isolation or vulnerability.

3. Sexual Health and Intimacy

PrEP can profoundly impact an individual’s perception of their sexual health and intimacy. While it offers protection against HIV, it doesn’t guard against other sexually transmitted infections (STIs). This duality can lead to complex emotions. 

PrEP users must still engage in open conversations about safer sex practices, including condom use and regular STI testing, to maintain their overall sexual health. Negotiating these discussions with partners and maintaining intimacy can be emotionally taxing for some.

4. Confidence and Peace of Mind

On a more positive note, PrEP can boost individuals’ confidence in their sexual health decisions. By taking control of their HIV risk, users may experience peace of mind, which can enhance overall well-being.

This psychological benefit is particularly significant for individuals who have faced anxiety or distress related to the fear of HIV infection in the past.

5. Adherence and Routine

The daily routine of taking PrEP can either be a source of stability or a reminder of potential risks. For some, the act of taking a daily pill reinforces a sense of responsibility for their health and adherence to the regimen.

However, others may find it a daily reminder of their perceived vulnerability to HIV, which can lead to heightened anxiety.

Navigating PrEP: The Role of Informed Decision-Making

Informed decision-making is a cornerstone of healthcare, especially when it comes to matters as personal and significant as sexual health. When considering the use of Pre-Exposure Prophylaxis (PrEP), individuals should have access to comprehensive and unbiased information about its various aspects. 

1. Understanding the Benefits: Individuals should first be informed about the primary purpose of PrEP, which is to prevent HIV infection. They need to understand that when taken consistently and correctly, PrEP is highly effective at reducing the risk of contracting HIV.

This knowledge can empower individuals to make an informed choice about whether PrEP aligns with their sexual health goals.

2. Potential Side Effects: Like any medication, PrEP may come with potential side effects. Individuals must be aware of these side effects, which can include gastrointestinal discomfort or changes in kidney function.

While side effects are generally mild and temporary, individuals should discuss any concerns with their healthcare provider.

3. Adherence: The effectiveness of PrEP hinges on adherence, meaning individuals must take it daily as prescribed.

It’s crucial to communicate the importance of consistent use and discuss strategies to help users remember to take their medication. Healthcare providers can offer advice on incorporating PrEP into daily routines.

4. Regular Testing: While on PrEP, individuals should continue to engage in regular testing for HIV and other sexually transmitted infections (STIs). This ensures that they are protected against HIV and can address any potential STIs promptly. Knowing the recommended testing schedule is essential for users.

5. Open Communication: Establishing open and honest communication with a healthcare provider is key. Individuals should feel comfortable discussing their sexual practices, concerns, and any issues related to PrEP. This dialogue allows healthcare providers to offer personalized guidance and support.

6. Cost and Accessibility: Individuals should be aware of the cost of PrEP and whether it’s covered by their insurance or available through assistance programs. Access to affordable PrEP is crucial to its successful use, and individuals should explore their options.

7. Alternatives and Additional Measures: PrEP is not the only HIV prevention method available. Individuals should be informed about other options, such as condom use and Post-Exposure Prophylaxis (PEP).

Additionally, they should understand that PrEP does not protect against other STIs, so the use of condoms remains essential for comprehensive sexual health protection.

Mitigating Potential Risks: Strategies for PrEP Users

While research on the link between PrEP and depression continues, it’s essential for individuals using PrEP to be proactive in maintaining their mental health. There are a few things you can do to reduce the risk of depression while taking PrEP:

1. Regular Exercise: Engaging in physical activity is not only beneficial for your physical health but also for your mental well-being. Exercise releases endorphins, which are natural mood lifters.

Establishing a regular exercise routine can help reduce the risk of depression and anxiety. Consider activities that you enjoy, whether it’s jogging, dancing, yoga, or team sports.

2. Healthy Diet: Proper nutrition plays a significant role in mental health. A balanced diet that includes a variety of fruits, vegetables, lean proteins, and whole grains provides essential nutrients that support brain function.

Omega-3 fatty acids found in foods like salmon, walnuts, and flaxseeds have been linked to improved mood and cognitive function.

3. Adequate Sleep: Quality sleep is vital for mental well-being. Ensure you get the recommended 7-9 hours of restful sleep per night. Establish a sleep routine, avoid caffeine and screens before bedtime, and create a comfortable sleep environment to enhance the quality of your sleep.

4. Stress Management: Chronic stress can contribute to depression and anxiety. Learning effective stress management techniques such as mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help you cope with stress more effectively.

5. Substance Avoidance: Alcohol and recreational drugs can exacerbate mental health issues and interact with medications like PrEP. Reducing or eliminating substance use can significantly benefit your mental health. If you’re struggling with substance abuse, seek support from a healthcare provider or counselor.

6. Social Support: Maintaining connections with friends, family, or support groups can be invaluable in preventing and managing depression. Sharing your concerns and feelings with trusted individuals provides emotional support and reduces feelings of isolation.

7. Pre Existing Depression: If you have a history of depression or other mental health conditions, it’s essential to have an open and honest conversation with your healthcare provider before starting PrEP.

They can work with you to develop a personalized plan that includes regular mental health check-ins and strategies to monitor and manage your mental well-being effectively.

Additionally, accessing mental health resources, such as therapy or counseling, can be an integral part of managing your mental health while using PrEP.

Discussing your concerns with a mental health professional can provide you with the tools and support necessary to navigate any emotional challenges that may arise during your PrEP journey.


While questions have arisen about the potential connection between PrEP and depression, the current body of evidence suggests that PrEP alone is not a direct cause of depression. Extensive research and clinical studies have failed to establish a causal link between the two. 

It is essential to recognize that any mental health challenges experienced while using PrEP may be influenced by various factors, including pre existing conditions and psychosocial aspects.

Decisions regarding PrEP use should be made in consultation with professionals, who can provide guidance on maintaining mental well-being while using this HIV prevention method.


1. Can PrEP interact with medications for depression?

PrEP medications primarily interact with antiretroviral drugs used to treat HIV. However, it’s essential to inform your healthcare provider about any medications you’re taking, including those for mental health, as they can provide guidance on potential interactions.

2. Are there alternative HIV prevention methods for those concerned about depression risk with PrEP?

Yes, alternative methods such as condoms, regular HIV testing, and discussing the risks and benefits of PrEP with a healthcare provider can be explored. Each individual’s situation is unique, and a healthcare professional can help determine the most suitable prevention approach.

3. Is PrEP covered by insurance plans?

Many insurance plans, including Medicaid, cover the cost of PrEP. However, coverage may vary, so it’s advisable to check with your insurance provider or consult with a healthcare navigator to explore options for financial assistance if needed.

4. Can PrEP be used as a long-term prevention strategy?

PrEP can be used for extended periods as long as it aligns with an individual’s risk factors and sexual health goals. Regular discussions with a healthcare provider are essential to reassess its continued suitability.

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  4. Can TRT Cause Depression
  5. How to Deal With Dui Depression



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