When it comes to preventing HIV, two of the most widely recognized options are PrEP (Pre-Exposure Prophylaxis) and condoms. Both offer powerful protection, but they work in different ways and come with their own advantages and considerations. With HIV still a major global health concern, understanding the effectiveness of each method is essential for making informed decisions about sexual health. In this blog, we’ll explore how PrEP and condoms compare in terms of HIV prevention, examine their pros and cons, and help you determine which option might be best for your lifestyle and needs.
In This Blog:
- Understanding PrEP
- Understanding Condoms
- Comparing Effectiveness
- Pros and Cons of Each Method
- Can They Be Used Together?
- Choosing the Right Method for You
Understanding PrEP
PrEP, short for Pre-Exposure Prophylaxis, is a prescription medication taken by individuals who are HIV-negative to reduce their risk of contracting the virus. When taken consistently, PrEP can lower the risk of getting HIV from sex by about 99%, making it one of the most effective prevention methods available. There are currently two FDA-approved PrEP medications: Truvada and Descovy. Truvada is approved for all at-risk individuals, while Descovy is approved for men who have sex with men and transgender women.
PrEP works by maintaining a level of antiretroviral medication in the bloodstream that blocks HIV from taking hold and spreading in the body. It is available in two forms: a daily pill and a long-acting injectable (Apretude) administered every two months. To be most effective, PrEP requires a commitment to routine use and follow-up medical visits every few months to monitor health and ensure ongoing protection. It is especially recommended for people with an HIV-positive partner, individuals with multiple sexual partners, or those who do not consistently use condoms.
Understanding Condoms
Condoms are a time-tested, widely accessible method of HIV prevention. They work by creating a physical barrier that blocks bodily fluids during sex, effectively reducing the risk of transmission of HIV and many other sexually transmitted infections (STIs). Both male (external) and female (internal) condoms are available, though male condoms are more commonly used.
When used correctly and consistently, condoms can reduce the risk of HIV transmission by approximately 85%. They are inexpensive, available without a prescription, and provide immediate protection. Condoms also offer the added benefit of preventing pregnancy and a range of STIs, including gonorrhea, chlamydia, and HPV.
However, the effectiveness of condoms depends heavily on proper use. Incorrect application, breakage, or inconsistent use can lower their protective benefits. Even so, condoms remain a reliable and important tool in HIV prevention, especially for individuals who may not have access to PrEP or are looking for protection against other STIs as well.
Comparing Effectiveness
When evaluating HIV prevention strategies, it’s important to understand how effective each option is under real-world conditions. PrEP offers approximately 99% protection against HIV transmission through sexual contact when taken daily as prescribed. Its effectiveness depends on adherence and missing doses can reduce its protective benefits. Long-acting injectable PrEP is also highly effective, especially for individuals who may find it challenging to maintain a daily pill routine.
Condoms, when used correctly and consistently, reduce the risk of HIV transmission by about 85%. They are most effective when they do not slip, break, or get used incorrectly—yet in practice, user error can impact their overall protection rate. Despite this, condoms offer a broader range of protection by also helping prevent other STIs and unintended pregnancies.
In summary, PrEP provides superior protection against HIV alone, especially for people at high risk or with HIV-positive partners. However, condoms offer additional safeguards that PrEP does not, such as STI and pregnancy prevention. For many people, the most effective strategy may be combining both methods for enhanced, comprehensive protection.
| Feature | PrEP | Condoms |
| HIV Prevention Effectiveness | ~99% when taken consistently as prescribed | ~85% when used correctly and consistently |
| Protection Against Other STIs | No | Yes (e.g., gonorrhea, chlamydia, syphilis, HPV) |
| Protection Against Pregnancy | No | Yes |
| Ease of Use | Daily pill or periodic injection | Must be used correctly during every sexual encounter |
| Access Requirements | Prescription and regular medical follow-up needed | Over-the-counter; widely available and inexpensive |
| User Adherence Needed | High (daily adherence or timely injections) | High (must be used properly each time) |
| Side Effects | Possible (e.g., nausea, kidney/liver issues, depending on the medication) | Minimal (possible latex allergies or irritation) |
| Discreetness | High (invisible during sex) | Moderate (visible and may interrupt intimacy for some users) |
| Additional Benefits | Reduces HIV-related anxiety; long-term prevention | Immediate protection against HIV, STIs, and pregnancy |
| Best For | Individuals at high risk for HIV, those with HIV-positive partners | Anyone seeking broader sexual health protection, including STI and pregnancy prevention |
Pros and Cons of Each Method
Both PrEP and condoms are effective tools for HIV prevention, but each comes with its own set of strengths and limitations. Understanding these pros and cons can help individuals make informed choices based on their lifestyle, preferences, and risk level.
PrEP:
Pros:
- High HIV protection rate: When taken consistently, PrEP provides around 99% protection against HIV from sexual transmission.
- Discreet and non-interruptive: Unlike condoms, PrEP doesn’t interrupt intimacy or require use during sex.
- Flexible dosing options: Available as a daily pill or long-acting injection, allowing for a tailored prevention plan.
- Peace of mind: Can significantly reduce anxiety for individuals in serodiscordant relationships or those at higher risk.
Cons:
- Requires medical access and monitoring: Users need a prescription and regular check-ups, including HIV and STI testing every few months.
- No protection against other STIs or pregnancy: PrEP only prevents HIV, so additional methods are needed for broader protection.
- Potential side effects: Some individuals may experience mild side effects like nausea, or more rarely, kidney or bone issues.
- Adherence matters: Missed doses can lower effectiveness, especially with the daily pill.
Condoms:
Pros:
- Broad protection: Condoms are effective not only against HIV but also many other STIs and unintended pregnancy.
- Widely accessible: Available over the counter at pharmacies, clinics, and even for free in some public health settings.
- No prescription required: Easy to obtain and use without needing a medical appointment.
- Affordable and convenient: Cost-effective and portable for on-the-go protection.
Cons:
- User-dependent: Effectiveness can drop significantly with improper use, slippage, or breakage.
- May reduce sensation: Some individuals report decreased pleasure or intimacy during sex with condoms.
- Not reusable: Must be used for every sexual encounter and disposed of afterward.
- Can be interrupted: May require pausing intimacy to apply, which some users find inconvenient.
While both methods have their place in HIV prevention, deciding which is best often depends on individual needs, habits, and sexual health goals. Many people find that combining PrEP and condoms provides the most complete protection.
Can They Be Used Together?
Yes—PrEP and condoms can absolutely be used together, and doing so offers the highest level of protection. While PrEP is extremely effective at preventing HIV, it does not guard against other sexually transmitted infections (STIs) such as gonorrhea, chlamydia, or syphilis. Condoms, on the other hand, provide a physical barrier that reduces the risk of both HIV and a range of other STIs, as well as unwanted pregnancy.
Using both methods together is often recommended for individuals with multiple partners, those in new or non-monogamous relationships, or anyone at higher risk for STIs. This approach—known as dual protection—ensures comprehensive coverage and peace of mind. It also offers a valuable backup plan: if one method fails (e.g., missed PrEP dose or condom break), the other can still provide a layer of protection.
Choosing the Right Method for You
Deciding between PrEP, condoms, or both comes down to your unique lifestyle, health status, and sexual activity. Here are a few factors to consider:
- Risk level: If you have an HIV-positive partner, multiple partners, or are part of a high-risk group, PrEP may offer vital protection.
- STI prevention: If you’re concerned about other STIs in addition to HIV, condoms are essential.
- Pregnancy prevention: Condoms offer dual protection by also preventing unwanted pregnancies.
- Consistency: Are you comfortable taking a daily pill or attending regular doctor visits? Or do you prefer a method you can use only when needed?
- Accessibility: While condoms are widely available, PrEP requires access to healthcare, lab tests, and ongoing prescriptions.
Ultimately, the best method is the one that you can use consistently and correctly. Many healthcare providers encourage a personalized prevention plan that balances effectiveness, convenience, and your overall health goals. Don’t hesitate to speak with a medical professional to help you determine what works best for you.
Conclusion
When it comes to HIV prevention, both PrEP and condoms offer significant benefits—each serving a unique role in protecting your health. PrEP delivers powerful protection against HIV when taken consistently, while condoms provide broader coverage by also guarding against other STIs and unwanted pregnancy. Rather than viewing them as competing options, many individuals find that using both together offers the most comprehensive protection. The right choice ultimately depends on your personal risk factors, lifestyle, and preferences. For the best results, speak with a healthcare provider to develop a prevention strategy tailored to your needs and empower yourself with the knowledge to stay safe and healthy.
Healthcare Unity Group (HUG) has locations in Melbourne, FL and Kearny, NJ. We are also available via telehealth in 30+ states. Contact us to schedule an appointment or for more information about our telehealth services.
