HIV PrEP guide

HIV PrEP (pre-exposure prophylaxis) online in Virginia and West Virginia

This guide is for starting or continuing daily HIV PrEP for ongoing prevention needs, with a recent negative HIV test and kidney function labs. PrEP is NOT for a recent high-risk exposure — that needs PEP, which is urgent in-person or ER care within hours, not PrEP.

Start online

Start a $59 online review for HIV PrEP.

PrEP (pre-exposure prophylaxis) is a daily pill that's highly effective at preventing HIV when taken consistently, for people with ongoing risk of exposure. If you have a recent negative HIV test and normal kidney function, online review can often start or continue PrEP quickly. PrEP is different from PEP (post-exposure prophylaxis) — if you've already had a high-risk exposure in the last 72 hours, you need PEP, which is urgent in-person or ER care, not PrEP.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

Start this visit See response windows

Quick facts

You must be physically in Virginia and West Virginia at the time of request
Starts at $59
No insurance needed
No app download
Physician review around the clock
Non-controlled prescriptions can be sent to your pharmacy when appropriate
A work or school note can be included when medically appropriate
Response windows: 24/7, every day

Common symptoms

Wanting to start daily HIV PrEP for ongoing prevention
Continuing PrEP you already take and need a refill
No symptoms — PrEP is prevention, not treatment for an existing infection

May fit online care

Adults 18 and older
A photo of a negative HIV test from within the past 7 days
A photo of a creatinine (kidney function) result from within the past 6 months showing adequate kidney function
Known hepatitis B status
No high-risk HIV exposure within the last 72 hours, and no fever/rash/sore throat/swollen lymph nodes after a recent exposure

Look for another care setting

A high-risk HIV exposure within the last 72 hours (you need PEP, not PrEP — seek care within hours)
Fever, rash, sore throat, or swollen lymph nodes after a recent exposure (possible acute HIV — needs in-person testing first)
No HIV test from the past 7 days, or no creatinine from the past 6 months
Reduced kidney function (eGFR under 60), or age under 18

What to have ready

A clear photo of your negative HIV test result (within the last 7 days)
A clear photo of your creatinine (kidney function) lab result (within the last 6 months)
Your hepatitis B status, if known
Whether you've had any high-risk exposure in the last 72 hours (if so, seek PEP care instead)

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer the fit questions, and choose the response window you want. If the concern still fits this service, a physician reviews it and sends a secure update after sign-in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

Your physician

Every visit is personally reviewed by Ankur Fadia, MD — board-certified, cardiology-fellowship-trained, and Alpha Omega Alpha. Recognized with the Act Fast Award for the fastest physician stroke-treatment times (2019–2022) and as the most efficient, highest-rated physician in the HCA LewisGale Alleghany emergency department (2018). Licensed in Virginia and West Virginia — your care is never handed off.

Verify Virginia medical license Verify West Virginia medical license Verify board certification

What's the difference between PrEP and PEP?

PrEP (pre-exposure prophylaxis) is taken before a possible exposure to prevent HIV — it's an ongoing daily (or on-demand) medication for people at continued risk. PEP (post-exposure prophylaxis) is taken after a specific, already-happened high-risk exposure and must be started within 72 hours, ideally much sooner. If you've already been exposed, PrEP will not work retroactively — you need PEP through urgent in-person or emergency care.

Why do I need a negative HIV test to start PrEP?

PrEP is not a full treatment regimen for existing HIV infection, so it's essential to confirm you're HIV-negative before starting, and periodically afterward. Starting PrEP with an undiagnosed HIV infection can allow the virus to develop resistance to the medication.

What is on-demand ('2-1-1') dosing?

On-demand dosing is an alternative to daily PrEP, studied specifically in men who have sex with men, involving a loading dose before sex and follow-up doses afterward. It requires planning ahead and precise timing, and is not established for vaginal sex. It's available as a shared decision after discussing whether it fits your situation.