Choosing how to protect yourself from HIV is a personal decision and today, there’s more than one highly effective option. While the prep pill has long been a trusted method, a newer injectable form of PrEP is now FDA-approved and gaining attention.
But which one is better for you?
In this guide, we’ll compare the PrEP Shot vs. Pill, covering:
- How each works
- Effectiveness
- Side effects
- Convenience
- Cost
- Who qualifies for each
Whether you’re exploring what is a prep pill for HIV, or curious about long-acting options, this post will help you make an informed decision especially if you’re considering getting started with MISTR.
Key Takeaways
- The PrEP pill is taken daily and is available via MISTR with free testing, consults, and delivery.
- The PrEP shot is injected every 2 months but requires clinic visits and may cost more.
- Both methods are highly effective at preventing HIV.
- Side effects are usually mild for both; the shot may cause injection-site pain.
- MISTR currently offers only the daily PrEP pill, not the injectable form.
- Users can also add DoxyPEP to their PrEP plan for STI protection.
- For those seeking privacy, flexibility, and $0 cost, the pill is the best place to start.
What Is the PrEP Pill?
The PrEP pill is a once-daily oral medication for people who are HIV-negative but at risk of exposure. It includes two drug options:
- Truvada® (and its generics)
- Descovy® (for some populations)
These medications are over 99% effective at preventing HIV from sexual transmission when taken consistently. With MISTR, the process is seamless, free at-home HIV and STD testing, online consultation, and monthly PrEP delivery with $0 cost for most users.
What Is the PrEP Shot?
The PrEP shot refers to Apretude®, a long-acting injectable form of PrEP approved by the FDA in 2021.
- It’s administered every 2 months
- Delivered by a healthcare provider via intramuscular injection
- Requires an oral lead-in period with pills (optional in some cases)
Apretude is also highly effective and ideal for those who struggle with daily adherence or simply prefer not to take pills.
Effectiveness: PrEP Shot vs. Pill
| Method | Effectiveness |
| Daily PrEP Pill | ~99% with consistent daily use |
| PrEP Shot | Slightly more effective (in trials) |
In clinical trials, Apretude was shown to be even more effective than daily oral PrEP, particularly among individuals who had difficulty taking pills every day. However, both options are considered extremely effective when used correctly.
Side Effects: What to Expect
Daily PrEP Pill (Truvada or Descovy)
- Nausea
- Headache
- Mild kidney or bone effects (rare, monitored)
- Usually resolves in the first few weeks
PrEP Shot (Apretude)
- Injection site pain or swelling
- Fever, fatigue, or headache after injection
- Rare allergic reactions
- Must be administered at a clinic
With the daily prep pill, side effects can be monitored and adjusted through telehealth. The PrEP shot requires on-site administration, which may not be accessible in all areas yet.
Convenience & Lifestyle Fit
| Factor | PrEP Pill | PrEP Shot |
| Frequency | Daily | Every 2 months |
| Administration | Self (oral pill) | In-clinic injection |
| Flexibility | Easy to pause/switch | Requires appointment |
| Accessibility (via MISTR) | Online, easy access | Not yet supported via MISTR |
If you prefer a daily routine and want to manage everything from home, the prep pill HIV method via MISTR is the easiest path. If you prefer fewer doses but can manage clinic visits, the shot may be appealing though it’s not currently available through MISTR.
Cost Comparison
| Method | With Insurance / Assistance |
| PrEP Pill | $0 (through MISTR) |
| PrEP Shot | Varies (limited coverage so far) |
Most users who access PrEP through MISTR pay $0 for the PrEP pill, including testing, consultation, and shipping. The PrEP shot may have higher out-of-pocket costs depending on insurance and availability, and requires clinic-based administration.
Who Is a Good Fit for the PrEP Pill?
You might prefer the PrEP pill if:
- You’re comfortable taking medication daily
- You prefer telehealth and at-home testing
- You want the option of DoxyPEP for STI prevention
- You value flexibility in stopping/starting your protection
- You live in a state where access to clinics is limited
Who Might Prefer the PrEP Shot?
The PrEP shot could be a better fit if:
- You have trouble remembering to take daily medication
- You don’t mind clinic visits
- You prefer longer gaps between doses
- You live in a metro area with LGBTQ+ clinics offering Apretude
Just note: MISTR currently provides only oral PrEP (not the shot), due to the need for in-person injection and follow-up.
What About Side Options Like DoxyPEP?
Another benefit of the PrEP pill route is access to additional STI prevention tools, such as the doxy prep pill (DoxyPEP). Taken after sex, this antibiotic reduces the risk of bacterial STIs like:
- Gonorrhea
- Chlamydia
- Syphilis
Ask your MISTR provider if DoxyPEP is right for you, it can be prescribed along with PrEP and delivered monthly.
Final Thoughts: Shot or Pill – What’s Best for You?
Both the daily prep pill and the PrEP shot offer incredible protection. The best choice comes down to your:
- Lifestyle
- Access to care
- Preference for pill vs. injection
- Insurance and cost coverage
With MISTR, starting and staying on PrEP is simple, private, and free for most users. If you’re not ready for the shot or simply want convenience, the PrEP pill is the gold standard.