Do I Need to be on PrEP if I’m in a Monogamous Relationship?

PrEP, a daily medication used to prevent HIV, has grown in popularity, especially within the gay and bisexual community.

Typically, PrEP is recommended for gay and bisexual men who are single or in non-monogamous relationships. Since being sexually active with multiple partners can increase your chances of contracting HIV, being on PrEP serves as an extra layer of protection, reducing the emotional and biological anxieties that comes with being sexually liberated.

But what if you’re in a monogamous relationship? If it’s just the two of you, and you’re only having sex with each other, do you still need to be taking PrEP?

It depends on the situation.

If one partner is HIV-positive and the other is not, it’s recommended that the HIV-negative partner takes PrEP as a precautionary measure, even if the HIV-positive partner is treated and undetectable.

But if both partners are not HIV-positive, and it’s one of those old-school relationships where you only sleep with each other, is PrEP necessary?

The question is more emotional than it is clinical.

Staying on PrEP while in a monogamous relationship has more to do with how much you trust your partner, how much you trust yourself, the way you both approach intimacy, and how past partners have treated you.

For some, relationships are anchored in trust first and foremost. If both partners have committed to just each other and to no one else, and they trust each other wholeheartedly, then being on PrEP is probably not called for.

“There’s no reason to be on PreP if you’re only having sex with your partner and you know your partner is good,” says an anonymous gay actor and writer in a seven-year relationship. “I think PreP is just a preventative. It’s almost like a condom in a way. So, if you’re wanting to have sex with a lot of people and you don’t want to worry about getting HIV, then that’s why you go on it.”

For others, it’s harder to fully trust a partner, even if the relationship’s rules are grounded in monogamy. People cheat; people get cheated on.

It took an STD-scare for an anonymous gay singer/songwriter to get PrEP.

“I had [a] UTI thing happen when I was in New York, [and] the doctor was like, ‘why aren’t you on PreP?’ and I was like, ‘Because I’m in a relationship’, and she was like, ‘You can’t always trust who you’re in a relationship with.’ And she was definitely right,” he says. “So, I got on PreP after that relationship ended.”

There have even been cases where people contract HIV while in monogamous relationships because there was an unforeseen splurge in promiscuity.

On a Reddit threat, an online personality equated this to putting on a seatbelt while someone else is driving. It’s not that you don’t trust their driving. It’s about choosing to protect yourself either way.

For many, it’s really about how you feel about the other person that you’re committed to. Some people, even if they were in a toxic relationship prior, find new partners with whom there is greater trust and less need to be on PrEP.

The singer/songwriter has since gone off PrEP since meeting his new boyfriend.

“When I met [him], I felt comfortable and safe enough to do that with him, and he felt the same, and I showed him my test results — I’d previously been tested — and so did he,” he says. “I’m not on it anymore because he got uncomfortable that I was on it.”

In some cases, partners may even be against being on PrEP while in a monogamous relationship. Since it’s a preventative measure taken for unprotected sex, it can be seen as an “open the door” to the possibility of cheating.

So, it’s really about the situation and your perspective.

Even among singles, there are different feelings about being on PrEP. Since it is a medication that requires blood work, some prefer old school prevention methods like condoms and/or abstaining from sex early on.

What’s wonderful about PrEP is that it offers choice. It’s a life-saving resource for everybody, even outside the gay and bisexual male demographic.

“I got on it when I was twenty,” says a queer female model. “I went to my doctor. I didn’t even know what it was. […] I was on it for about two years, and it really gave me peace of mind whenever I was having sex with anyone. PreP will make sure that you have a 98% chance of not catching [HIV], so just having that relief in the back of my mind was amazing. I think I’m going to get back on it.”

Whether you’re single and having fun, in an open relationship and want to be extra careful, or in a committed monogamous relationship but want to stay safe on your terms, PrEP is there to serve your safety—sexually and emotionally.