​Effective October 25, 2024, estradiol, conjugated estrogens/bazedoxifene, leuprolide, raloxifene and spironolactone have been added to the PrEP-AP formulary. Testosterone was added to the PrEP-AP formulary effective November 15, 2024.

Gender-affirming medications are an important part of clinical care for many transgender and nonbinary individuals. Their use helps align physical characteristics with their gender identity, improving engagement in clinical care, mental health, and quality of life. Integrating access to gender-affirming medications and pre-exposure prophylaxis (PrEP) improves adherence to HIV prevention by minimizing logistical and systemic barriers, such as the need to navigating multiple healthcare providers and benefit programs. A strong therapeutic relationship fostered through gender-affirming care can enhance trust and communication encouraging clients to adhere to PrEP which is vital for its effectiveness. Studies show that individuals are more likely to stay engaged in care when their provider is supportive of their gender identity. Gender-affirming medications have been shown to reduce symptoms of anxiety, depression, and gender dysphoria, and to improve overall mental health which can improve healthcare engagement, including consistent use of PrEP.

In addition to being available in pharmacies, some of the medications will also be available to PrEP-AP clients for administration in a clinical setting. For a full list of PrEP-related services covered by PrEP-AP, along with instruction for providers to bill PrEP-AP for administration, please see the PrEP-AP Resources webpage here: PrEP-AP Clinically Administered Medications. Uninsured clients, clients with confidentiality concerns, and minor clients must receive physician-administered medications from our contracted clinical providers who may be located here: PrEP-AP Clinical Providers and Enrollment Sites.

PrEP-AP requests that you share this information with your clinical leadership team and local prescribers. The PrEP-AP formulary (PDF) has been updated to reflect the addition of the various gender-affirming medications.

If you have any questions regarding this new PrEP-AP benefit, please email PrEP-AP at PrEP.Support@cdph.ca.gov.

Thank you,

​​

Joseph Lagrama

ADAP Branch Chief

California Department of Public Health