Which PrEP Is Best? Compare 6 Top Brands — Tenof, Descovy, Truvada (2025 Update)

In today’s world, HIV prevention is no longer limited to condoms alone. PrEP (Pre-Exposure Prophylaxis) has become a powerful, proactive option for those who want reliable protection and peace of mind.

There are now multiple PrEP brands available in Thailand, including Tenof EM, Ricovir EM, TAF EM, Descovy, and Truvada — each with unique benefits, ingredients, and suitability depending on your health, kidney function, and lifestyle.

This article compares six leading PrEP formulas for 2025, summarizing their key differences, pros, and precautions — to help you make an informed decision with guidance from the medical team at Safe Clinic.

What is PrEP and why are there many brands?

PrEP stands for Pre-Exposure Prophylaxis, a preventive HIV medication taken before potential exposure to reduce the risk of infection. When used correctly and under medical supervision, it offers strong protection for people at higher risk.

Different brands of PrEP contain the same core active ingredients — Tenofovir and Emtricitabine — but vary in formulation, dosage, and delivery type (TDF or TAF). These differences affect suitability; for example, newer TAF-based options may be gentler on the kidneys.

In Thailand, PrEP is available in both oral and injectable forms, allowing individuals to choose the most convenient method in consultation with a healthcare professional.

What’s new with PrEP in 2025?

The year 2025 marks a new era for PrEP, with innovations that improve convenience and minimize side effects. The latest TAF-based PrEP (Tenofovir Alafenamide) uses a lower dose than older TDF-based formulas and is gentler on the kidneys and bones.

Another major development is the injectable PrEP (Cabotegravir), which is administered every two months — ideal for people who find daily pills difficult to maintain. This long-acting option has been approved by the WHO and is now available in select clinics across Thailand.

Overall, PrEP in 2025 focuses on personalization — giving users safer, more flexible options tailored to their health and lifestyle needs.

How are PrEP brands different (TDF vs TAF)?

Most PrEP medications combine Tenofovir and Emtricitabine, but the main difference lies in the form of Tenofovir: TDF (Tenofovir Disoproxil Fumarate) and TAF (Tenofovir Alafenamide).

TDF-based PrEP has been widely used for years — it’s effective and affordable, suitable for people with healthy kidneys. Meanwhile, TAF-based PrEP is a newer formulation that uses a smaller dose and tends to be gentler on the kidneys and bones, making it ideal for those seeking fewer long-term side effects.

Both types are endorsed by the World Health Organization (WHO) as proven methods for HIV prevention when taken consistently under medical supervision.

Comparison Table of 6 PrEP Brands (Tenof EM / Ricovir EM / Teno EM / TAF EM / Descovy / Truvada)

There are several PrEP brands available today, all containing similar active ingredients but differing in formulation, technology, and suitability for individual health needs. The table below summarizes their key differences to help guide your discussion with a doctor.

Always consult your healthcare provider to choose the PrEP type that fits your health and lifestyle best.

How do PrEP brands differ in real life?

In real-world use, the difference between PrEP brands isn’t just in their names — it’s about how each formula fits an individual’s body and lifestyle. TDF-based options such as Tenof or Truvada are stable and cost-effective, while TAF-based PrEP like Descovy or TAF EM is gentler on the kidneys and bones, making it ideal for users concerned about long-term side effects.

Some choose based on convenience and monitoring frequency. For example, injectable PrEP (Cabotegravir), taken every two months, suits those who prefer not to take daily pills. Regardless of the formula, all PrEP regimens should be used under medical guidance to ensure safety and effectiveness.

Which PrEP is right for you?

There’s no single “best” PrEP — the right choice depends on your health, lifestyle, and budget. For first-time users, TDF-based options like Tenof EM or Ricovir EM are popular for their proven effectiveness and affordability.

If you have kidney concerns or want to minimize side effects, TAF-based PrEP such as Descovy or TAF EM may be more suitable, as they are gentler on the body. For those seeking ultimate convenience, injectable PrEP (Cabotegravir) is an emerging option for people who prefer not to take a daily pill.

Is PrEP different for women or heterosexual couples?

PrEP is effective for all genders and sexual orientations — men, women, and heterosexual couples alike — with the same HIV-prevention mechanism. The main difference lies in medical evaluation before starting treatment. For women, doctors may conduct additional checks related to hormones, pregnancy, or liver health to ensure the most suitable formula.

For mixed-status couples (where one partner is HIV-positive), PrEP provides strong protection when used consistently. However, it should always be combined with regular HIV testing and condom use to reduce the risk of other sexually transmitted infections (STIs).

Which PrEP is suitable for people with kidney problems?

People with reduced kidney function should be cautious when taking TDF-based PrEP (Tenofovir Disoproxil Fumarate), as it may affect kidney health over time. Doctors often recommend TAF-based formulas, such as Descovy or TAF EM, which use a smaller dose and have better absorption, resulting in less strain on the kidneys.

Before starting PrEP, your doctor will perform blood tests — such as eGFR or creatinine levels — to assess kidney function and choose the safest option. Regular monitoring helps ensure both protection and long-term safety.

Which PrEP causes the least weight change?

In general, PrEP does not cause major weight changes. However, some studies suggest that TAF-based PrEP — such as Descovy or TAF EM — may lead to a slight weight increase in certain individuals, compared to TDF-based formulas like Tenof EM or Truvada, which tend to maintain more stable weight.

That said, body weight can be influenced by many factors, including diet, exercise, and overall health. Therefore, medication choice shouldn’t be based solely on potential weight effects — always consult your doctor to find the formula that best suits your body and lifestyle.

Which PrEP is safer for people with hepatitis B (HBV)?

For people living with hepatitis B (HBV), choosing the right PrEP requires close medical supervision, as these medications can affect liver function. Tenofovir-based PrEP — such as Truvada, Tenof EM, or Descovy — can also suppress HBV replication in some cases, making them generally more suitable options.

However, stopping PrEP abruptly without a doctor’s guidance can trigger HBV reactivation, which may worsen liver inflammation. Regular blood tests and medical follow-ups are essential to ensure safe, long-term liver management when using PrEP.

Real user reviews + Doctor’s advice from Safe Clinic

“I used to worry about side effects, but after consulting a doctor and starting PrEP properly, I feel more confident and live my life with peace of mind.”
— Verified patient at Safe Clinic

Most users report that PrEP gives them reassurance and confidence in managing HIV risk, with minimal side effects when used consistently under medical guidance.

Doctor’s advice (Safe Clinic):

“Safe PrEP use starts with proper blood testing and personalized medical assessment. Avoid self-prescription, as inappropriate use may affect kidney or liver health over time.”

At Safe Clinic, doctors provide complete PrEP care — from initial screening and medication selection to ongoing monitoring — ensuring both effectiveness and long-term safety.

How much does PrEP cost in 2025? (Updated)

In 2025, PrEP prices in Thailand vary depending on the formula and brand. TDF-based PrEP is generally more affordable, while TAF-based PrEP tends to be slightly higher due to its newer, kidney-friendly formulation.

This price does not include other medical services. For consultation and updated pricing, contact Bangkok Safe Clinic.

Oral PrEP vs Injectable PrEP — What’s the difference?

Today, PrEP is available in two main forms — daily oral tablets and bi-monthly injections. Both are highly effective in preventing HIV infection when used consistently, but they differ in convenience and lifestyle fit.

Oral PrEP (Tenof EM, TAF EM, Descovy, etc.)

• Taken daily at around the same time
• Available in various brands and price ranges
• Suitable for those who prefer daily self-administration
• Monthly cost: ~1,000–3,600 THB

Injectable PrEP (Apretude – Cabotegravir LA)

• Administered by a doctor every 2 months
• Ideal for users who find daily pills difficult to maintain
• Cost per injection: ~19,900 THB
• Requires scheduled medical visits for each dose

Both options offer strong HIV protection when taken under medical supervision. The choice depends mainly on your lifestyle, consistency, and comfort with the method.

How to Start PrEP Safely (Doctor’s Advice from BSC)

Starting PrEP should always be done under medical supervision to ensure your body is ready and the medication suits your health profile. The Bangkok Safe Clinic recommends the following steps:

Safe Steps to Begin PrEP

1. Pre-PrEP Health Check — Blood tests for HIV, hepatitis B, and kidney/liver function (BUN, Creatinine).
2. Consultation & Prescription — Doctor assesses risk factors and selects the most suitable formula (TDF or TAF).
3. Start Medication — Take one tablet daily, or begin injectable PrEP (every 2 months) as prescribed.
4. Follow-Up Every 3 Months — Routine check-ups to monitor safety and ensure effectiveness.
5. Do Not Stop Without Doctor’s Advice — Abruptly stopping PrEP may increase risk or cause side effects.

Proper medical monitoring ensures maximum protection and long-term safety while using PrEP.

Summary: Key Benefits and Considerations by Brand

Each PrEP brand provides reliable HIV prevention, but they differ in how they interact with the body and which users they best suit. The table below summarizes the key strengths and precautions for easier comparison.

Always consult your doctor to choose the PrEP formula that fits your health and daily routine best.

Frequently Asked Questions about PrEP (FAQ)

Q1: Do I need to take PrEP every day?
Yes. PrEP should be taken daily at around the same time to maintain effective drug levels in the blood and ensure consistent HIV protection.

Q2: What should I do if I forget a dose?
If you miss one pill, take it as soon as you remember within the same day. If you miss multiple doses, consult your doctor before restarting to reassess your risk and retest for HIV.

Q3: What’s the difference between PrEP and PEP?
PrEP is taken before potential exposure to HIV for prevention, while PEP is taken after exposure (within 72 hours), such as after a condom break or needle injury.

Q4: Does PrEP prevent other STIs?
No. PrEP only prevents HIV. It does not protect against other sexually transmitted infections like syphilis, gonorrhea, or herpes — condoms are still recommended.

Q5: How often should I get tested while on PrEP?
You should have blood tests every 3 months to check kidney and liver function and confirm that your HIV test remains negative.

Final Thoughts — How to Choose the Right PrEP for You

Choosing the right PrEP starts with understanding your health status and personal risk factors. Your doctor will help determine whether a TDF-based or TAF-based formula suits you best and guide you on regular testing and follow-up care.

Those with healthy kidneys may use Tenof EM or Truvada, while people seeking fewer long-term side effects may prefer Descovy or TAF EM. For anyone who struggles with daily pills, injectable PrEP (Cabotegravir) offers a convenient alternative under medical supervision.

PrEP works best when taken consistently and monitored by a qualified healthcare provider

Reference

1. WHO — Pre-exposure prophylaxis (PrEP) guideline
2. CDC — Preventing HIV with PrEP
3. CDC — PrEP Clinical Guidance & Injectable PrEP info
4. WHO — Implementation tool for PrEP

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