HIV prevention conversations often center on gay and bisexual men — and for good reason, given the disproportionate burden this group carries. However, women in Florida face real and frequently underestimated HIV risk, and the prevention tools available to them are just as powerful and just as accessible. Yet many women in Southwest Florida have never been offered a conversation about PrEP, PEP, or their personal HIV risk.
At Florida Infectious Disease Care in Fort Myers, we believe HIV prevention for women in Florida deserves the same attention and urgency as for any other population. This guide covers everything women need to know about their HIV risk, the prevention tools available, and how to access them confidentially in Fort Myers.
HIV Risk for Women in Florida: The Real Picture
According to the CDC, women account for approximately 19 percent of new HIV diagnoses in the United States each year. In Florida — one of the highest-burden states for HIV — women face above-average rates of new infection compared to women in most other states.
The most common HIV transmission route for women is heterosexual sex with a male partner whose HIV status is unknown or positive. Additional risk factors include injection drug use, having a partner who injects drugs, and having a partner who has sex with other men. Importantly, many women do not know their partner’s HIV status — or their partner may not know their own status — making individual protection strategies all the more critical.
Why Women Are Biologically More Vulnerable to HIV
The biology of HIV transmission places women at higher risk than men during heterosexual intercourse. The vaginal mucosa has a larger surface area of exposure compared to penile tissue, and the higher concentration of HIV in semen relative to vaginal fluids means that the probability of female acquisition per sexual act is higher than male acquisition.
Additionally, other STIs — which are common in Florida and which cause inflammation and disruption to the vaginal mucosa — significantly increase HIV susceptibility. A woman with an untreated STI such as herpes, chlamydia, or gonorrhea may be two to five times more likely to acquire HIV during an exposure, according to research cited by the National Institutes of Health.
PrEP for Women: How It Works and Who Should Take It
PrEP — Pre-Exposure Prophylaxis — is one of the most powerful HIV prevention tools available to women. Taken as a daily oral pill, PrEP reduces the risk of HIV acquisition through heterosexual sex by approximately 99 percent when taken consistently, according to CDC data.
Despite this effectiveness, women are significantly underrepresented among PrEP users. A 2021 CDC report found that while women account for nearly one in five new HIV diagnoses, they make up only about one in four PrEP users nationally. This gap represents a significant missed opportunity for prevention.
Women who should consider PrEP include those who have a male partner who is HIV-positive or whose status is unknown, those who do not consistently use condoms, those with a prior STI diagnosis in the past year, and those with partners who use injection drugs or who have sex with other men. Our dedicated PrEP program at Florida Infectious Disease Care welcomes women of all backgrounds and provides complete, confidential evaluation and ongoing monitoring.
Important Considerations for Women on PrEP
Pregnancy and PrEP
PrEP is considered safe during pregnancy and breastfeeding. In fact, continuing PrEP during pregnancy is strongly recommended for women at ongoing risk of HIV, because acquiring HIV during pregnancy carries serious risks for both the mother and the developing baby. The specific PrEP formulation used during pregnancy will be discussed with your provider, as Truvada is currently preferred over Descovy for pregnant women due to more extensive safety data.
PrEP and Hormonal Contraceptives
There are no significant drug interactions between PrEP medications and hormonal contraceptives including the pill, patch, ring, injection, or IUD. Women can safely use PrEP alongside their chosen contraceptive method. PrEP provides HIV protection only — it has no contraceptive effect.
PrEP Build-Up Time for Women
Daily oral PrEP takes approximately 21 days to reach full protective levels in vaginal tissue — longer than the 7 days required for rectal tissue. This is an important distinction for women to understand: starting PrEP and having unprotected sex within the first three weeks does not provide full protection. During this build-up period, consistent condom use is strongly advised.
PEP for Women: Emergency HIV Prevention
If a woman has had a potential HIV exposure in the past 72 hours — whether through unprotected sex with a partner of unknown or positive HIV status, sexual assault, or needle sharing — PEP (Post-Exposure Prophylaxis) may be appropriate. PEP is an emergency 28-day course of antiretroviral medication that must be started as soon as possible after exposure.
Florida Infectious Disease Care provides rapid access to PEP emergency HIV prevention for women in Fort Myers and Southwest Florida. We treat patients who have experienced sexual assault with particular sensitivity and in full coordination with survivor support services.
STI Prevention and HIV Risk Reduction for Women
Reducing other STIs directly reduces HIV risk. Women who are sexually active in Florida should receive comprehensive STI screening at least annually — and more frequently if they have multiple partners. Our team also offers Doxy-PrEP for eligible patients as a strategy for reducing bacterial STI acquisition, which in turn lowers the biological susceptibility to HIV.
Condom use remains one of the most effective tools for reducing both STI and HIV risk. For women who feel unable to negotiate condom use with partners, internal (female) condoms provide an alternative that women can control themselves.
Getting Tested: The Foundation of HIV Prevention
No prevention strategy works without knowing your status. Women in Florida should receive HIV testing at least annually if sexually active, and more frequently — every three months — if on PrEP or if risk factors are ongoing. Testing is simple, fast, and fully confidential at Florida Infectious Disease Care. Knowing your status empowers you to make the best decisions for your health.
Frequently Asked Questions
Q: Can a woman transmit HIV to a male partner?
Yes. Female-to-male HIV transmission does occur, though it is statistically less efficient per act than male-to-female transmission. A woman living with HIV who is on effective antiretroviral therapy and maintains an undetectable viral load cannot transmit the virus to sexual partners — the U=U (Undetectable = Untransmittable) principle applies regardless of the gender of the partner.
Q: Is PrEP covered by insurance for women in Florida?
Yes. Under the Affordable Care Act, PrEP — including the required clinic visits and laboratory monitoring — must be covered without cost-sharing by most insurance plans. Medicaid in Florida also covers PrEP. For uninsured women, manufacturer patient assistance programs and Ryan White funding can cover costs. Our team helps every patient navigate their coverage options.
Q: Can I get PrEP without my partner knowing?
Absolutely. PrEP is a personal health decision that does not require disclosure to a partner. You have the right to protect your own health confidentially. Our care is completely discreet, and we will not contact anyone on your behalf without your explicit permission.
Q: How does HIV affect women differently than men?
Women living with HIV may experience different clinical presentations and complications than men, including gynecological conditions such as recurrent vaginal candidiasis, cervical dysplasia, and pelvic inflammatory disease that are more frequent or more severe with HIV infection. Women also metabolize some antiretroviral drugs differently, which may affect side effect profiles. These are important reasons why HIV care for women benefits from providers experienced in managing HIV across diverse patient populations.
Ready to Take the Next Step?
At Florida Infectious Disease Care in Fort Myers, our board-certified infectious disease specialists provide expert, compassionate, and completely confidential care for every patient. Call us at 239-245-8223 or visit us at 14192 Metropolis Ave, Fort Myers, FL 33912.
Book your appointment online at floridaidcare.com/make-an-appointment or find us on Google Maps. You deserve expert infectious disease care — and we are here when you need us.