Truvada vs Descovy: which is better for you?

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Yen Feng

Yen Feng

Yen is a freelance editor and yoga instructor at on Instagram/TikTok and @yenyogasg on Telegram.


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When it comes to HIV prevention, Descovy and Truvada are two antiretroviral medicines that are commonly prescribed. For many years, Truvada was the only FDA-approved drug for pre-exposure prophylaxis (PrEP), or prevention of HIV. However, in October 2019, Descovy also received FDA approval for PrEP.

Now, although Descovy is a newer medication, it’s not necessarily “better” or “safer” than Truvada. However, because Truvada has been available for many more years than Descovy, there is substantially more data to support its use when compared to Descovy.

So how are the two medications different, and which one is better for you? Let’s take a look.

Who is it for?

For people who are at risk of HIV, both medications can be taken once daily to prevent HIV infection. Those who may be at risk of HIV include sexually active adults and adolescents as well as IV (intravenous) drug users.

But because its data for PrEP approval did not include cisgender women, Descovy is not approved for use in those at risk from vaginal sex. It has however has been studied for PrEP in trans-women and men who have sex with men. Truvada, on the other hand, has been studied for PrEP in these same populations plus IV drug users and heterosexual couples.

Which is more effective?

Both Descovy and Truvada have been shown to be effective in treating and preventing HIV infections. However, as a newer drug, Descovy is often marketed as a safer and more effective option, as it appears to cause fewer bone- and kidney-related problems than tenofovir disoproxil fumarate, an active ingredient in Truvada. Some studies however show Descovy can cause weight gain in some patients.

Though both are effective, the bottom line is this: Despite their proven efficacy and safety, both Descovy and Truvada only work when they’re taken consistently every day. Without proper adherence to the medication, the risk for HIV resistance increases.

What about side effects?

Both drugs have similar side effects, which can include nausea, diarrhea, and fatigue. However, at least one study has shown that Truvada may cause more of these symptoms – though, these differences may not be significant enough to make a meaningful impact on which medicine to take.

More serious side effects of both Descovy and Truvada may include rash or other signs of an allergic reaction, and they also have the potential to cause impaired kidney function and reduced bone mineral density.

Should I switch from one drug to another?

If you have any kidney- or bone-related issues, it might make sense for you to switch from Truvada to Descovy, but this is a conversation best had with your doctor in PULSE Clinic Singapore

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