safety and efficacy data available studying ED-PrEP in these populations. ED-PrEP can be beneficial to help reduce the pill burden for people and decrease costs, as fewer pills are needed. In 2016, the World Health Organization (WHO) consolidated guidelines regarding the use of antiretroviral drugs for treatment and prevention of HIV infection support the use of PrEP in pregnant and breastfeeding women who are at continued and substantial risk of HIV infection. In clinical PrEP trials, exposure to TDF-containing PrEP during the first trimester of pregnancy was not associated with adverse pregnancy or infant outcomes. The increased risk of mother-to-child HIV transmission outweighs any potential risks of PrEP. The guidelines also note the need for continued monitoring of pregnant and breastfeeding women receiving PrEP. However, global PrEP accessibility for women, including those who are either pregnant or breastfeeding, is limited. Efforts to increase accessibility to women who are at risk for HIV are necessary for reducing rates of global HIV infections. Contraindications Truvada and Descovy Truvada and Descovy are contraindicated for use as pre-exposure prophylaxis (PrEP) in individuals who have an unknown or positive HIV status. HIV positive or negative status must be determined before someone begins the use of either of these medications as PrEP. Additionally, any hypersensitivity or severe allergy to any ingredient, emtricitabine, tenofovir disoproxil, or tenofovir alafenamide is a contraindication for continued use of these medications. Side effects Research shows that pre-exposure prophylaxis (PrEP) is generally safe and well tolerated for most individuals, although some side effects have been noted to occur. Some people experience a "start-up syndrome" involving nausea, headache, and/or stomach issues, which generally resolve within a few weeks of starting the PrEP medication. Research has shown that the use of Truvada as PrEP has been associated with mild to moderate declines in kidney function, mostly associated with older people over 50, those with predisposing conditions such as diabetes, or glomerular filtration rate lower than 90. These declines were usually of no concern, stabilized after several weeks of being on the drug, and reversed once the drug was discontinued. However, these side effects were serious enough for several people on PrEP to file lawsuits against the makers of Truvada as well as the makers of other similar drugs. Osteopenia or bone loss has been reported in clinical studies. Bone loss was not seen as a major concern for ending the service since bone loss