I hear of it, but typically it's only taken by those who engage in high risk activities. There are potential issues with the liver and kidney that make it not worthwhile if one isn't at moderate to high risk.
More than 1/5 of HIV transmissions are heterosexual in the US. Additionally, prep requires quarterly testing to monitor any potential issues you mentioned (Which are pretty rare), and they also run an STD panel.
Just having a quarterly panel would be a huge boon to anyone with more than one partner. Normalizing prep for anyone who thinks they might need it would be a major step forward.
Yes, I don't disagree. It's just that most of the people that I know that have multiple partners are only on prep if those partners are seeing untested other folks.
Said differently, those I know on prep are taking it because they cannot account for the extent of the sexual network of their partners. Those that aren't on prep have multiple partners, but they all test and have complete information on the status of everyone involved in the sexual network graph.
I see it as a good choice if you cannot attest for accurate, recent results of every possible connection in your sexual network.