Thinking about taking PrEP?
What is PrEP?
PrEP stands for pre-exposure prophylaxis. If you are HIV negative taking PrEP, usually daily, can significantly reduce you chance of contracting HIV. If you are taking PrEP as prescribed by your Doctor and you are exposed to the HIV virus, it can stop the HIV virus getting into your body and causing infection, it is almost 100% effective. Generally, PrEP is a well tolerated safe medication and in most cases is subsidised by the PBS.
Does PrEP protect me against sexually transmitted infections (STIs)?
It is important to remember that PrEP doesn’t protect against STIs or pregnancy. It is also possible that having an STI can reduce the effectiveness of PrEP in preventing HIV. STIs can be asymptomatic which means people can have an STI without having any symptoms. For this reason, a lot of patients choose to have an STI screen every three months when they see their GP to get their prescriptions for PrEP. It can be awkward and embarrassing talking about our sex lives but remember everything you discuss with your GP is completely confidential.
Most patients find PrEP reduces some on the anxiety and fear people have around HIV and having the regular STI screens gives peace of mind.
Am I eligible for PrEP?
There are many situations in which it might be worth considering PrEP. It is based on your risk of HIV and people of all genders and sexualities can be eligible for PrEP. You can talk to your GP about your thoughts and concerns and they can help you make an informed choice about whether PrEP is right for you.
Are there other options?
Condoms are another way to reduce your risk of contracting HIV as well as STIs. They are best used with water base lubricant but remember oil-based lubricant can destroy the condom and stop It from working properly.
If someone living with HIV is on effective treatment and has an undetectable viral load they cannot pass on HIV. This is known as U=U (undetectable=untransmittable).
Remember that if you think you might have been exposed to HIV, post exposure prophylaxis (PEP) might be an option and is best started ASAP. Speak to your doctor today if you think you might have been exposed.
Are there tests I need before taking PrEP?
There are some tests recommended when starting PrEP:
STI screening tests; these can include blood tests, a urine test, and some swabs (usually self-taken)
An HIV test
A blood test for Hepatitis B and C
A blood test to check your kidney function
How do I take PrEP?
PrEP is prescribed with one prescription for 30 pills with two repeats lasting 90 days in total. The active ingredients in PrEP are a combination of two medications: tenofovir and emtricitabine.
In most cases daily PrEP is recommended. This means taking one pill every day. You need to take it for at least seven days to get protection. If you are a cisgender man who has sex with men you can start with a single dose of two pills then continue with one daily to get protection sooner.
Some simple tips to remind you to take PrEP every day include keeping it next to something you use every day like your toothbrush or charger for your mobile phone, setting a daily alarm on our phone or using a weekly pillbox.
On-demand PrEP
On-demand PrEP is another option. It is only an option if you’re having anal sex. If you’re having any other kind of sex, daily PrEP is recommended. On-demand PrEP also isn’t suitable who people of trans experience who are taking feminising hormones for whom daily PrEP is recommended.
On-demand PrEP involves taking two pills at the same time between 2 and 24 hours before having sex, then taking one pill daily until 48 hours have passed from the last time you had sex. This is only an option worth considering if you generally know when you are planning on having sex.
What if I want to stop PrEP?
If you are thinking about stopping PrEP, talk to your doctor first. If you are a cisgender man who has sex with men you need to take PrEP for a further two days after your last possible exposure to HIV (after 24 and 48 hours). For anyone else you have to take PrEP for a further 28 days after your last possible exposure.
Are there any side effects?
A small number of people experience side effects from PrEP including headaches and stomach upset. These can be minimised by taking your PrEP with or just after food. Remember other prescribed medications, supplements and recreational drugs could interact with your PrEP.
It’s rare, but sometimes people experience a decrease in their kidney function and some reduction in the density of their bones whilst taking PrEP. This is more common if people have certain other health problems. Your GP will usually do blood tests every three months when you go for your PrEP scripts to monitor your kidney function.
If you’ve been thinking about PrEP it’s probably worth having a chat with your GP about whether it’s an option for you!