HIV Pre-Exposure Prophylaxis ‘PrEP’
Pre-Exposure Prophylaxis
PrEP is a drug taken by HIV-negative people before sex that reduces the risk of getting HIV.
Taking PREP before any kind of sexual encounter helps to block the replication of HIV and Hepatitis B in case of an accident.
The medication used for PrEP is a tablet that contains tenofovir and emtricitabine (drugs commonly used to treat HIV). The brand name of this is Truvada. There are also now generic versions of this available.
Who would benefit from PrEP?
Anyone who is considered to be at high risk of contracting HIV would benefit from PrEP. It can be used as a way to reduce your risk of HIV if you are HIV negative and don’t always use condoms.
Other factors related to a higher risk of HIV
A recent STI (especially rectal infection such as syphilis, Hepatitis C or Lymphogranuloma venerum )
Use of PEP (post-exposure prophylaxis)
Using some recreational drugs (crystal methamphetamine, mephedrone or GHB/GBL) – also known as Chemsex
PrEP is not a vaccine and only provides protection from HIV so long as you continue to take it as prescribed. It is important to remember that PrEP will not protect you from acquiring other STIs. This is an important advantage of using condoms.
Methods of taking PrEP
On-demand: Take two tablets, 2-24 hours before sex. One tablet 24 hours after this and one tablet after this. (4 in total).
Daily
The ‘T’s and the ‘S’s: Taking one tablet on Tuesday, Thursday, Saturday and Sunday. This gives the same level of protection as taking it daily.
Before starting PrEP
Before starting we would perform these tests:
HIV
Hepatitis B: PrEP can also help to protect against the Hepatitis B virus
Kidney function tests: In a very small number of people PrEP can damage renal (kidney) function. This is rare and usual only in people with existing kidney problems or taking other medication that may affect their kidneys.
A full sexual health screen: this is recommended even if you don’t have symptoms.
Health monitoring whilst on PrEP
Once pre-exposure prophylaxis (PrEP) is initiated, we encourage a return for follow-up after 3 months. This is so that we can:
Perform another HIV test
talk about side effects you may have
talk about adherence to the medication regimen
answer any questions you may have.
After this, if PrEP is being taken continuously, every 6 months, we would like to take blood tests for kidney function, urine function and perform an HIV test and a Hepatitis B test if you haven’t been vaccinated.
