Pre-exposure prophylaxis (PrEP) is an HIV prevention approach where HIV-negative individuals use HIV antiretroviral medications to reduce their risk of becoming infected if they are at high risk of exposing to the virus. PrEP can stop HIV from spreading throughout the body and keep the virus from establishing a permanent infection.
The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) regard PrEP as an important measure for preventing HIV.
PrEP is highly effective for preventing HIV from sex or injection drug use. Studies have shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily. Among people who inject drugs, PrEP reduces the risk of getting HIV by at least 74% when taken daily.
PrEP is much less effective when it is not taken consistently. As PrEP only protects against HIV, condoms are important for the protection against other sexually transmitted infections (STIs). Condoms are also an important prevention strategy if PrEP is not taken consistently.
*Before taking PrEP you must undergo HIV testing, liver and kidney function examination to ensure PrEP is suitable for your body. Follow-up check-up will be required every 3-6 months for regular HIV testing, monitoring live and kidney function and refill prescription."
Daily or On demand PrEP?
Taking PrEP every day is a great option if you generally have a busy sex life or want to be protected from HIV without having to anticipate when your next sexual encounter may be. Sex can be spontaneous~ So if you take PrEP every day, you are always protected! If you are having receptive anal sex (bottoming), it takes 7 days of daily PrEP before you are protected from HIV. If you are having insertive anal sex (topping) or vaginal sex, it takes 20 days of daily PrEP before you are protected.
On-demand PrEP can suit people who infrequently have sex, or plan to have sex for a short period of time (a night out, festive event or sex party). If you don’t like to take daily medication or if you are concerned about side-effects, then on-demand PrEP could be good for you. When used correctly on-demand is PrEP is just as effective as daily dosing.
This method only works for men having anal sex with men, not for people having vaginal sex. For on-demand PrEP, the timing for taking your doses is extremely important.
- Take 2 PrEP pills at once — a double dose — between 2-24 hours before you have sex
- Take 1 more PrEP pill 24 hours after your first dose (double dose)
- Take 1 final pill 24 hours after the second dose (48 hours after your first dose)”
*If you find yourself frequently having sex, or find it hard to stick to a carefully timed dosing schedule like on demand PrEP requires, taking daily PrEP might be a more suitable option."
The formula is 2-1-1:
Post-exposure prophylaxis (PEP)
PEP (post-exposure prophylaxis) is the use of antiretroviral medicines (ART) after being potentially exposed to HIV to prevent becoming infected. PEP should be used only in emergency situations and must be started within 72 hours after a recent possible exposure to HIV. If you’re prescribed PEP, you’ll need to take it once or twice daily for 28 days. It can effectively reduce the risk of infection by up to 81% or higher.
If you think you’ve recently been exposed to HIV during sex or through sharing needles or if you’ve been sexually assaulted, talk to your health care provider or an emergency room doctor about PEP right away.
*The above approaches are only for HIV prevention but not other STIs.
11. Is PrEP a vaccine?
No. PrEP does not work the same way as a vaccine. A vaccine teaches your body to fight off infection for several years. For PrEP, you need to take a pill orally every day or on-demand. If you take PrEP, the presence of the medicine in your bloodstream can often stop HIV from taking hold and spreading in your body. If you do not take PrEP every day or on-demand accordingly, there may not be enough medicine in your bloodstream to block the virus.
22. Is it safe to take PrEP?
PrEP can cause side effects like nausea in some people, but these generally subside over time. No serious side effects have been observed, and these side effects aren’t life threatening. If you are taking PrEP, tell your health care provider about any side effects that are severe or do not go away.
33. How long do I have to take PrEP before it is effective?
When taken every day, PrEP is safe and highly effective in preventing HIV. PrEP reaches maximum protection from HIV for receptive anal sex at about 7 days of daily use. For receptive vaginal sex and injection drug use, PrEP reaches maximum protection at about 21 days of daily use.
44. What should I do if I forget a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. *DO NOT take a double dose to make up for a missed one!
55. I can’t afford Truvada for PrEP, is there other option?
The pill (brand name Truvada) is manufactured by pharmaceutical company Gilead, which is a patent drug, hence the price. It contains two medicines (tenofovir disoproxil fumarate and emtricitabine) that are used in combination with other medicines to treat HIV.
A study done by the Imperial College London, confirmed that all the PrEP tablets purchased form online suppliers (All Day Chemist, Dynamix International, Green Cross Pharmacy, IMPACT trial, In House Pharmacy, Silom Pulse and United Pharmacy) contained 94.3% to 104.9% of what they claimed on the label. The generic drug names are TENVIR-EM, RICOVIR-EM, TENOF-EM, Adco-Emtevir, TENO-EM, TAVIN-EM and Emtricitabine/ Tenofovirdisoproxil.