a condom in a silver wrapper next pre-exposure prophylaxis

Complete guide to PrEP and when to take it

PrEP has helped millions of people prevent HIV infections, and yet it remains a relatively unknown drug outside of the LGBTQ+ community.

Today, we’re shedding light on what PrEP does, how you can access it, and whether you’re a candidate for this fantastic medication.

Let’s go!

What is PrEP?

You may have heard of PrEP, but do you know what this miracle medication actually does?

PrEP is designed for people who are at risk of contracting an HIV infection. It’s highly effective when used with other antiretroviral drugs and mainly works to prevent HIV infections after exposure and for those at high risk of exposure.

What does PrEP stand for?

PrEP stands for pre-exposure prophylaxis.

“Pre-exposure” represents the fact that the drug is taken before a potential HIV exposure. For example, the medication is taken by those who are HIV-negative but at risk of contracting the virus through exposure.

Prophylaxis refers to the prevention of an infection or disease. This word can be used for vaccines, medication, and other methods that spread the development of diseases and infections.

How effective is PrEP?

Like most medications, if you take PrEP as prescribed, it’s about 99% effective at preventing sex-based HIV infections. When taken in order to avoid HIV from injecting drugs, PrEP is around 74% effective.

Consistency is key when taking this medication. Make sure you take it at the same time every day for the best results.

You may also want to use other forms of protection while taking PrEP. For example, condoms and regular HIV testing. You should also follow your doctor’s advice for personalised assistance.

a man taking pre-exposure prophylaxis with a glass of water

How to get PrEP in the UK

In the UK, you can currently only get free PrEP from sexual health clinics. It’s not available via community pharmacists or your GP.

If you can’t access free PrEP from sexual health services, you can buy it privately. For example, Asda Online Doctor and Superdrug Online Doctor provide PrEP after a brief questionnaire.

I Want PrEP Now is an excellent resource for discovering more about PrEP in the UK.

If you’re a sex worker and interested in PrEP, contact your local sexual health clinic for a confidential appointment and free medication. Alternatively, you can anonymously buy it online.

How and when to take PrEP

PrEP is usually taken once per day. If you’ve been prescribed PrEP, you should always follow the individual instructions given to you by your healthcare provider. You should also take note of the instructions on the medication packaging.

Daily dosing

If you’re taking PrEP daily, you’ll usually only take one tablet orally every day. The standard strength of PrEP in the UK is 200/245mg (200mg of emtricitabine and 245mg of tenofovir).

When needed (Event-Based Dosing)

Daily dosing isn’t the only way to take PrEP. You can also take it after potential HIV exposure – known as “Event-Based Dosing”. It may also be called the “2+1+1 Method” or “On-Demand PrEP.”

Rather than taking the pills every day, you instead take them before and after exposure. Usually, this regime involves two pills 2 to 24 hours before exposure and another pill 24 hours after the first round. You then follow up with another pill 24 hours after the second dose. This method typically provides 48 hours of coverage.

How long should you wait before sex after taking PrEP?

For those on the daily PrEP regimen, you should take the medication for seven days before engaging in unprotected sexual intercourse. This buffer period gives your body time to absorb the medication and protect you against HIV.

You can still engage in sexual contact during the week, but it must be with condoms.

What happens when you miss a dose of PrEP?

A missed dose of PrEP can affect its HIV prevention effectiveness. If you’ve missed a dose, take the missed one as soon as possible on the same day. However, if it’s been 24 hours and it’s time for the next scheduled dose, just take this at the usual time. You may wish to use condoms for a few days for extra protection.

Who can get PrEP?

Anyone who is at risk of HIV exposure can use prep. However, the most at-risk demographics are:

  • Men who have sex with men
  • Transgender individuals
  • Sex workers
  • People with a history of injection-bases drug use or sharing injection equipment
  • HIV-negative people in a relationship with an HIV-positive partner (Serodiscordant relationships)
  • Those with a history of STIs

Can women use PrEP?

Yes. All genders and sexes can take PrEP as a method of HIV prevention. As for men, PrEP is very effective in reducing the chance of HIV infections in women. But it must be taken consistently to achieve this effect.

Women who may benefit from PrEP include:

  • Women with a history of STIs
  • Inject drugs and share injection equipment
  • Have multiple sexual partners and don’t use condoms
  • Have an HIV-positive partner

a clock with blue pills on a white background

Does the type of sexual activity affect your PrEP dosage?

Some healthcare professionals prescribe different dosing strategies depending on the type of sexual activity you’re engaging in.

Typically, for regular anal sex, daily PrEP is recommended to protect against HIV infections. In contrast, event-based dosing and on-demand dosing are sometimes prescribed for vaginal sexual activity.

When in doubt, speak to your healthcare provider for explicit dosing instructions.

What about intercourse with an HIV-positive, undetectable partner?

Individuals with HIV are very unlikely to pass on HIV with an undetectable viral load. However, not that this only lowers the chance of HIV transmission. You’ll still be at risk of other STIs.

So, if you and your partner are regularly testing while using PrEP, you can have unprotected intercourse. But if you’re not testing and engaging in intercourse with multiple partners, you should use condoms.

Don’t forget other STIs

To build on the point above, you must keep yourself protected from all sexually transmitted infections – not only HIV.

Alongside taking PrEP, you should use condoms, get tested regularly, and practice safe sex. This way, you’ll not only put your own sexual health first, but you’ll also be looking out for your partners, too!

The takeaway

PrEP is a miracle medication that helps patients worldwide reduce their chances of HIV transmission. If you think this drug might complement your lifestyle, contact your local sexual health clinic today to start the conversation.

Read more about sexual health and relationships on our blog now.

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