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What is pre-exposure prophylaxis (PrEP)?

Truvada

Truvada - the drug used as PrEP

FAST FACTS

  • Pre-exposure prophylaxis (PrEP) is a course of HIV drugs taken daily by HIV-negative people at greater risk of HIV to prevent infection.
  • PrEP can virtually eliminate the risk of getting HIV if taken consistently and correctly.
  • PrEP won’t protect you against other sexually transmitted infections (STIs) such as hepatitis C. Condoms are still the best protection from these STIs.
  • PrEP is not taken for life – it is only taken for short periods when a person may be at risk of HIV infection.  

What is PrEP?

Pre-exposure prophylaxis (PrEP) is a course of HIV drugs taken daily by HIV-negative people most at risk of HIV to reduce their risk of HIV infection.

Truvada is currently the only drug approved for use as PrEP. Truvada is a single pill that is a combination of two anti-HIV drugs, tenofovir and emtricitabine.

How does PrEP prevent HIV?

The anti-HIV drugs in PrEP stop the virus from entering cells and replicating in your body. If you are exposed to HIV but have been taking PrEP correctly, there will be high enough levels of the drugs to prevent you from getting HIV.

How effective is PrEP?

If used consistently and correctly, PrEP can virtually eliminate the risk of you becoming infected with HIV.

A number of large, high profile trials undertaken across the world have continued to prove PrEP’s effectiveness.

If I take PrEP, can I stop using condoms?

This will depend on your circumstances. PrEP will protect you from HIV, but it doesn’t give you any protection against sexually transmitted infections (STIs). Using a condom is the best way to prevent other STIs such as gonorrhoea, chlamydia and hepatitis C.

Who can take PrEP?

PrEP isn’t recommended for everyone. It’s for people who are HIV-negative and at a high risk of HIV infection.

PrEP may be an option for you if:

  • you’re in an ongoing sexual relationship with a partner living with HIV whose HIV is not well controlled.
  • you’re a gay or bisexual man who has multiple casual sexual encounters, and you don't always use condoms.
  • you’re a gay or bisexual man in a new sexual relationship but not yet aware of your sexual partners HIV status and not using condoms.
  • you’re not using condoms with partners of the opposite sex whose HIV status is unknown and who are at high risk of HIV infection (for example, they inject drugs, have multiple partners at the same time, or have bisexual male partners)
  • you’ve shared injecting equipment or have been in a treatment programme for injecting drug use.

Where is PrEP available?

Currently, PrEP is not available everywhere in the world and even in countries where it has regulatory approval (meaning it’s approved as medication) it may not be easy to get hold of for a number of political or resourcing reasons.

In some countries PrEP is available for free, or subsidised as part of the national health system, in other countries you will have to pay for it privately.

The good news is that international guidelines now recommend that PrEP should be made widely available, so even if it's not available to you right now, it may be an option in the future.

If you are interested in getting PrEP contact a healthcare professional who should be able to advise you on how you can do this. They will also be able to offer the advice, monitoring and support to help you take PrEP correctly and ensure you are fully protected.

There are also dedicated websites that can help you buy PrEP. However, taking PrEP without medical advice and monitoring has health risks, so you should always get a professional health check if you do buy PrEP online.

How can I start PrEP and how long do I take it for?

You must take an HIV test before starting PrEP to be sure that you don’t already have HIV.

PrEP needs to be taken every day for it to work effectively.

While you’re taking PrEP, you’ll have to visit your healthcare professional for regular check-ups (at least every three months).

Unlike HIV treatment, people do not stay on PrEP for life. PrEP is normally taken for periods of months or a few years when a person feels most at risk of HIV. This might be during specific relationships, after the break-up of a relationship and dating new people, when planning a holiday when you know you will be sexually active with new people whose status you may not know, while dealing with drug use problems, or when trying to conceive and one of you is known to be HIV positive.

Does PrEP have any side effects?

In some people PrEP can cause minor side effects like nausea, vomiting, fatigue and dizziness, but these usually disappear over time.

In rare cases PrEP can also affect kidney functions.

If you’re taking PrEP and experience any side effects that are severe or don’t go away, tell your healthcare professional.

Last full review: 
12 July 2017
Next full review: 
12 July 2020
Sources: 

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Last updated:
03 August 2017
Last full review:
12 July 2017
Next full review:
12 July 2020