What is PrEP?
PrEP stands for Pre-Exposure Prophylaxis.
It is a drug that can be taken to prevent HIV-negative people from getting HIV. It contains 2 anti-HIV drugs in a single blue pill.
PrEP does not protect against unplanned pregnancy or other STIs, so you will need to use another form of contraception alongside it.
It works by stopping the HIV virus from replicating (making copies of itself) in the bloodstream. You are only protected if there are high enough levels of the drug in your body, so it it’s important that you take it correctly.
For people having vaginal sex, you will need to take it for at least 7 days before you are protected. For people who are having anal sex, or who are ‘event-based dosing’, the dosage is different.
If you stop taking PrEP, you will no longer be protected against HIV and will need to use condoms if you plan to continue having sex.
There are two ways PrEP can be taken:
Daily dosing
Starting with a double dose (2 pills) on the first day. The initial double dose means you are protected within two hours. Once you have started, you must take it once a day for at least 4 days a week to remain protected. It is safe to take PrEP every day but knowing you can miss a few pills should be less stressful.
Daily dosing means you can have sex anytime without having to plan for PrEP or use PEPSE. It is recommended for people who have regular anal sex, MSM (men who have sex with men), sex workers, or people who engage in riskier sexual practices.
Event-based dosing
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2:1:1 dosing: start with a double dose (2 pills) between 2 and 24 hours before sex. Then take one tablet 24 hours after sex, and then a final tablet 24 hours after that. This method is recommended for men who have sex with men, or people who have anal sex. It is not suitable for people with vaginas who have vaginal sex.
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2:7 dosing: start with a double dose (2 pills) between 2 and 24 hours before sex, then one pill every day for 7 days after sex. This method is recommended for people who have vaginas who are having vaginal sex.
Event-based dosing is beneficial for those who do not have sex regularly or engage in planned riskier sexual practices.
If you wish to stop taking PrEP, take one tablet for 2 days after the last time you had sexual intercourse, then you are free to stop.
PrEP is safe to take during pregnancy, and whilst breastfeeding if a doctor says your baby is healthy. There is no evidence to suggest that it affects your fertility or hormonal treatments including hormonal contraception, gender-affirming treatment or hormonal replacement therapy (HRT).
Taking other medicines, supplements or herbal remedies may lower its effectiveness, so please speak to a doctor or nurse before starting treatment.
PrEP is available for all HIV-negative people aged 16 and above who will benefit from its use.
If you are under 16, you can be prescribed PrEP if you are deemed at high risk of getting HIV. It is not suitable for children under the age of 12.
You do not generally need PrEP if you always use condoms, have a HIV-positive partner with an undetectable viral load, or are deemed low-risk of catching HIV.
Common side effects of taking PrEP are:
- Nausea or vomiting
- Bloating and indigestion
- Diarrhoea
- Headache
- Feeling dizzy or weak
- Insomnia or trouble sleeping
PrEP can sometimes affect your kidneys, so you will be monitored during your treatment, and before starting.
You can access PrEP for free from your local sexual health clinic, including specialist HIV clinics. Find your nearest sexual health clinic in Bexley.
Some pharmacies and online clinics sell PrEP. It is important to ensure you are buying a genuine product from a reputable source.