PrEP (pre-exposure prophylaxis)

Description

Pre-exposure prophylaxis (or PrEP) is a way for people who do not have HIV but who are at very high risk of getting HIV to prevent HIV infection by taking a pill every day. The pill (brand name Truvada) contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV. When someone is exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from establishing a permanent infection.

When taken daily, PrEP is highly effective for preventing HIV. 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 if it is not taken consistently.

As PrEP only protects against HIV, condoms are important for the protection against other STDs.

Condoms are also an important prevention strategy if PrEP is not taken consistently.

Why Take PrEP?

PrEP is highly effective when taken as indicated.

The once-daily pill reduces the risk of getting HIV from sex by more than 90%. Among people who inject drugs, it reduces the risk by more than 70%.

Your risk of getting HIV from sex can be even lower if you combine PrEP with condoms and other prevention methods.

Is PrEP Right for You?

PrEP may benefit you if you are HIV-negative and ANY of the following apply to you:

You are a gay/bisexual man and you:

  • have an HIV-positive partner
  • have multiple partners, a partner with multiple partners, or a partner whose HIV status is unknown–and you also:
    • have anal sex without a condom, or
    • recently had a sexually transmitted infection (STI)

You are a heterosexual and you:

  • have an HIV-positive partner
  • have multiple partners, a partner with multiple partners, or a partner whose HIV status is unknown–and you also:
    • don’t always use a condom for sex with people who inject drugs, or
    • don’t always use a condom for sex with bisexual men

You inject drugs and you:

  • share needles or equipment to inject drugs
  • are at risk for getting HIV from sex

What Drugs Are Approved for PrEP?

Currently, there are only two medications approved for daily use as PrEP. Both are combinations of two anti-HIV drugs in a single pill:

  • Emtricitabine (F) 200 mg in combination with tenofovir disoproxil fumarate (TDF) 300 mg (F-TDF; brand name Truvada®) is recommended for all adults and adolescents at risk for HIV through sex or injection drug use.
  • Emtricitabine (F) 200 mg in combination with tenofovir alafenamide (TAF) 25 mg (F-TAF; brand name Descovy®) is recommended for adults and adolescents at risk for HIV through sex, excluding people at risk through vaginal sex. Descovy® has not yet been studied for HIV prevention for receptive vaginal sex.

Is PrEP Safe?

No significant health effects have been seen in people who are HIV-negative and have taken PrEP for up to 5 years.

Some people taking PrEP may have side effects, like nausea, but these side effects are usually not serious and go away over time. If you are taking PrEP, tell your health care provider if you have any side effect that bothers you or that does not go away.

And be aware: PrEP protects you against HIV but not against other sexually transmitted infections (STIs) or other types of infections. Combining PrEP with condoms will reduce your risk of getting other STIs.

How does PrEP prevent HIV?

The anti-HIV drugs in PrEP stop the virus replicating in your body. If you are exposed to HIV, for example during sex without a condom, 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 will 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. PrEP also doesn’t prevent pregnancy.

Who can take PrEP?

PrEP is for people who are HIV-negative and more at risk of HIV infection. PrEP can be used by men and women, both trans and cisgender.

PrEP may be a good option for you if:

  • you’re in an ongoing sexual relationship with a partner living with HIV who does not have an undetectable viral load.
  • you’re a gay or bisexual man who has multiple sexual partners 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 partner’s HIV status and don’t always use 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, or have bisexual male partners)
  • you have sex for money, or receive gifts for sex
  • you’ve shared injecting equipment or have been in a treatment programme for injecting drug use.

Is PrEP effective for vaginal and anal sex?

Yes. PrEP can prevent HIV infection during both vaginal and anal sex, but there are different recommendations for how to take it depending on your gender and the sex you have.

How do I take PrEP?

There are two ways to take PrEP:

One tablet per day 

Recommended for:

  • women (both trans and cisgender)
  • transgender men having vaginal/frontal sex
  • men having vaginal or anal sex with women
  • gay and bisexual men

Things to consider:

You will need to take PrEP for 7 days before you are protected, and then every day for as long as you want protection.

Event-based (on-demand) where you take PrEP before and after planned sex

Recommended for:

  • gay and bisexual men

Things to consider:

This option would work for you if you are able to plan for sex at least two hours in advance or you can delay having sex for at least two hours.

There are different types of event-based PrEP depending on your pattern of sexual activity, so make sure you talk this option through with a health professional.

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. If you have HIV already then taking PrEP may increase the likelihood of developing drug resistance which makes HIV treatment less effective.

While you’re taking PrEP, you should 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 weeks, 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 our healthcare professional on +233267000104.

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