What is PrEP?
PrEP stands for Pre-Exposure Prophylaxis. It's a pill that HIV negative people take to prevent HIV transmission. Some people take it daily, some take it on demand or when they plan to have sex. How you take it all depends on the sex you are having. Several studies show that PrEP works to stop HIV transmission. When taken correctly (and we need to say that again... when taken correctly) it can prevent HIV 99.9% of the time. How amazing is that?

Right now PrEP is available to all for free on the NHS. If you want to access PrEP we recommend you either contact your GP or local GUM clinic. However, it is also legal to buy generic versions for personal use. Generic versions can be bought online. We still recommend you let your GP or GUM clinic know you are using PrEP and attend regular check ups. 

Why do we need PrEP?

There are now over 108,000 people living with HIV in the UK (as of 2019). We need to improve HIV prevention. Tens of thousands of HIV transmissions have been prevented by condom use. However, many people do not use condoms all of the time and each year there are thousands of new infections. This is why PrEP needs to become a bigger part of our HIV prevention strategy. 

PrEP has the potential to prevent new infections among some of those at greatest risk of acquiring HIV. Condom use will remain a core strategy in HIV prevention. However, PrEP gives people who already find it difficult to consistently use condoms an additional way to protect their health.

How effective is PrEP?

It has been shown in most major studies that no one became infected with HIV if they took PrEP as it was recommended. When taken correctly, PrEP is 99.9% effective. However, it's important to know that if you don't take PrEP correctly - that means not missing doses - it may not work. You need to follow the guidelines, otherwise it may not work for you. 

Why take HIV treatment to avoid taking HIV treatment?

People living with HIV need to take lifelong treatment. PrEP consists of fewer drugs and people only need to take it during periods when they are at risk of HIV. Many people find that their sexual behaviour changes over time, for example when they begin or end a relationship. 

What is event based PrEP / PrEP on Demand?

EBP or Event Based PrEP (also known as PrEP on Demand) is when you take PrEP before you have sex, and a day or two after. Studies have shown that event bases PrEP is just as effective as daily dosing. Event based PrEP should be for people who may not engage in lots of sexual activity or plan their sexual encounters in advance. This is how it works: 

If you know that you might have sex without condoms at least 24 hours in advance:

  • take two pills at least 2 hours and up to 24 hours before sex
  • take one pill 24 hours later
  • take one more pill 24 hours after that

For example, if you are planning on hooking up at 10pm on a Friday, you take TWO pills at 2pm that day. On Saturday you take a pill at 2pm and on Sunday you take a final pill at 2pm. 

If you’re having sex for a longer period, maybe for a few days or a weekend, continue to take a pill every 24 hours until you have two days without engaging in sex. 

Event based PrEP or PrEP on Demand should only be a strategy for those who plan their sexual activities and do not engage in a lot of hook ups. If you have a lot of sex, that's unplanned, then taking PrEP on a daily basis might be the correct approach for you.

Does PrEP have side-effects?
Any medicine can have side-effects, so taking PrEP is a serious decision. The drugs in PrEP have been used as part of HIV treatment for many years. This has shown that they have a low risk of serious side-effects. Most people taking PrEP don’t report side-effects. Some people have stomach problems, headaches and tiredness during the first month but these usually go away. People taking PrEP have regular check-ups at a clinic.

Does PrEP mean people take more risks?
The PROUD study did not find significant difference in risk behaviour between the control arm of the study (those not on PrEP) and the immediate arm (those prescribed PrEP at the commencement of the study). Other studies of PrEP have consistently reported that being on PrEP did not result in people adopting riskier behaviours.  Instead it gives people who already find it difficult to consistently use condoms a way to protect their health.


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References


http://www.aidsmap.com/PrEP/cat/1623/

http://i-base.info/qa-on-prep-in-the-uk-and-changes-to-the-hiv-proud-study/

http://www.proud.mrc.ac.uk