What is PrEP? Expand Pre-Exposure Prophylaxis (or PrEP) is a pill that people who are HIV-negative can take which prevents HIV. It stops HIV from taking hold and spreading throughout your body. It is highly effective for preventing HIV but does not protect you from other sexually transmitted infections or pregnancy.
Who is eligible? Expand In Scotland, the following criteria is used to decide whether PrEP is right for you: You are aged 16 or over; You have tested negative for HIV; You can attend for regular reviews every three months; You are willing to stop taking PrEP if you become no longer eligible in the future; You live in Scotland. In addition, you also need to fulfil ONE or more of the following criteria: You sexual partner is HIV positive and has a detectable load; Cis and transgender gay, bisexual men and other men who have sex with men, and transgender women who have either: Had a rectal sexually transmitted infection (STI) in the last year; or Had anal sex without condoms with more than one person last year – and you are likely to do this again in the next three months. Individuals, irrespective of gender, at an equivalent highest risk of HIV acquisition, as agreed with a clinician. Check out www.PrEP.scot for a handy flow-chart to check if you’re eligible for PrEP.
Can women access PrEP? Expand Yes. Women that are deemed at risk of HIV can access PrEP. Whilst PrEP is not recommended for all women by Health Workers, there are some groups of women who will be at enhanced risk of HIV and would be recommended to explore using PrEP. The risk of acquiring HIV is higher for anyone who come from countries with a high prevalence of HIV (e.g. sub-Saharan Africa, south east Asia) and for their sexual partners. It is also higher for people travelling to those countries and having sex with people they meet there. In addition, women who experience coercive power dynamics within their relationships, and who have little control over their condom use, might also be at enhanced HIV risk. Some women who want PrEP might not fit into the recommended guidelines. International guidance suggests that if someone requests PrEP, it’s an indication they are likely to be at substantial risk of HIV, and PrEP should be considered.
Where can I get PrEP? Expand If you are eligible for PrEP on the NHS, please contact your local sexual health clinic. You can’t access PrEP through your GP.
What if I’ve been told I can’t get it through the NHS? Expand You may have been told that you are currently ineligible for PrEP on the NHS but still want to access it. PrEP is available for purchase online. HIV prevention campaigners have worked to ensure that PrEP bought online is genuine. For more information on buying PrEP, see: prepster.info iwantprepnow.co.uk
How do I take PrEP effectively? Expand PrEP is only effective, when taken both before and after sex. There are two ways you can take PrEP, depending on your circumstances and how often you have sex: Daily dosing – continuous use of PrEP every day. On-demand dosing or event-based dosing – see our FAQ about on-demand or event-based doing for more information. See also our FAQ about vaginal sex and women.
What about on-demand or event-based dosing? Expand Taking PrEP before and after anal sex is still very effective. But the “before-sex” dose is especially important. This is to make sure there are good drug levels before you have sex. On-demand dosing involves: Taking a double dose of PrEP (two pills) before sex. Ideally this is the day before sex (i.e. about 24 hours). PrEP can still be effective if taken between 2 and 24 hours before sex. Taking a single pill 24 hours later. Taking another single pill a further 24 hours later. You should have 48 hours between sex and your last PrEP pill – so keep taking PrEP every 24 hours until this is the case.
What are the side-effects? Expand Very few people who use PrEP encounter side effects – the most common can be headaches or feeling sick and these usually disappear after a few days. Less than 10% of people have reported mild nausea, mild bowel disturbance, bloating, and headaches. These side effects usually stop within the first month. Occasionally, PrEP can cause more serious side effects that reduce kidney function. Therefore you will have monitoring blood tests before and during the time you’re on PrEP.
Does PrEP interact with other medications? Expand Always check with your doctor before starting a new medication. PrEP can interact with some painkillers that are non-steroidal anti-inflammatory drugs (NSAIDs). These include diclofenac, ibuprofen, and naproxen. Taking PrEP with these NSAIDs can sometimes cause kidney problems. Avoid using these medications if you are taking PrEP, or let your doctor know if you need to use them.
Does it work for vaginal sex? Expand For vaginal sex, you need to take PrEP every day. This is because PrEP does not get into the vaginal tissues as well as it gets into rectal tissues. Daily dosing keeps the drug levels higher for better protection, and you will need to take PrEP for a week before reaching drug levels that give the highest protection. On-demand or event-based dosing is NOT suitable if you are having vaginal sex.