PrEP

What is PrEP?

Tops, Bottoms, and PrEP: What You Need to Know about HIV Prevention

It is crucial for everyone to take necessary precautions to protect themselves from HIV transmission. While certain individuals may have a higher risk based on lifestyle choices or other practices, it is important to dispel the misconception that the risk of HIV transmission is solely determined by sexual orientation or preferred sexual position. For instance, there is a common belief among some individuals who assume that tops (those who do not engage in receptive penetration) are at a lower risk of HIV transmission and therefore do not need to take PrEP. However, it is important to note that PrEP (pre-exposure prophylaxis) is a medication specifically designed to reduce the risk of HIV transmission. It works by preventing the virus from multiplying or growing within the body. PrEP consists of a combination of two drugs that not only help fight off infection but also inhibit the reproduction of HIV within a healthy host.

PrEP stands for pre-exposure HIV prophylaxis.

Pre-exposure prophylaxis (PrEP) is a method to prevent HIV infection by consistently taking a pill before and after sexual encounters. It is specifically designed for individuals who do not have HIV but wish to protect themselves from acquiring the virus. The PrEP pill contains antiretroviral medication, which is also used for treating HIV in individuals who are already diagnosed with the virus.

PrEP is most commonly taken as a once-a-day-pill.

PrEP, which stands for pre-exposure prophylaxis, is a method used to prevent the transmission of HIV. It involves taking a pill that contains a combination of two drugs, TDF and FTC, commonly known as Truvada. Truvada is also used to treat HIV.

More recently, there’s a new version of PrEP called Descovy, which comes in a pill form. Descovy contains a slightly different formulation of drugs, TAF and FTC. However, it’s important to know that Descovy is not widely approved for use as PrEP in most parts of the world.

The most common approach to PrEP is taking a pill every day, but there have been tests on different regimens, like taking PrEP before and after sexual activity. However, these non-daily regimens haven’t been extensively studied for all groups of people and haven’t been tested with Descovy yet. Non-daily PrEP might be more suitable for those who can plan and anticipate when they’ll be sexually active.

Remember, it’s crucial to consult healthcare professionals to find the best PrEP regimen for your specific circumstances. They’ll ensure that you use it safely and effectively.

But how does PrEP work?

When someone who is taking PrEP is exposed to HIV, the medications they have taken act as a shield. These drugs prevent HIV from entering and reproducing in their cells. This way, HIV cannot establish itself and the person remains protected from getting infected. It’s crucial to take PrEP consistently to ensure that enough medication is in the bloodstream to effectively protect against HIV. So, it’s really important to take PrEP correctly to make sure it works as it should!

What should I do before starting PrEP?

Before starting PrEP it’s important to know for sure that you don’t have HIV.

If you already have HIV, it’s important not to use PrEP. Instead, it’s recommended to go for a ‘4th generation’ HIV test, which is more effective in detecting recent HIV infections compared to older tests. Most sexual health clinics use these 4th generation tests. Rapid tests that provide quick results are not as accurate in detecting recent HIV infection. If you’re using a ‘finger-prick’ test at home, it’s better to use tests that are sent away for processing, as they are more reliable.

If your 4th generation HIV test comes back negative, you can start taking PrEP right away. However, if you have engaged in any HIV risks within the four weeks before that test, it’s a good idea to take another test four weeks later to make sure it didn’t miss a recent HIV infection. If this second test comes back positive for HIV, stop taking PrEP and seek immediate advice and support from a sexual health or HIV clinic.

If you have recently experienced flu-like symptoms after an HIV risk, it’s important not to start PrEP. These symptoms might be an indication of recent HIV infection, so it’s best to seek advice and support from a sexual health clinic.

Whether you use PrEP or not, if you’re sexually active, it’s recommended to follow the same guidelines for HIV and STI (Sexually Transmitted Infection) screenings. Getting a full HIV and STI screen is a good practice for all sexually active individuals. It’s also advisable to have a kidney function test and a test for Hepatitis B every year. While at the clinic, it’s a good idea to check your vaccination status for Hepatitis B and inquire about the HPV (warts virus) vaccination.

In addition to an HIV test and a standard STI screen, the only additional tests required before starting PrEP are kidney function tests and a test for Hepatitis B. These tests are necessary because PrEP drugs are effective against Hepatitis B as well. If you have Hepatitis B, you can still use PrEP, but you will need guidance on the safest way to do so.

A very small number of people may experience kidney issues while using PrEP. Kidney function tests help identify any problems and enable you to discuss with a healthcare professional whether you should use PrEP or stop using it. These tests can also identify any pre-existing kidney issues unrelated to PrEP use. It’s advisable to have a blood test (checking creatinine and eGFR levels) and a dipstick urine test (checking protein levels in urine) before starting PrEP or as soon as possible after starting it.

Many people go through periods of starting and stopping PrEP (pre-exposure prophylaxis) multiple times. Our relationship status might change, we might take breaks from having sex, or we might just feel the need for a temporary pause. Stopping and re-starting PrEP is not complicated, but it’s crucial to do it correctly!

To stop PrEP

If you identify as a cis man and haven’t had sex in two days, you can continue taking PrEP for two more days (Sunday and Monday if you last had sex on Saturday). After that, it’s safe to stop.

For everyone else, whether you’ve been taking PrEP for vaginal or frontal protection, continue taking it for seven sex-free days. Once those seven days are over, you can stop taking PrEP because it’s considered safe.

To start taking PrEP again:

If you haven’t had sex since you last stopped taking PrEP, you can restart it as usual. If you’re a cis man and want to have sex immediately, you have the option to take a double dose of PrEP (two tablets) 2 to 24 hours before having sex. Afterward, you can either continue taking PrEP daily or switch to event-based PrEP. Remember to take the after-sex doses, as they are crucial!

For everyone else, if you’re planning to have sex after stopping PrEP, take a daily dose of PrEP for seven days before engaging in sexual activity, regardless of whether it’s for vaginal or frontal protection. After those seven days, continue with daily dosing. Again, make sure to take the after-sex doses!

If you’ve had sex since stopping PrEP and there was a potential risk of HIV exposure, it’s highly recommended to get an HIV test before restarting PrEP. For more information on how to get tested, find out more details [here](provide a link to the relevant information).

PrEP does not interact with most other medicines.

PrEP (Pre-Exposure Prophylaxis) is a medication that helps prevent HIV infection. It’s great because it’s safe for most people! You don’t need to worry about it interacting with alcohol, recreational drugs, or even hormonal contraceptives. It’s also compatible with many over-the-counter medicines. So, you can take PrEP without any hassle.

However, if you have a pre-existing health condition or are taking other medications, it’s always a good idea to consult a healthcare professional before starting PrEP. There’s a chance that Tenofovir disoproxil fumarate, which is an ingredient in PrEP (such as Truvada and its generic versions), might interact with other medications that could affect your kidneys. So, to be on the safe side, it’s best to have a chat with a healthcare practitioner about any potential concerns.

To make things easier, there’s a helpful website from Liverpool University that allows you to look up interactions between PrEP and other medications. This way, you can have all the information you need to make an informed decision and ensure your health and well-being.

I hope this revised explanation is easier to understand and more conversational! Let me know if you have any more questions.

Where can I get PrEP?

Can I get PrEP straight away from my sexual health clinic?

It took a while for some clinics to get-up-to-speed to provide the new service, especially as they were also dealing with COVID. But most clinics are now providing a PrEP service. Some clinics will have a short waiting list – add your name to that list and try to access PrEP as soon as possible. 

n many places, PrEP is available through health services, either for free or at affordable prices. PrEP is also sometimes available as part of clinical trials. When PrEP hasn’t been easily or freely available, many people have reverted to

Where is PrEP available from?

The new service provides PrEP from free NHS sexual health clinics. At the moment PrEP will not be routinely available through other health services such as family doctors. Some clinics might provide PrEP through outreach services, including to community based services.

I don’t have a secure UK address – can I get PrEP?

Anyone in the UK can access sexual health services for free. You do not have to provide proof of address (but you’ll be asked to provide a postcode or zip code). You do not have to use your local clinic. You can still access PrEP, HIV + STI testing, and HIV + STI treatment if you do not have a secure UK address, or if you do not have secure immigration status. Sexual health services in the UK are confidential. By law they cannot share your details without your permission.

I was on the IMPACT trial – what should I do?

Everyone who was on the IMPACT Trial will be able to access PrEP through the new service. You don’t have to stick with your IMPACT clinic to access PrEP if you don’t want to. You can get PrEP at any sexual health clinic, even if it’s not your nearest clinic.

I’m buying PrEP online – what should I do?

If you currently buy PrEP online and want to move to the NHS service then contact your usual sexual health clinic for an appointment. Not all clinics will be able to offer a PrEP appointment immediately – so it’s a good idea to keep a supply of online PrEP until you’re able to access the NHS service.

In the UK, PrEP is now available for free through the National Health Service.

In Scotland, PrEP is available for free on the Scottish health service for people 16 and over who live in Scotland. Find out more here.

In Wales, PrEP is available through the PrEPARED project.

PrEP is available in Northern Ireland by initial consultation at all sexual health clinics.

To find out about PrEP in England click HERE.

I need PrEP but can’t get a clinic place.

If you are having sex that puts you at risk of acquiring HIV then accessing PrEP as soon as possible is important. It’s possible to buy PrEP legally and safely online.

No matter your sexual orientation or preferred position, if you are at risk of HIV transmission, you should consider taking PrEP. This is by far the best way to protect yourself from HIV transmission, in addition to safer practices to lower your risk.