PrEP Info

The information below has been collated from various reputable sources including the World Health Organization, US Centers for Disease Control and Prevention, Planned Parenthood and PrEP Facts.

What is PrEP?

PrEP is a pill you can take to protect yourself from HIV. When used as directed, PrEP has been shown to be highly effective at reducing the risk of contracting HIV - up to 99% in some cases.

PrEP stands for Pre-Exposure Prophylaxis - meaning a treatment or action you take before risk of exposure (in this case to HIV) to prevent disease. It is different from PEP (Post-Exposure Prophylaxis).

What PrEP contains and how it works

PrEP is currently available in two forms - the branded drug Truvada, and unbranded generic forms. The two most widely used versions of generic PrEP are Ricovir-EM (from Mylan) and Tenvir-EM (from Cipla), both of which are approved by the US FDA.

Generics contain exactly the same active ingredients as Truvada (Tenofovir TDF and Emtricitabine FTC), and work in the same way - by stopping the virus from replicating in your body. They are manufactured by companies that do not own the original patent.

However, Truvada is significantly more expensive than generics, in some cases costing up to $1,800 a month. This is because pharmaceutical companies that invent original brand-name drugs need to recoup their costly investment in the development process, while generic manufacturers only need to demonstrate to regulators that their version is as good and effective as the original.

We sell US FDA-approved Ricovir EM sourced directly from Mylan Pharmaceuticals from just $30 a month.

Why take PrEP?

For those at very high risk of HIV, taking PrEP can significantly reduce the risk of infection if taken daily.

According to the iPrEx study:

Frequency of PrEP usage Estimated level of protection against HIV
7 pills per week ~99%
4 pills per week ~96%
2 pills per week ~76%

You should consider taking PrEP if:

  • You are HIV negative
  • You often find yourself in situations where condoms are not easily used or not always used
  • You want to protect yourself from HIV

PrEP is not suitable for you if you are HIV positive. You should seek antiretroviral treatment in this case.

How to take PrEP

How you take PrEP depends on how far in advance you plan on having sex and how regularly you have sex, but does not necessarily depend on how much sex you have.

There are four key ways to take PrEP:

Daily PrEP
  • Recommended if you want the peace of mind and relief from stress of trying to stay HIV negative
  • Take one pill every day at the same time each day
  • Suitable for both anal and vaginal or front hole sex
  • You can miss a pill from time to time and still have adequate protection
Event based dosing
  • Recommended if you know that you might have condomless sex 24 hours in advance
  • Take two pills 2 - 24 hours before sex, then take 1 pill 24 hours later, and 1 more pill 24 hours after that
  • If having sex for an extended period of time, continue to take a pill every 24 hours until you have 2 sex-free days
  • Only suitable for anal sex, not vaginal or front hole sex
  • Important not to miss any doses
4 pills per week (a.k.a. Ts and Ss)
  • Suitable for people who have sex less frequently (around once or twice a month)
  • Take pills on Tuesday, Thursday, Saturday and Sunday (hence Ts and Ss)
  • 4 pills a week maintains a good baseline of anti-HIV drugs in your system, and you can choose to increase this to 7 pills per week when you’re in a more sexually active period
  • Only suitable for anal sex, not vaginal or front hole sex
Holiday PrEP
  • Recommended if you have an upcoming block of time when your risk of exposure to HIV will be higher (e.g. due to increased number of partners, usage of substances, or traveling to places with higher HIV prevalence rates)
  • Take PrEP daily 7 days before your travels, daily for the entire duration of your travels, and finally daily for 7 days after your travels
  • Suitable for both anal and vaginal or front hole sex

PrEP risks and side effects

PrEP only protects you against HIV but not other sexually transmitted infections (STIs) such as gonorrhoea, chlamydia, syphilis and hepatitis C.

In some cases, PrEP can cause minor side effects like nausea, vomiting, fatigue and dizziness, but these usually disappear over time. In very 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, inform your healthcare professional.

Before starting PrEP

It is essential that you undergo a few tests before or as you start PrEP.

Most importantly, PrEP can only be used if you are HIV negative. If you are already HIV positive and don’t realise it, you could develop resistance to drugs that you will need for treatment.

You should approach your healthcare provider for the following tests before purchasing and using PrEP:

  1. A full sexually transmitted infections (STI) screen. A full STI screen is recommended every 3 months – even if you don’t have any symptoms
  2. A ‘fourth generation HIV antibody antigen test’. These tests have a much shorter ‘window period’ of 4 weeks than other tests. They can give an accurate result 4 weeks after potential exposure to HIV. It’s a good idea to repeat the fourth generation HIV test after 4 weeks to make sure an acute or recent infection was not missed by the first test
  3. A hepatitis B test, to rule out an active hep B infection. The the drugs in PrEP can also suppress the hep B virus and we’d take this into consideration when helping you start or more importantly stop taking PrEP
  4. A blood test to check your kidney function. In a very small number of people PrEP can damage renal (kidney) function. This is rare and usual only in people with existing kidney problems or taking other medication that may affect their kidneys

Other resources

The information above has been collated from sources including the following, which you can read through if you wish to find out more about PrEP:

Ready to start using PrEP?