PrEP

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HIV PrEP (Pre-Exposure Prophylaxis)

 

What is PrEP?

PrEP stands for Pre-Exposure Prophylaxis. It is a medication taken by people who do not have HIV to prevent them from getting HIV.

When taken correctly, PrEP is highly effective at protecting against HIV.

Who is PrEP for – Everyone!

PrEP can benefit anyone who may be at risk of HIV and it may be particularly important if you

  • Have sex without condoms
  • Are starting a new relationship and don’t know your partner’s HIV status
  • Have multiple sexual partners
  • Inject drugs and share equipment
  • Are travelling to or spending time in countries where HIV rates are higher  
  • Have a partner living with HIV who is not on treatment or not virally suppressed
  • Feel you may be at risk

If you're unsure, a healthcare professional can help you decide if PrEP is right for you.

How effective is PrEP?

PrEP is up to 99% effective at preventing HIV when taken as prescribed.

PrEP does not protect against other sexually transmitted infections (STIs).

Where can I get PrEP?

PrEP is available free of charge from sexual health services

Find a sexual health service here Find a sexual health clinic - NHS

Support is available through PaSH partners.

We understand that conversations about HIV can sometimes feel sensitive. Our services are:

  • Confidential and non-judgemental
  • Experienced in supporting people from all cultural backgrounds
  • There to help you make informed decisions at your own pace

 

PrEP support and Initiation clinics from LGBT Foundation

For more information from the LGBT Foundation and details of their community PrEP clinics held jointly with The Northern sexual health service visit What is PrEP? - LGBT Foundation

PrEP support and referral from BHA for Equality

For people from Black, Asian, and Minority Ethnic Communities BHA offers PrEP information and advice and a PrEP fast track referral service. Register here PrEP - BHA for Equality

Getting started on PrEP

Before starting PrEP, you will need:

  • A full sexual health screen including HIV and Hepatitis B  
  • A kidney function test

PrEP can cause a decline in kidney function. This is not common, but it is important to check out the any existing kidney problems before starting.

You will be given your PrEP medication, usually 3 months’ supply initially  

Ongoing tests and repeat prescriptions

The clinician providing your PrEP will assess what regular monitoring and testing is needed and how long your PrEP prescriptions should last. You may be offered 3, 6 or 12 moths supply depending on their clinical assessment.

Depending on factors like your age they will determine if your kidney function test needs to be done every three, six or 12 months and this may determine the length of your prescription.

Full STI testing is usually recommended every three months, but the clinician may decide that they can be done less frequently.  Ongoing STI testing may be provided by sending you home testing kits. Ask the service providing your PrEP how they manage this.

Taking PrEP: Daily and On-Demand Options

There are two main ways to take PrEP. A clinician will help you choose what’s right for you.

Daily PrEP (most common)

  • Take one tablet every day
  • Builds up protection in your body over time
  • Provides ongoing protection without needing to plan in advance
  • Suitable for most people, including women, heterosexual men, and people with regular or unpredictable sexual activity

On-demand PrEP (event-based)

  • Taken around the time of sex, rather than every day
  • Requires planning ahead
  • Usually follows a 2‑1‑1 schedule (two tablets before sex, then one tablet daily for two days after)
  • Only recommended for some people, mainly cisgender gay and bisexual men

Choosing the right option

  • Daily PrEP is best if your risk is ongoing or unpredictable
  • On-demand PrEP may suit you if sex is less frequent and planned

If you’re unsure, a sexual health professional can talk through your options.

PrEP and PEP: What’s the difference?

Both PrEP and PEP help prevent HIV, but they are used in different situations:

PrEP (Pre-Exposure Prophylaxis)

  • Taken before potential exposure to HIV
  • Used on an ongoing basis (daily or on-demand)
  • Helps prevent HIV before sex or exposure happens

PEP (Post-Exposure Prophylaxis)

  • Taken after a possible exposure to HIV
  • Must be started within 72 hours (3 days)
  • Taken for 28 days
  • Used as an emergency treatment to reduce the risk of HIV infection

PEP is available:

  • From sexual health clinics during opening hours
  • From Accident & Emergency (A&E) departments when clinics are closed

If you think you may have been exposed to HIV, do not wait — seek advice as soon as possible.

Common questions

Does PrEP have side effects?

  • PrEP is generally safe and well tolerated. But some people may experience mild side effects when starting.  

Common side effects include feeling sick, diarrhoea, bloating, indigestion, headache, feeling tired or weak and sleeping problems. They usually go away after the first couple of weeks.

  • Taking PrEP with or just after food may help reduce some side effects.

Does PrEP protect against other STIs?

  • No. PrEP only protects against HIV. Condoms, vaccinations, doxypep and regular testing help prevent other infections. For more information look at the prevention options here Prevention | PaSH

What happens if I miss a dose?

  • Missing an occasional dose may not significantly reduce protection, but try to take it as prescribed. If you miss doses regularly, speak to a healthcare provider.

What about long-acting injectable PrEP?

  • Cabotegravir PrEP is an injection given every two months. It is available from sexual health clinics but only for people who cannot have oral PrEP. This may be because of side effects of oral PrEP, kidney problems or a range of issues like not being able to keep tablet safely at home.

 

 

More information from the NHS is available here About Pre-Exposure Prophylaxis (PrEP) - NHS