PrEP in Our Community

PrEP is medication that protects against HIV even if you don’t use condoms. It stands for ‘Pre Exposure Prophylaxis’.

• ‘Pre’ means ‘before’ – i.e. taking meds before you have sex (and also afterwards). 
• ‘Exposure’ means you are exposed to a risk of catching HIV. 
• ‘Prophylaxis’ means a way of preventing an infection.

Most people who take oral PrEP use a single pill that contains two drugs: 

• Tenofovir DF (TDF) and
• emtricitabine (FTC) 

It can be taken daily or just when you will be having sex. 

For people who might have, or be at risk of kidney problems, they make take a slightly different pill containing tenofovir AF and emtricitabine.

Both pills are taken in the same way, with the same instructions. 

Injectable PrEP is also an option if you are not able to easily use pills.

Please talk to your doctor about different ways to use PrEP.

PrEP is free in local sexual health clinics and through the online digital service; it is also available in some GP surgeries across South East London. 

Before you start PrEP, you just need a HIV and kidney test.  All testing and monitoring is free.

Adult PrEP works whatever your age, gender or sexuality.

• If you don’t always use condoms. 
• If you recently had an STI. 
• If you ever use PEP (post exposure prophylaxis).
• If you use recreational drugs, including chemsex. 
• If worrying about HIV stops you enjoying sex. 
• If your partner is HIV positive but not on treatment. (An undetectable viral load has no risk of HIV transmission).

PrEP can be used for any job linked to the sex industry. Even if you look after your sexual health, your clients might not.

PrEP will protect against HIV if you are under pressure to not use condoms.

Specialised services that are free from stigma and judgement are available and recommended.

See more: Ugly Mugs - a national organisation that provides greater access to justice and protection for sex workers.

National Ugly Mugs (NUM) is a UK-wide charity working with sex workers to do research, design and deliver safety tools and to provide support services to people in adult industries.

Using PrEP just needs a few tests:

• A HIV test - this is to make sure you are HIV negative before you start PrEP and should be done every 3-4 months whilst taking PrEP.
• Tests for sexually transmitted infections (STIs) are recommended when starting PrEP and when you attend for monitoring. It includes hep B because oral PrEP is active against hep B. 
• Kidney tests when starting and the once or twice a year when taking PrEP. These tests are free whether getting PrEP from online, through a GP or a sexual health clinics.

Oral PrEP has two options.

Option 1

Daily dosing – although this involves taking one pill every day, even if you take at least four pills a week this will still provide high levels of protection.

• Daily dosing can be easier if you have sex every week.
• Daily dosing can also be easier if you are not certain when you are next likely to have sex.
• Daily dosing is needed if you have hepatitis B. 

Option 2

On-demand dosing involves only taking PrEP when you might have sex. This uses  either 2:7 or 2:1:1 dosing.

• 2:7 dosing is suitable for women (cis and trans) having vaginal/neovaginal sex. It involves taking 2 tablets from 24 to 2 hours before sex followed one tablet every day for 7 days after last episode of sex.
• 2:1:1 dosing is suitable for all other types of sex (including giving or receiving anal sex or giving vaginal sex). It involves taking 2 tablets from 24 to 2 hours before sex followed by one tablet each day for two days after sex.

Everyone should start oral PrEP (either TDF/FTC or TAF/FTC) by taking TWO pills between 2 and 24 hours BEFORE  sex (or before any possible exposure to HIV). Then, continue to take ONE pill every day until stopping PrEP (see below).

How to safely stop PrEP, depends on the type of sex you are having:

• Vaginal or neovaginal sex: If you are using oral PrEP to prevent HIV during vaginal (including neovaginal) sex, then take a single dose of PrEP EVERY day for SEVEN sex-free days after the last time you have sex. It’s then safe to stop. This is sometimes called “2:7 dosing” and may be needed by women (cis and trans). 
• Any other type of sex (including anal sex): If you are using oral PrEP for preventing HIV from ANY other kind of sex (including giving or receiving anal sex), then take a single PrEP pill for another two sex-free days after the last time you had sex.
  If you have sex over a few days, keep taking a pill each day. Continue for two days after the last day you have sex.