What is PrEP?

What is PrEP?

PrEP is a medicine that can be taken before sex to help reduce your risk of HIV acquisition (catching HIV). It contains the active drugs tenofovir/emtricitabine. These drugs have been used as HIV treatment for many years. PrEP is different to PEP, in that you take it in preparation for sex, rather than afterwards as an emergency.

It is now available on the NHS in England following the completion of the IMPACT clinical trial. It is also available via the NHS in Scotland and via the PrEPARED project in Wales.

How effective is PrEP?

How effective is PrEP?

The success of PrEP is measured by how well it reduces the risk of acquiring HIV. A wide range of results have been reported from PrEP studies, with some finding high effectiveness and some finding that PrEP made no difference.

For men who have sex with men (MSM) the two most significant studies to date (PROUD and IPERGAY) found PrEP reduced your acquisition risk by at least 86%. Our experience in the clinic is that it is likely to be even more effective than that.

For women and heterosexual men the results are mixed. The key difference in results is linked to what we call adherence ie. how regularly you take the medication. We now know it takes longer to build up protective levels of PrEP in your body ready for vaginal sex, and also that it wears off quickly. This means heterosexuals have to take PrEP for a week or longer, and keep taking it daily, for it to be effective.

We are learning more all the time through PrEP research, including the IMPACT trial. We are increasingly confident it is an effective and safe way to help protect people at risk of acquiring HIV.

 

Did you know, PrEP can be taken two ways?

Did you know, PrEP can be taken two ways?

  • DAILY dosing (taking it every single day, at the same time)

or, alternatively

  • ON DEMAND or EVENT BASED DOSING (taking it before sex, and for 48hrs after)

Daily dosing can be taken by anybody. For MSM it will be working after you swallow your third tablet. For heterosexual women after you swallow your eight tablet.

Event based dosing can only be used by MSM. It has been a very useful strategy over the COVID lockdown when people have needed to take PrEP on and off.

Do I need it?

Do I need it?

PrEP is recommended for people at higher risk of HIV acquisition. In the UK this is most likely to be MSM who have condomless anal sex. This is because HIV is most easily passed on through condomless  anal sex. However PrEP may also be suitable for some heterosexual men and women who have sex with partners who have a higher risk of having undiagnosed HIV (eg. sex with gay and bisexual men, sex with people from areas of the world where HIV is common).

Condoms remain the primary way to prevent most STI’s. If you use condoms consistently, then we would not encourage you to swap them for PrEP. Condoms and PrEP should work in tandem to reduce your risk of acquiring all STIs.

I think I might need PrEP, where can I get it?

I think I might need PrEP, where can I get it?

PrEP is now available in the clinic – please call us to discuss if you are interested. We will assess your eligibility for PrEP – this is to determine if your risk of acquiring HIV is high. We will also assess your suitability for PrEP – this is to check for the small number of reasons PrEP cannot be prescribed safely.

PrEP is also available to buy online here at iwantprepnow.co.uk, or via the PrEP shop at 56 Dean St. These websites provide good quality PrEP at affordable prices, and have really helped thousands of patients over the last 3 years when PrEP has been difficult to access in England.

Some prescription or over the counter medicines cannot be taken alongside PrEP. Please speak to a doctor or nurse at the clinic, or your GP if you are taking, or are planning to take other medicines alongside PrEP. You can also check for interactions here

PEP

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Accessing our service during the COVID pandemic

How to access our service:

We have now implemented a telephone triage system for all of our clinics. This system will be in place for the duration of the pandemic. Please contact our services to access this triage system. Our central telephone number is 0300 303 3989.

If you are experiencing symptoms of Coronavirus please do not attend the clinic. Clear advice for people with symptoms of coronavirus is available at nhs.uk/coronavirus .

Advice from our service:

We have updated information on the provision of routine contraception during this pandemic here.

If you need the combined contraceptive pill please try (if you can) to get updated measurements of your height, weight and blood pressure before calling us.

We are currently prioritising these groups for coil and implant (LARC) fits:

  • Those with vulnerabilities including but not limited to those who are: <18, attending abortion and maternity services, homeless, sex workers, victims of sexual assault, people with language barriers, drug and alcohol problems, learning disability, serious mental illness
  • Those aged <30 years

More details on LARC fittings at our service are found here

There is also specific advice on coronavirus available for People Living with HIV here, and for pregnant women here

Self-requested Sexual Health screening by post is available for for under 25s only - more info here

For others with testing requirements please contact the service on 0300 303 3989.

Information is now also available to advise on sexual contact during a time of social distancing here.

Alternative provision:

Please be aware that we may have to cancel, rearrange or shut clinical services in response to changing clinical and staffing pressures created by the Coronavirus pandemic. 

If you are struggling to access sexual health services, alternatives may be available:

  • Emergency Contraception - at your local pharmacy - more info
  • Contraceptive pills and LARC procedures - obtained from your GP
  • HIV postal testing - available to at-risk groups for a small fee -  more info
  • HIV PEPSE - available via A+E departments - more info
  • Condoms by post (for gay and bisexual men only) - more info