Anyone who is HIV negative and wants to protect themselves from HIV; especially those who have sex without using barrier protection e.g. condoms. In the UK, the groups considered to be at higher risk of contracting HIV are people with a penis who have sex with people with a penis; and people of any gender or sexuality who come from a country with a high incidence of HIV.
PrEP stands for pre-exposure prophylaxis. PrEP is a pill you can take to protect you from HIV. You’re protecting your own HIV negative status by taking PrEP.
What the name PrEP means:
‘pre’ is something you do before a risk of exposure (in this case to HIV)
‘prophylaxis’ is a treatment or action you can take to help prevent disease.
There are 4 different methods of taking PrEP, depending on how far in advance you plan on having sex, and also how regularly you have sex. It does not necessarily depend on how much sex you have.
1. Daily PrEP - one pill taken at the same time every day. Suitable for those having anal, vaginal and/or frontal sex.
2. On Demand PrEP or Event Based Dosing (EBD) - This dosing option is only suitable for those having anal sex, not vaginal or frontal sex. If you know that you might have condomless sex 24 hours in advance:
take 2 pills 2 – 24 hours before sex
take 1 pill 24 hours later
take 1 more pill 24 hours after that
If you’re having sex for an extended period of time, perhaps over a few days or a weekend, continue to take a pill every 24 hours until you have 2 sex-free days. This option is not recommended if you have an active hepatitis B infection.
3. 4 pills a week or the "Ts and Ss" - This dosing option is only suitable for those having anal sex, not vaginal or frontal sex. 4 pills per week usually involves taking a pill on Tuesday, Thursday, Saturday and Sunday — that’s why it’s called ‘the Ts and Ss’. This option may be for you if you only have sex once or twice a month, and don't want to take a pill every day. You might feel it’s more pills than you need to protect you for these 1 or 2 events.
4. Holiday PrEP - Consider Holiday PrEP before a pre-planned block of time when your risk of exposure to HIV will be higher due to:
an increased number of partners of unknown HIV status
situations where condoms are not easily or always used
where substances might be used
having sex while travelling to a country with a high HIV prevalence.
Holiday PrEP is suitable for those having anal, vaginal and/or frontal sex.
Switching between dosing options to match your sexual activity and patterns is totally OK. You can adjust your PrEP regime to best suit you as your situation changes. However, it is recommended that trans people on hormone treatment use daily PrEP (including holiday PrEP) as there is not sufficient data to support other dosing options.
PrEP is a pill you can take to protect you from HIV. It is extremely effective when taken properly. If you take PrEP correctly, you don’t need to worry about a sexual partner’s HIV status. You’re protecting your own HIV negative status by taking PrEP.
PrEP is a great idea for you if:
- you are HIV negative, and
- you have sex in a variety of situations where condoms are not easily used or not always used.
PrEP only protects you against HIV.
You need to take other precautions to reduce your risk of contracting other sexually transmitted infections (STIs) such as gonorrhoea, chlamydia, syphilis and hepatitis C. You should still get regular STI tests. You will also need to do an HIV test every three months.
- NHS Scotland has provided PrEP across Scotland since July 2017.
- NHS Wales started the PrEPared Wales project in July 2017. Set to make PrEP routinely available on the NHS imminently.
- PrEP is being rolled out on the NHS in England throughout 2020. NHS England started enrolling 10,000 people onto PrEP Impact in October 2017. The trial was increased to 26,000 places. It closed for recruitment in July 2020.
- Health and Social Care in Northern Ireland started offering PrEP through a pilot in summer 2018. Set to make PrEP routinely available through HSCNI imminently.
Find out more information about how to access PrEP on the NHS here. Always talk to a doctor or medical professional before deciding to take PrEP.
If you are not eligible for PrEP on the NHS, you can buy it online, but talk to a medical professional before doing this. The Mags Portman Fund exists to help those who cannot afford PrEP to access it.
real life experiences
"For me personally, learning about PrEP changed the way I saw HIV, contracting HIV had always been a fear of mine. I was anxious that if I were to sleep with someone who had HIV, I would contract it myself even if we were using condoms. I was worried that contracting HIV would change my whole life, that I wouldn’t be able to live the same way I was before. Understanding how treatment can keep the body healthy and can actually prevent it from being passed on really changed my mindset. I always use some form of protection myself, whether that’s condoms or PrEP, regardless of the status of my partner, as I believe looking after my sexual health is my responsibility. But that anxiety around sleeping with those who have HIV has melted away." Karim, he/him