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PrEP



What is PrEP?

PrEP (HIV Pre-exposure Prophylaxis) is a tablet taken by HIV negative people, who are at higher risk of HIV infection, to reduce risk of acquiring HIV.

It is taken before sex, hence the term pre-exposure; prophylaxis means to prevent infection.

It has been shown to be highly effective in clinical trials.


Dorset HealthCare is now commissioned to provide PrEP free for everyone who is eligible.


Who's suitable for PrEP?

Men and transgender women who:

  • Have sex with men;
  • AND have had an HIV negative test during in the preceding year;
  • AND report condomless sex (excluding oral) in the previous 6 months;
  • AND are likely to continue having condomless sex (excluding oral).

HIV negative partners of an HIV positive person when:

  • The HIV positive partner is not known to be virally suppressed (<200 copies/ml for 6 months or more);
  • AND condomless sex (excluding oral) is anticipated before treatment of the HIV positive partner takes effect,

Other HIV negative people assessed to be at high risk of HIV acquisition:

  • This may include people having condomless sex (excluding oral) with partners from parts of the world where HIV is common (such as Southern Africa, South East Asia and the Caribbean) and commercial sex workers who report regular condomless sex.

Did you know?

Those who make up nearly half of the new HIV diagnoses in the UK amongst heterosexuals are Black African men and women – despite making up less than 2 per cent of the British population. Approximately half of Black African men and women diagnosed with HIV in the UK are thought to have acquired HIV while living in the UK.

Use this tool to work out if PrEP is right for you:

https://www.startswithme.org.uk/prep-tool/

There is also a great resource here for women who are considering if PrEP might be right for them: https://www.womenandprep.org.uk

Where and how to get PrEP?

We are here to support you if you have any questions about using PrEP.

If you decide to access PrEP from other sources, we can provide you with safety monitoring, STI and HIV testing, vaccinations you may benefit from and to give you advice on usage.

Call 0300 303 1948 to speak to us.

Before you start

PrEP is not the same as PEP.

PrEP protects you against HIV but not any of the other STIs - it’s important to get tested regularly (you can order a free postal test or visit one of our clinics) and use condoms to protect against infections like gonorrhoea and chlamydia.

It is important for you to be tested for HIV before starting PrEP. This is because the medicines used for PrEP are also used for treatment for HIV, and if you are already infected but don’t know that you are, your future treatment options may be limited or you could become resistant to the medication if you miss or take a late dose.

You should also be tested for hepatitis B before starting PrEP. This is because the medicines are also used for a treatment of this infection, and it may affect how we advise you to take PrEP. If you don’t have hepatitis B and haven’t been vaccinated, we would strongly advise that you get vaccinated.

You need to have an STI screen, a urine test and a blood test to check your kidney function; the drugs can sometimes affect your kidneys so we need to know how well they are working before you start.

The clinician will also talk to you about the best way to take PrEP.

Whilst you are on PrEP

Whilst you are taking PrEP you should have regular HIV and STI tests – every 3 months. Once a year at least, you should have a blood test to check your kidney function.

If you get ill with fevers and/or if you have missed some pills and had sex, you will need to come in sooner and have an HIV test in case you have “seroconverted” (i.e. become infected with HIV). It is important to identify this early so we can get you on the right medication and test any contacts you could have caught the infection from.

Stopping PrEP

It is important to speak to a doctor before you stop PrEP.

Stopping PrEP should be timed correctly after the last risk, and you (and your partner if relevant) should have an HIV test 6 weeks after your last risk.

That said, if you are no longer having the same risks, it’s not sensible to stay on PrEP just because it is “easy” to do so. There are some long-term risks associated with these drugs, as there can be with any medications. As outlined above, they can affect kidneys and also bone health.

Extra sources of information

These links will take you to information about PrEP:

http://i-base.info/guides/prep

https://www.iwantprepnow.co.uk/

https://www.womenandprep.org.uk

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