PrEP (HIV Pre-exposure Prophylaxis)
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What is PrEP?
Is PrEP right for me?
Can women use PrEP?
Where can I get PrEP in West Sussex?
What should I expect before starting PrEP?
How do I take PrEP?
Frequently asked questions (FAQs) about PrEP
Related content
What is PrEP?
PrEP (pre-exposure prophylaxis) is a medication that protects you from HIV. It is a course of tablets that you take before and after sex. There are different ways to take PrEP depending on the type of sex you are having, but if taken correctly it is 100% effective. Taking PrEP means you can feel in control of reducing your risk of HIV.
There are two types of PrEP:
- Tenofovir Disoproxil and Emtricitabine (sometimes known by its patented name of Truvada)
- Tenofovir Alafenamide and Emtricitabine (sometimes known by its patented name of Descovy)
Both are types of medication used to treat HIV. They work by stopping HIV from getting into your body and replicating (making copies of itself). PrEP is only effective if there is enough medication in your body at the time you come into contact with HIV, so it is important to take it correctly.
As PrEP only protects against HIV, we recommend that you have regular sexual health screening, especially if you are using PrEP instead of condoms.
Is PrEP right for me?
PrEP is for all people, regardless of their gender or sexual orientation
PrEP lets you take control of protecting yourself from HIV. It is discrete and private to you
PrEP may be suitable for you if you:
- are HIV negative
- have anal, vaginal or frontal sex in a variety of situations where condoms are not easily or always used
- want to protect yourself from HIV
Can women use PrEP?
Yes! PrEP is a safe and effective way to protect against HIV for people of any gender. It is safe to use in pregnancy and when breastfeeding and doesn’t interact with any hormonal treatments.
A benefit of PrEP is that it puts you in control of protecting yourself against HIV. We would recommend PrEP to anyone who wants to reduce their risk of HIV.
Where can I get PrEP in West Sussex?
PrEP is provided for free as part of NHS specialist services in sexual health clinics in England, Scotland and Wales.
In West Sussex PrEP is accessible from our Chichester, Crawley & Worthing clinics.
If you want to start PrEP, come and see us – to book an appointment you can call us on 01903 285 199
If you’re already taking PrEP, it’s important to have regular STI/HIV screens (and kidney monitoring if necessary) every 3 months.
Your follow-up appointments can be booked when you attend for your PrEP appointment. If you’ve missed an appointment, please call us on 01903 285 199.
- If our phone lines are closed, please wait until they re-open.
- If you have run out of PrEP, use condoms for sex and contact us to arrange further treatment.
- Do not use PrEP that has been prescribed for someone else.
- If you are not in West Sussex, you can still access PrEP from your local sexual health clinic.
What should I expect before starting PrEP?
You will be seen by a nurse or Dr, who will discuss whether PrEP may be right for you. This will include talking about the sex and relationships you have and taking a medical history.
You will need to have an HIV test as well as a kidney function (blood and urine) test on the day you start PrEP or just before. You may need to repeat tests 4 weeks after starting PrEP.
If you have requested an online test kit to do at home, you will need to complete a blood sample, to test for HIV which is carried out in our laboratory.
You will also be offered:
- Testing for sexually transmitted infections (STIs)
- Vaccinations to protect yourself against hepatitis A, hepatitis B, Gonorrhoea, M.Pox & HPV, if you are eligible and have not had in the past.
How do I take PrEP?
There are two ways that PrEP is usually taken:
1. Daily PrEP: PrEP is usually taken as a once daily tablet. Your first dose will be 2 tablets and you will be protected after 2 hours.
2. On Demand or Event-Based PrEP: this refers to taking PrEP before and after sex, and is a non-daily way to take PrEP which is recommended for some people. It may also be more popular for people who know in advance when they are going to have sex.
- 2:1:1 dosing; suitable for people having anal sex or using their penis using penetrative vaginal or anal sex – Two tablets taken 2-24 hours before sex, then daily until 48 hours after the last sex
- 2:7 dosing; suitable for people using their vagina, neovagina during sex – Two tablets taken 2-24 hours before sex, then daily until 7 days after the last sex
We usually recommend daily PrEP for everyone unless you are able to plan in advance when you will be having sex.
Frequently asked questions (FAQs) about PrEP
Does PrEP have any side effects?
We know from research studies that PrEP is a very safe medication.
Often when people start taking PrEP they experience some gastrointestinal side effects (usually feeling sick or having diarrhoea). These are usually mild and resolve within a few weeks of starting PrEP.
If you experience these side effects whilst taking the double dose (2 tablets) when event-based dosing, you can separate the 2 doses (2 tablets) by up to 12 hours as long as they are both taken in the 2-24 hours before sex.
Less frequently, taking PrEP can affect kidney function and bone mineral density. This is why we need to take blood tests to check how your kidneys are working while you are using PrEP.
If your kidney function changes while using PrEP, there are things we can do to avoid any damage to your kidneys.
It is really important that you inform the sexual health nurse or Dr, if you have any other medical problems (even if they are not related to sexual health) or if you take any medications (including over the counter medications or recreational drugs), so that we can choose the safest option for your PrEP treatment.
Any effect on bone mineral density is usually mild and reverses once PrEP is stopped, however if you have a condition which affects your bones like osteoporosis, please ensure you tell the clinician this so we can choose a treatment which won’t have this effect.
Do I need PEP if I’ve missed a dose of PrEP?
Taking PrEP offers excellent protection against HIV, but it needs to be taken as prescribed. If you have missed doses and have had sex without a condom you may need PEP (hyperlink). The advice about when PEP might be needed also depends on whether you are taking daily PrEP or event based PrEP.
- Daily PrEP – missing a pill occasionally will not affect your level of HIV protection, as long as you have taken at least 4 days of PrEP a week for having anal sex or 6 days of PrEP a week for vaginal or frontal sex.
If you have missed more pills you may need PEP - Event-based PrEP – You may need PEP if you haven’t taken event-based PrEP exactly as prescribed (2-1-1 dosing).
If you currently have a supply of PrEP we recommend that you take a double dose as soon as possible and continue with PrEP daily while you seek advice about PEP.
How often do I need to come into clinic if I take PrEP?
When you first start PrEP we will see you at 3-6 months for review, and to complete vaccinations or other treatment as needed.
When you have been taking PrEP for a while we offer the opportunity to book your appointments through our PrEP Emerge app.
We will see you in clinic every 6 months for a review, a sexual health screen, and kidney function tests (if needed).
At 3 and 9 months we will send you a home STI testing kit https://www.sexualhealthwestsussex.nhs.uk/online-testing/ to complete and send back to us. Your results will be uploaded to the PrEP Emerge app for easy access. If you would like this option but prefer to attend for sexual health screening you can book into one of our ‘quick check’ clinic sessions.
What should I do if I run out of PrEP?
We will aim to give you enough PrEP to ensure you don’t run out before your next appointment.
If you are about to run out of PrEP please contact us on 01903 285199 and we will try to see you as soon as possible.
If you do not have enough PrEP you will need to use a condom every time you have sex until you have restarted to protect yourself from HIV.
My partner has HIV, is PrEP for me?
If your partner has HIV, is taking daily medication and is undetectable, you do not need to take PrEP.
Once someone is undetectable they cannot pass HIV on to anybody else. However, if you have unprotected sex with other people than your partner, we would recommend PrEP.
I have HIV, is PrEP for me?
If you are HIV positive, PrEP is not suitable for you. PrEP is only suitable for people who are not diagnosed with HIV.
If you have been diagnosed with HIV we can can offer access to HIV care and treatment (Local hyperlink)
Do I need to tell my GP or other health care professionals if I’m taking PrEP?
UK sexual health services are confidential and so your GP will be unaware that you have attended.
If you take any other medications we advise letting your GP know that you take PrEP so they can make sure it won’t interact with your treatment.
Do I need to take PrEP if my partner is taking it?
Even if your partner takes PrEP we recommend you also consider it.
This means that you know you are in control of your own HIV risk even if your partner forgets to take their PrEP.