“The challenges ahead of us are formidable. We should subscribe to and support the principle that all populations have a right to effective HIV prevention and treatment. Now that PrEP has shown that it works, it seems that extending access to PrEP is not only a matter of public health policy, but an imperative human right.” — Françoise Barré-Sinoussi, Nobel Prize in Medicine, 2008

Pre-exposure prophylaxis (PrEP)

Pre-exposure prophylaxis, or PrEP, involves giving a combination of antiretroviral drugs to HIV-negative individuals who are exposed to the virus, with the aim of reducing the risk of infection.

Sunscreen is another example of a pre-exposure prophylaxis. If you know that you will be exposed to the sun, you use a sunscreen to prevent sunburn.

Two types of PrEP to prevent HIV infection

• Continuous PrEP, which involves taking antiretrovirals every day to reduce the risk of HIV infection.
• Intermittent (or “on demand”) PrEP, which involves taking two pills between 2 and 24 hours before high-risk sexual relations, followed by one pill between 24 and 48 hours after sexual relations.

How does PrEP work?

Truvada is a pill that combines two drugs (tenofovir and emtricitabine) and is taken once daily. It is often used in treating HIV. As part of a PrEP treatment, Truvada can block the replication of HIV, if you are exposed to it, and prevent the virus from infecting your body.

The latest studies indicate that Truvada, when used by HIV-negative people, reduces the risk of infection by 92%, if the treatment is followed to the letter.

For whom is PrEP intended?

For certain people who are at high risk of HIV infection, PrEP can be effective as an additional protective measure, but this is not the case for everyone.

You should not use PrEP as a stand-alone treatment, but rather in combination with other preventive measures, including condoms and regular screening for HIV.

When used properly, PrEP has shown to be effective in women and men who are at high risk of HIV exposure, including gay men and heterosexuals whose partner is HIV-positive but has not been treated, or men who have sex with men but do not always use a condom.

PrEP has also shown to be effective in reducing the risk of HIV infection among injection drug users who do not always use sterilized needles and syringes.

What constitutes high-risk activity for contracting HIV?

• Active or passive penetration without a condom, or if the condom breaks
• Sharing sex toys without disinfecting them, with your regular partner or other partners
• Fisting (a.k.a. ‘fist-fucking’) without gloves, or when sharing contaminated gloves, with your regular partner or other partners
• Contact between semen and open sores, cuts or abscesses in the mouth or on the body

How long does PrEP treatment last?

PrEP is indicated for times when you face a high risk of exposure to HIV. These periods may be short-term or long-term, or may be more or less repetitive.

Consequently, PrEP is not necessarily a lifelong treatment. If you change your mind regarding your treatment, speak with your doctor.

What should I do if I forget to take the pill?

The effectiveness of PrEP depends on your adherence to the treatment. The better you follow the treatment to the letter, the more effective PrEP will be.

What are the side effects of PrEP?

Side effects are rare, and can include nausea or headaches. Generally, they occur at the beginning of treatment and are short-lived. In any case, it is important to discuss potential side effects with your doctor.

In very rare cases, other more serious side effects can occur. For this reason, you should see your doctor every three months during your PrEP treatment, to monitor any potential side effects, get your blood tested and be screened for HIV and other STIs.

What is the difference between pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP)?

Post-exposure prophylaxis, or PEP, is prescribed to uninfected people after they have been exposed to HIV. Research indicates that if you begin PEP treatment within three days after engaging in an activity involving a high risk of exposure to HIV, you can reduce the risk of infection.

If you believe that you are a good candidate for PrEP, never try it on your own. For guidance, you should speak with your doctor. You can also make an appointment at one of our PrEP Clinics, where you will meet with a doctor and a nurse who can answer your questions and determine if you are eligible for the treatment.