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What is PrEP?
PrEP stands for Pre-Exposure Prophylaxis – meaning a treatment or action you take before risk of exposure to protect yourself from HIV. It is different from PEP (Post-Exposure Prophylaxis).
When used as directed, PrEP medicines has been shown to be highly effective at reducing the risk of contracting HIV – up to 99% in some cases.
What PrEP contains and how it works
PrEP is currently available in two forms – the branded drug Truvada, and unbranded generic forms.
In addition to Truvada, there are two other PrEP medications: Descovy and Apretude, though they are not as widely used as Truvada. If you are interested, find out more about PrEP Medicines.
Generics contain exactly the same active ingredients as Truvada (Tenofovir TDF and Emtricitabine FTC), and work in the same way – by stopping the virus from replicating in your body. They are manufactured by companies that do not own the original patent.
However, Truvada is significantly more expensive than generics. This is because pharmaceutical companies that invent original brand-name drugs need to recoup their costly investment in the development process, while generic manufacturers only need to demonstrate to regulators that their version is as good and effective as the original.
Why take PrEP?
For those at high risk of HIV, taking PrEP can significantly reduce the risk of infection if taken daily.
The use of PrEP is currently recommended in national guidelines in many countries including the United States, United Kingdom and Australia. The World Health Organization recommended in 2015 that “PrEP should be offered as an additional prevention choice for people at substantial risk of HIV infection as part of combination HIV prevention approaches”.
Several studies on PrEP have been carried out in recent years, conclusively proving the effectiveness of the drug in preventing HIV. These studies include the following:
| Study | Key Details |
|---|---|
| iPrEx Study | – Conducted among 2499 men and transgender females – Protection against HIV infection was significantly higher among study participants who took the drug regularly enough to have detectable drug concentrations in their systems, as measured through blood analysis |
| IPERGAY Study | – Conducted among 414 MSM comparing on-demand PrEP vs placebo – Study found a relative reduction in HIV infections of 86% for those taking PrEP on-demand vs the placebo group |
| PROUD Study | – Conducted among 544 MSM in England – Participants either received daily PrEP immediately or after a deferral period of 12 months – Study found that daily PrEP conferred even higher protection against HIV than in placebo-controlled trials, without evidence of an increase in other sexually transmitted infections |
You should consider taking PrEP if you:
- Have sex with a person with HIV who is not on suppressive Antiretroviral Therapy (ART) or has a detectable viral load
- Have anal or vaginal intercourse without consistent use of condoms with more than one partner
- Have difficulties or concerns using condoms
- Use recreational drugs (chemsex)
PrEP is not suitable if you:
- Have a known HIV infection
- Have clinical symptoms that suggest acute HIV infection or HIV seroconversion illness
- Have known impairment of renal (kidney) function
- Have an allergy to any of the drugs in the PrEP regimen
Ready to start using PrEP?