PrEP is short for Pre-Exposure Prophylaxis. It involves taking pills containing the drugs Tenofovir and Emtricitabine to protect you from catching HIV. It’s now available on the NHS to those at risk. The treatment needs to be started BEFORE sex.
Do either of these apply to you?
I’m a man who has sex with other men | I’m Trans or non binary.
Your sexual partner(s) has HIV and is not ‘undetectable’ on treatment.
You inject party drugs and share needles. (e.g. Crystal meth, mephedrone).
PrEP may be recommended if
Your job involves condomless sex.
You have condomless sex with people from a population group or country where HIV is more common. (see below*)
You have condomless anal sex with a man who has sex with men
*Angola, Antigua and Barbuda, Bahamas, Barbados, Belize, Benin, Botswana, Burundi, Cote d’Ivoire, Cameroon, Central African Republic, Chad, Congo, Democratic Republic of the Congo, Djibouti, Equatorial Guinea, Eswatini, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Guyana, Haiti, Jamaica, Kenya, Lesotho, Liberia, Malawi, Mali, Mauritius, Mozambique, Namibia, Nigeria, Russia, Rwanda, Saint Vincent and the Grenadines, Sierra Leone, South Africa, South Sudan, Suriname, Tanzania, Thailand, Togo, Trinidad and Tobago, Uganda, Ukraine, Zambia & Zimbabwe.
Have you been diagnosed with HIV?
PrEP is a treatment that protects people from catching HIV.
You’ve told us that you already have HIV.
So you don’t need PrEP.
If you are taking HIV treatment and are ‘undetectable’ you cannot pass HIV to other people.
Do you have anal sex?
Most people catch HIV from anal sex.
You’ve told us you don’t have anal sex.
So PrEP is not recommended.
You can catch HIV from sharing injection needles. So we might recommend PrEP if you inject party drugs. (e.g. Crystal meth or mephedrone)
Gay, bi or queer trans men, as well as trans women and non-binary people may also be at risk of catching HIV from frontal/vaginal sex. We might recommend PrEP for you. Contact your local service for an individualised assessment.
Do you always use a condom?
Condoms protect you from catching HIV.
If you always use condoms for anal sex, you don’t need PrEP .
Condoms also protect you from other sexually transmitted infections.
If something goes wrong with condoms you can take a course of post exposure prophylaxis treatment (PEP).
PEP involves taking HIV medicines for 4 weeks after you have sex. You should ideally start it within 24 hours and definitely within 72 hours of condomless anal sex. It’s available from all sexual health clinics. You can also get a starter pack from any hospital A&E (emergency) department.
Are you in a monogamous/exclusive relationship?
You’ve told us you are having condomless anal sex with a person/people who may have HIV.
Studies show that this means you are at extremely high risk of catching HIV.
PrEP is a very effective way of protecting yourself.
You’ve told us that you’re only having sex with one person. It’s important that you both know your HIV status before you have condomless anal sex.
You don’t need PrEP if you both test HIV negative. However, it’s important that you agree to be honest if one of you has condomless anal sex with another person.
If one of you tests HIV positive there are a few options to choose from.
You could use condoms for anal sex.
The person with HIV could start treatment. Once levels of HIV in their blood are ‘undetectable’, they cannot pass the infection to other people.
The HIV negative person could use PrEP to protect themselves from catching HIV (until their partner has started HIV treatment and become ‘undetectable’).
If both of you test HIV positive, check with your doctor whether it’s OK for you to have condomless sex.
Are they on treatment & ‘undetectable’
People who are ‘undetectable’ on HIV treatment cannot pass the virus to other people.
Your partner’s treatment is protecting you from HIV.
You don’t need PrEP.
You’ve told us that you are having condomless anal sex with an HIV positive person who is not ‘undetectable’.
Studies show that this means you are at extremely high risk of catching HIV.
PrEP is a very effective way of protecting yourself.
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