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PrEP (pre-exposure prophylaxis)

PrEP is a form of HIV prevention that uses anti-HIV medication to protect HIV negative people from becoming infected with HIV.

  • Pre = before
  • Exposure = coming into contact with HIV
  • Prophylaxis = treatment to prevent an infection from happening

Research shows that PrEP is highly effective in preventing the sexual transmission of HIV as long as the drugs are taken as directed, before and after sex. It comes as a tablet, a combination of two HIV drugs: Tenofovir and Emtricitabine.

PrEP is now FREE from most NHS sexual health services across the UK. Alternatively, you can buy PrEP privately and/ or online but you are strongly advised to connect with your sexual health service for medical observation. PrEP is one preventative measure that can reduce the risk of contracting HIV, though condoms are still the most effective method of preventing HIV and other sexually transmitted infections (STI).

Even if PrEP is the game-changer many believe it to be, it offers zero protection against other STIs, which are on the rise. The excessive use of antibiotics in treating these other STIs reduces their efficacy.

Most people who take PrEP do not get any side effects. A few experience mild nausea (feeling sick), diarrhoea, headache and bloating, which usually go away after about a month. The HIV medications in PrEP can affect your kidneys and bones, which is why sexual health services will carry out tests before and during treatment and may ask you about your sexual history.

As PrEP only protects against HIV, condoms are important for the protection against other sexually transmitted infections (STIs). Condoms are also an important prevention strategy if PrEP is not taken consistently.

More about PrEP

Pre-exposure prophylaxis (PrEP) | nam aidsmap
PrEP (Pre-exposure prophylaxis) | iBase
PrEP (Pre-exposure prophylaxis) | LGBT Hero
PrEP (Pre-exposure prophylaxis) | Terrence Higgins Trust (THT)
PrEP (Pre-exposure prophylaxis) | National AIDS Trust (NAT)
PrEP (Pre-exposure prophylaxis) | Wikipedia

Where to get PrEP

Contact an NHS sexual health service in your area.

PrEP online

PrEP (Pre-exposure prophylaxis) | Prepster
PrEP (Pre-exposure prophylaxis) | I Want PrEP Now

The evidence for PrEP

In February 2015, the PROUD study reported that PrEP reduced the risk of HIV infection by 86% for gay men and other men who have sex with men. It measured the effectiveness of daily PrEP for those recruited during the 2-year study. In the UK there is still some concern that widespread use of PrEP could reduce the number of people who are using condoms and therefore increase the number of exposures with people who are not aware of their HIV infection, and who are potentially very infectious.

Updates and selection of news articles

PrEP Impact Trial | Public Health England/ NHS England
PrEP trial updates | NHS England

New research released today has revealed two thirds (65%) of people who want to access highly effective HIV prevention drug PrEP (pre-exposure prophylaxis) are unable to do so. This comes as the latest data from the UK Health Security Agency shows seven people are still being newly diagnosed with HIV every day in England.

Campaigners celebrated the prevention drug becoming available on the NHS in England two years ago as a significant milestone in achieving the Government’s target to end new HIV cases by 2030. But this new research from a coalition of concerned organisations found that significant access barriers are denying people opportunities to protect themselves against HIV, risking progress towards the 2030 goal.

The research was conducted by National AIDS Trust, Terrence Higgins Trust, PrEPster, Sophia Forum and One Voice Network. Data from 1,120 people in England struggling to access PrEP found the most common waiting time for a PrEP appointment at a sexual health clinic was 12 weeks (35%) – with more than half of those seeking appointments waiting more than 12 weeks to be seen (57%). People trying to access PrEP for the first time faced the biggest hurdles (68% reported access issues).

Not PrEPared: Barriers to accessing HIV prevention drugs in England  | PDF | NAT | Prepster | Sophia | One Voice | THT | Oct 2022

Huge fall in new HIV infections after roll-out of PrEP in Scotland | nam aidsmap | 21 Jan 2021
Communities with high virus rates 'left behind' due to Tory public health cuts | Mirror | 5 Apr 2021

 How PrEP users decide whether to use condoms | nam aidsmap | 30 Nov 2020
On-demand PrEP is highly effective, but some may find it confusing | nam aidsamap | 8 Jul 2020
Statement: government intend to cut PrEP funding by a third in England | NAT | 3 Jul
A quarter of gay men report casual sex during UK lockdown | nam aidsmap | 11 Jun 2020
PrEP, the drug that prevents HIV, will finally be fully rolled out in England | BuzzFeed | 16 Mar 2020
 HIV drug PrEP to be available across England | GOV.UK | 15 Mar 2020
 PrEP: Preventative HIV drug available in England from April | BBC | 15 Mar 2020
A drug can stop HIV infection – so why isn't it available on the NHS in England? | The Guardian | 16 Feb 2020
Does PrEP cause more HIV drug resistance? Yes, some | nam aidsmap | 12 Feb 2020
Why do people turn down the offer of PrEP? | nam aidsmap | 14 Jan 2020
 Trust and stigma affect gay couples’ choices on PrEP and PEP | nam aidsmap | 7 Jan 2020

Second case of unintended HIV transmission during HIV cure study prompts questions about PrEP provision | 22 Nov 2019 | nam aidsmap
Taking HIV drug PrEP 'doesn't mean you're promiscuous' | BBC | 26 Apr 2019
London Councils to add 4,000 new places to PrEP trial | Pink News | 12 Apr 2019
First year of PrEP in Scotland: more users than expected, few dropouts, few HIV infections | NAM aidsmap | 2 Apr 2019
Sadiq Khan: Cash row is denying Londoners access to HIV ‘wonder drug’ | Evening Standard | 12 Mar 2019
Scotland's introduction of HIV drug PrEP 'puts England to shame' | The Guardian | 27 Feb 2019
PrEP drug uptake 'exceeds predictions' | BBC News | 26 Feb 2019

 Truvada and the truth: is HIV prevention propelling the STI epidemic? | The Guardian | 21 Oct 2018
The HIV-positive man who stopped thousands getting the virus | BBC News | 28 June 2018
New (US) research explores the reasons men stop taking PrEP | Avert 28 Mar 2018

PrEP: HIV 'game-changer' to reach NHS in England from September | BBC | 3 Aug 2017
Fall in HIV among gay men could spell end for Britain's epidemic, say experts | The Guardian | 22 Jun 2017
Sex without fear – my experiment with... PrEP | The Guardian | 22 Jun 2017
Massive drop in London HIV rates may be due to internet drugs | New Scientist | 9 Jan 2017

NHS England has power to fund Prep HIV drug, court decides | BBC 10 Nov 2016
NHS loses court appeal over 'game-changing' HIV drugs | The Guardian | 10 Nov 2016
NHS England 45 Day PrEP Consultation | 10 Aug 2016
HIV drug row: A very modern dilemma for the NHS | Nick Triggle, BBC | 2 Aug 2016
NHS England: August update on the commissioning and provision of PREP for HIV prevention | 2 Aug 2016
HIV campaigners win NHS drug battle | BBC 2 Aug 2016
Judicial review over HIV Prep drug | BBC News | 13 June 2016
Buying PrEP online: safer use and NHS monitoring | i-Base and others | June 2016
NHS England reconsiders HIV Prep drug decision | BBC | 19 Apr 2016
NHS will now consider putting PrEP back... | NAT | 19 Apr 2016
England’s PrEP policy in disarray after NHS U-turn | NAM Aidsmap | 22 Mar 2016
Row over HIV prevention drug Prep (Funding 500 over 2 years) | BBC | 22 Mar 2016
PrEP: Why we are waiting | The Lancet HIV | Jan 2016

Older: 2019-16


Some gay and bisexual men see PrEP as a 'social problem'
"Gay and bisexual men have differing attitudes towards men who are using pre-exposure prophylaxis (PrEP), according to US research published in Sociology of Health & Illness. A series of focus groups conducted in New York City showed that some men regarded PrEP users as immoral, irresponsible, naïve and vectors of disease. In contrast, other men saw PrEP as a beneficial new option for preventing the spread of HIV. They had a nuanced view about the effectiveness of condom-based prevention campaigns and the epidemiology of sexually transmitted infections (STIs) among gay and bisexual men."
Some gay and bisexual men see PrEP as a 'social problem' | nam aidsmap | 5 Oct 2018

So, what is the problem with PrEP? Why is there stigma around a pill that, ultimately, prevents HIV infection and can save lives?
"Ultimately, we are a community living in the shadow of a devastating and traumatic chapter in our history (AIDS). With PrEP and undetectable, we are asking people to unlearn everything they ever learned in a climate of fear, infection and death. We are asking people to learn the new science and the new facts, and oftentimes, change or something new can stir deep emotions and reactions. It requires us all to use the basic components of constructive debate, which are respect, compassion and kindness. It will require us to listen and be open to learn. It will be uncomfortable but it needs to happen.”
PrEP: The battle against stigma | GMFA | 2018 FS 168

Do-it-yourself HIV prevention: who do men buying PrEP online get support from?
"Gay men in London who source their own supply of generic pre-exposure prophylaxis (PrEP) drugs, usually from overseas internet pharmacies, most often learnt about this possibility from people in their social network and would like more support from other PrEP users to be available. Nonetheless, clinicians’ endorsement of purchasing PrEP online was important in convincing men of the legitimacy of the practice and men would have much preferred the NHS to actually provide PrEP, according to a study in PLOS ONE."
Do-it-yourself HIV prevention: who do men buying PrEP online get support from? | aids map | 18 Sep 2018

PrEP, condoms, STIs and antibiotics
Studies show a significant rise in bacterial STIs in men who are using PrEP that appears to be related to their sexual networks and the level of condom use. Even if PrEP is the game-changer many are hoping it to be, PrEP offers zero protection against other STIs which are on the rise at a time when antibiotics are failing.
Rapid rise in anti-HIV PrEP pills linked to drop in condom use | The Guardian | 6 June 2018
Antibiotics 'may be lost' through overuse, says chief medical officer | BBC | 13 Oct 2017 | 59s

R.I.P. Condoms | Michael Henry | 2 Jan 2019 | 3m 23s

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