PrEP: protection you plan in advance

PrEP means pre-exposure prophylaxis: medicines used by someone without HIV before possible exposure. When used correctly, protection against acquiring HIV through sex is very high. PrEP is not HIV treatment, does not prevent pregnancy and does not cover all other infections. Medical assessment and an appropriate negative HIV test are needed before starting.

Do not start PrEP on your own to try to cover an exposure that has already happened. Seek urgent assessment for PEP. Explain when the exposure occurred, whether you already take PrEP, which medicine and whether any doses were missed. When appropriate, transition from PEP to PrEP can be planned without an unnecessary gap.

People without HIV who want additional protection during sexual contact or certain blood exposures. You do not need to fit a label or justify your wish. Discuss your exposures, preferences and ability to follow the regimen and monitoring. A partner with a sustained undetectable viral load does not sexually transmit HIV; PrEP can still be a personal choice for other exposures or reassurance.

The medicines prevent the virus establishing infection. CDC reports around a 99% reduction in HIV risk through sex when PrEP is taken as prescribed. This does not mean equal protection with missed doses or every regimen. Effectiveness depends on an appropriate medicine, enough time for protection and correct use.

Prepare the date of your last possible exposure, previous HIV results, a list of medicines and supplements, and information about PrEP/PEP and vaccinations. A clinician assesses HIV status, kidney function for oral PrEP, hepatitis B and the need for other tests. Discuss pregnancy, breastfeeding and chronic conditions openly; these call for an appropriate option, not assumptions.

A PrEP regimen is not sufficient treatment for established HIV. Starting during unrecognised acute infection can complicate diagnosis and lead to resistance. Recent exposure, symptoms or previous antiretroviral use may require a laboratory combination test and RNA testing according to a clinical plan. A negative home test is not always enough to start.

For tenofovir-based oral PrEP, kidney function is checked to confirm suitability for the chosen medicine. Some of these medicines also act against HBV. Abruptly stopping them in chronic hepatitis B can therefore cause a flare. A positive HBV result requires a coordinated treatment, prevention and monitoring plan, rather than self-directed cycles of use.

With daily oral PrEP, medicine is taken every day as prescribed. A convenient time, reminders and a travel supply can help. Daily use suits many situations, but the medicine and required tests are chosen individually. Not all oral products have the same indications for every type of sex.

For daily oral PrEP, CDC gives approximate times to maximum protective levels of up to seven days for receptive anal sex and up to 21 days for receptive vaginal sex and injecting risk. Exact timings for other exposures are less well established. This is not a universal starting regimen: follow instructions for your medicine and use additional protection initially.

For certain people, a clinician may discuss oral TDF/FTC around sex: two tablets 2–24 hours before sex, followed by one tablet 24 and 48 hours after the first dose. This is educational information, not a personal prescription. With sex on consecutive days, the plan is extended according to specific instructions; do not improvise or apply it to a different medicine.

WHO allows event-driven PrEP for sexual exposure in cisgender men and certain trans and gender-diverse people assigned male at birth who are not taking estradiol-based hormones. Do not extend this to receptive vaginal sex or injecting risk. Episodic use should be avoided with active HBV because of liver flare risk. Difficulty planning doses is another reason to choose a different approach.

WHO includes 2-1-1 as an option for certain groups. CDC describes possible off-label prescribing for some adult men who have sex with men but does not routinely recommend this regimen. These are different positions, not evidence that every regimen suits everyone. A consultation clarifies applicable European and local guidance.

The significance depends on the medicine, regimen, number of missed doses and exposure. Do not take arbitrary double doses or rely on general forum advice. Check your written instructions and contact the prescribing specialist. Mention immediately if a potentially unprotected exposure occurred within the past 72 hours so the need for PEP can be assessed.

Mild nausea or stomach discomfort can occur at the start. Not every symptom is caused by PrEP. Persistent symptoms, new medicines or illness warrant a conversation. Kidney function and other markers are monitored with certain oral medicines; periodic checks help detect problems promptly.

PrEP is not a one-off consultation. The plan includes HIV tests, review of adherence and side effects, tests for other infections and kidney checks as needed. With oral PrEP, HIV follow-up is usually every three months; other forms have different schedules. Symptoms between appointments should be assessed without waiting for the next date.

PrEP does not prevent syphilis, gonorrhoea or chlamydia. Tests are selected according to genital, oral and anal exposure. A urine test does not check the throat or rectum. Condoms and barriers remain useful choices and can be combined with PrEP according to your preferences.

Needs can change, and PrEP is not a commitment to permanent use. When to stop after the last exposure depends on the regimen and exposure; do not decide on your own to stop on the day of sex. Before restarting, reassess HIV status, exposures during the break and medical factors. With HBV, stopping always requires a clinician’s plan.

Check your tablet supply, storage requirements and next testing date. With different time zones, advance planning is easier than guessing while away. You can discuss PrEP with a partner as health care, not a test of trust. A prevention choice says nothing about someone’s character or worth.

International guidance also includes long-acting options. Availability, approved indications, price and access differ between countries. This information does not mean a particular product is offered at CheckPoint. Seek consultation and current information about actual options.

Prepare your questions: is PrEP suitable for me, which tests do I need and what will follow-up involve? See the PrEP consultation page and current booking conditions. After exposure within the past 72 hours, seek urgent PEP assessment instead of waiting for a routine appointment.

After consultation you should be able to answer five questions: which medicine am I taking, when does protection begin for my exposures, what do I do if I miss a dose, when is my next test and whom do I contact with a problem? Ask for written instructions if anything is unclear. Your plan should work on weekdays, weekends and when travelling.

Different sexual practices do not carry equal HIV risk. Oral sex usually has very low HIV risk but can transmit gonorrhoea, syphilis and other infections. PrEP assessment and choosing STI samples are therefore separate decisions. Explain which body sites were exposed instead of relying on the general statement “I had sex”.

This describes their HIV prevention, not proof that they have no infections. Your conversation can include when testing took place, your preferred protection and important boundaries. You do not need to hand control of your own sexual health to someone else’s promise about taking medicine.

New relationships, pregnancy, another treatment or changes in exposure may require an updated regimen. This is a normal part of care. Tell the specialist when you want to stop too, so a safe time can be chosen and testing or alternative protection arranged.