PrEP 2-1-1: PrEP on-demand

When used as prescribed, PrEP is one of the most effective HIV prevention methods available. Usually, PrEP is a pill that’s taken daily to give the user ongoing protection from HIV (for as long as it continues to be taken every day). 

PrEP on-demand (also called PrEP 2-1-1), however, is another way of using PrEP by taking it around the time when you are planning to have sex; starting 24 hours in advance and for 48 hours after.

It is important to note that while PrEP on-demand has been endorsed by the World Health Organization, it has not been approved by the Department of Health in South Africa, and the standard daily regime remains the recommended method of use of PrEP by Engage Men’s Health.

This is how PrEP 2-1-1 (PrEP on-demand) works:

  • Two pills 24 hours before sex
  • One pill 24 hours after the first two pills
  • One final pill 24 hours after the second single pill

If you have sex more than 24 hours after taking your first dose (two pills), or over multiple days, you will need to continue taking one pill every day until you have taken two doses following your last sex encounter, at which point you can stop taking tablets.

Because PrEP 2-1-1 is taken around times of sex instead of every day, it may make sense for people who have sex less frequently.

PrEP 2-1-1 has been proven to be just as effective as taking PrEP daily if it is taken and used correctly. It is very important that you understand this method of using PrEP before you have sex. Don’t make reckless decisions about sex without understanding the HIV risk and best prevention practices.

The Pros and Cons of PrEP on-demand:

Pro: PrEP on-demand means that you don’t have to take the medication every day, especially if you are not having sex regularly.
Pro: PrEP on-demand means that your PrEP medication will last longer as you only take it when needed.

Con: PrEP on-demand means that you have to plan or know when you will be having sex in advance.
Con: You won’t be protected from HIV if you have sex unexpectedly or on the spur of the moment.
Con: With PrEP on-demand, you don’t get into the habit of using PrEP making it more likely to not use it correctly.

Conclusion: PrEP on-demand may be right for some people but daily PrEP use is more effective at ensuring that you are ALWAYS protected from HIV.

Engage Men’s Health does not endorse PrEP on-demand but provides free daily PrEP and other sexual health services in Joburg, Buffalo City and Nelson Mandela Bay. WhatsApp/Telegram us on 082 607 1686 to book an appointment or for more information. 

PrEP Daily:
San Francisco Aids Foundation: