What you need to know about PrEP

Not sure if PrEP is for you or how it works? Here are some frequently asked questions we get about PrEP:

What is PrEP?

PrEP is a daily pill taken by people who are HIV negative to prevent HIV infection.
PrEP stands for Pre-Exposure Prophylaxis.

• Pre – before
• Exposure – coming into contact with HIV
• Prophylaxis – a medicine to prevent infection

What’s the difference between PrEP, PEP and ARVs?

PrEP is taken by HIV negative people in advance BEFORE sex to prevent HIV.
PEP is taken by HIV negative people as an emergency treatment AFTER high risk exposure to HIV.
ARVs are medication taken by people who are HIV positive to stay healthy.

What is the standard PrEP dosage?

1 pill per day

How much does it cost?

PrEP is supplied free by Engage Men’s Health to gay, bisexual and other men who have sex with men (MSM).

How well does it work?

HIV-negative people who take PrEP every day can lower their risk of HIV by 99%.

Who should take PrEP?

Only people who are HIV negative, especially those at high risk of HIV infection. This includes people who have multiple sex partners and inconsistent (or no) condom use, men who have sex with men, those in relationships with HIV positive partners, recreational drug users who engage in chemsex, injecting drug users and sex workers.

For how long do I take it?

You need to take PrEP for as long as you feel you will need HIV prevention. You can stop taking it when you don’t need it anymore. This depends on your sexual behaviour. It is important to remember that if you stop taking PrEP you are not protected from HIV. You can start PrEP again in future if you want to go back on it. It is advisable to let your healthcare worker know when you decide to stop and to speak to them if a long period has passed since you stopped and want to start again.

What does PrEP prevent?

PrEP ONLY prevents HIV infection, and not other sexually transmitted infections (STIs).

How does PrEP work?

PrEP does not work the same way as a vaccine. A vaccine teaches your body to fight off infection for several years. For PrEP, you take a pill every day by mouth. PrEP works by interfering with the virus’ ability to reproduce itself in your body. Because the virus is not able to reproduce itself it gives your body the chance to fight off the virus and prevent infection. PrEP only works if it is in the system before a HIV negative person comes in contact with HIV. This means if you decide to take PrEP don’t forget to take it daily. .

What about using condoms?

Daily use of PrEP will protect you from HIV infection, even without condoms. The use of condoms and water-based lube is, however, still recommended as this will also help protect you from other sexually transmitted infections (STIs). PrEP is not designed to fight other STIs so it’s important that even if you are on PrEP that you continue to test for STIs at your local sexual health clinic

What are the side effects?

Some people may experience mild side effects when they start PrEP.
• Nausea
• Headache
• Tiredness
• Diarrhoea
• Depression
• Unusual dreams
• Vomiting
• Rash
• Problems sleeping
• Changes in appetite
In most people, these side effects go away after a few weeks.

How do I start PrEP?

Make an appointment at one of our sites in Johannesburg, Port Elizabeth or East London or see one of our outreach teams:

• We will give you a rapid HIV test.
• If the result is negative, you’ll be given PrEP for a month.
• Blood will also be drawn from your arm and will be sent to the lab. The lab will:
+ double check your HIV status again
+ check for kidney function
• You return to see us after a month.
• If blood results from the lab show you are HIV positive or that your kidney function is bad: you stop PrEP immediately.
• If blood results from the lab confirm you are HIV negative and kidney function is good: you will receive a 3 month supply of PrEP.
• Your next appointment for blood tests and PrEP collection will be in 3 months.

How long before it starts to work?

You need to take PrEP every day for at least 7 days before it will protect you when it comes to anal sex. Individuals who have receptive vaginal sex (e.g. cisgender women, transgender men) must take PrEP daily for 21 days for it to work.

What happens if I forget to take it?

If you forget to take your PrEP pill on a certain day, take it as soon as you remember (but don’t take it twice in a day). If you take PrEP daily, you will become more than 90% protected from HIV. Very occasionally missing a day shouldn’t have a major impact but the more you miss taking it daily the less effective it becomes. If you stop completely, you will no longer be protected at all.

Any other tips for taking PrEP?

* Drink plenty of water while on PrEP to keep kidney function good
* Set an alarm to remind you to take PrEP
* Talk to your clinician about side effects
* If you forget to take PrEP, take it in the moment you remember it (but don’t take it twice in a day).

Can I donate blood when I am on PrEP?

Unfortunately, the SANBS does not currently accept blood donations from people on PrEP.

What is PrEP on-demand?

PrEP on-demand is a less common way of using PrEP by only taking it around the time when you are planning to have sex, starting 24 hours in advance and for 48 hours after. This method, however, may be complicated for some, does not accommodate unplanned sex and is not approved by the Health Department. Daily PrEP use remains the current recommended approach in South Africa. Find out more here.

Who do I contact to get free PrEP?

  • If you live in the Johannesburg, Nelson Mandela Bay or Buffalo City areas, call or WhatsApp / Engage Men’s Health on: 082 607 1686.
  • If you live in other areas, you can also contact us and we will try to refer you to another service closer to you.