What’s the tea? PEP, PrEP and ARVs

If you don’t know the difference between PEP, PrEP and ARVs then you are not alone. It’s something we at EMH are often asked. So to make it easier to understand, we’ve compiled all the essential information about all three right here. 

WHAT ARE ARVs?

What is it for?  

The drugs used to treat HIV are called antiretrovirals (ARVs). There are several different types of ARVs, but they do similar things in your body. HIV treatment is made up of three or more antiretroviral drugs normally combined into one pill.

What about other STIs?

ARVs do not treat or prevent sexually transmitted infections like gonorrhoea, chlamydia, HPV (genital warts), herpes and syphilis. Certain types of ARVs are sometimes used to treat Hepatitis C.

How do you take it? And for how long? 

ARVs need to be taken daily and for the rest of your life if you are HIV positive. ARVs only stay in your body for 24hrs, which is why you need to take them consistently – ensuring that there is always the correct level of medication in your bloodstream working to keep the HIV under control. This is vital – remember, ARVs do not kill HIV or cure you of the virus, what they do is prevent it from replicating.

How do I get it?

You need to get tested regularly for HIV if you are negative. If you test positive you will be started on ARVs immediately. Starting early with ARVs will have much better results and long-term benefits for your health. You can get ARVs through most clinics or from your GP.

Do I need a script, or can I get it over the counter at a pharmacy?        

Only a doctor or qualified nursing sister can start you on ARVs. Never try taking someone else’s ARV medication.

How do I know if I must go on it?    

Any person who is HIV positive need to start ARV treatment as soon as possible. There is no cure for HIV and ARVs are the only medication currently available to control HIV in your body. This will ensure you have a long healthy life.

WHAT IS PEP?

What is it for?  

Post-Exposure Prophylaxis (PEP) is a course of ARVs (antiretroviral tablets used to treat HIV) but it is given to someone who is HIV negative after he has had a high-risk exposure to HIV. This could be a condom breaking during anal sex, especially if he was the bottom (receptive partner). PEP reduces his risk of becoming infected.

What about other STIs?

PEP does not treat or prevent any other sexually transmitted infections like gonorrhoea, chlamydia, HPV (genital warts), herpes and syphilis.

How do you take it? And for how long? 

PEP must be started as soon as possible after the risky sex, and not later than 72 hours.
Men who have been raped are likely to need PEP unless they are already HIV positive. The pills must be taken correctly, at the same time every day for 28 days.

How do I get it?

If you think you are HIV negative and may have been infected or if you have had high-risk exposure to HIV, you need to contact your healthcare provider as soon as possible.  You must start using PEP within 72 hours after the risk took place for it to prevent becoming HIV positive. The sooner you start PEP the better it works. The healthcare provider will check to see whether you are already HIV positive – PEP can only be used by HIV negative people to prevent infection.

Do I need a script, or can I get it over the counter at a pharmacy?        

Only a doctor or qualified nursing sister can start you on PEP. Never try taking someone else’s medication.

How do I know if I must go on it?     

• You can get PEP if you are HIV negative and you were potentially exposed to HIV:
• A condom slipped off or broke during anal sex.
• You had sex without a condom, and you don’t know your partner’s HIV status (especially if you were the bottom partner). Your risk is greater if your partner has cum inside your anus, or if your partner was bleeding during sex.
• You had sex with someone who is HIV positive who is not on ARV treatment or is on ARV treatment but not undetectable.
• You were raped.
• You were exposed to blood for example you were pricked with a syringe needle or you were involved in a car accident.

WHAT IS PrEP?

What is it for?  

Pre-exposure prophylaxis (PrEP) is an HIV prevention strategy where HIV negative people take medications daily to prevent them from becoming positive if they are exposed to the virus. PrEP has been shown to significantly reduce the risk of HIV infection in sexually active adults and in people who use drugs.

What about other STIs?

PrEP also does not treat or prevent other STIs like gonorrhoea, chlamydia, HPV (genital warts), herpes or syphilis.
PrEP can prevent Hepatitis B.

How do you take it? And for how long? 

If you take PrEP daily, you lower the risk of being infected with HIV. Regular testing and STI screening (every 3 months) will ensure that if you should become infected, it will be detected early.

You can stop taking PrEP altogether if you no longer think that you need it, but you need to speak to your doctor first.

How do I get it?

PrEP is available for free at selected public clinics, at your GP and most medical aids would cover it. It requires a script from a GP and you will need a kidney function test first, as well as other relevant tests to see it is safe to continue. Patients accessing healthcare in the private sector should therefore access PrEP from an educated GP.

Do I need a script, or can I get it over the counter at a pharmacy?           

Only a doctor or qualified nurse can start you on PrEP. Never try taking someone else’s medication.

How do I know if I must go on it?     

• PrEP is recommended for HIV negative who fit these criteria:
• A history of not using a condom during anal sex.
• Multiple sex partners.
• If you recently had one or more other STIs (sexually transmitted infections) like chlamydia, gonorrhoea or syphilis.
• You have an HIV positive sex partner who is not on ARVs or not undetectable.
• If you are a sex worker.
• If you use recreational drugs for chemsex.

Engage Men’s Health offers free and confidential sexual health services to gay, bisexual, and other men who have sex with men (MSM). You can get PrEP, PEP and ARVs from EMH in Johannesburg, Nelson Mandela Bay and Buffalo City. Our services include free HIV and other STI testing, treatment, PrEP and also PEP. WhatsApp/Telegram message or call us on 082 607 1686.