Oral Pre-Exposure Prophylaxis (PrEP) is one of many tools that can be used to prevent HIV, however a very effective one. The PrEP pill contains antiretroviral medication, which has shown to prevent HIV infection among HIV negative people. It prevents HIV in multiplying itself in the body. Studies have shown that it is effecacious in reducing the risk for acquiring HIV, if it is taken properly.
PrEP is for individuals who are HIV negative but who are at higher risk of getting infected with HIV. It is very important to test for HIV before you start using, and to keep testing for HIV when you are taking PrEP. Also, it is important that you are followed up by a healthcare provider to verify that there are no problems with taking the medication (for example, for your liver or kidneys). In Belgium you only get PrEP reimbursed if you are eligible. To see whether you are eligible, please see here.
PrEP has a protective effect of about 99% when it’s taken correctly.
Adherence is crucial: it’s important to take the pills correctly and not miss a single dose. It’s assumed that PrEP is as effective as a condom. As all prevention methods, PrEP cannot offer 100% protection either and it’s recommended to use condoms as well.
When HIV penetrates the body, it needs certain body cells in order to multiply. PrEP prevents the virus to penetrate those cells and to multiply, so it actually prevents HIV to settle in the body.
The most obvious positive aspect is that you are better protected against HIV.
In the Be-PrEP-ared study (the predecessor of PROMISE) we also found that men using PrEP generally experienced less anxiety for getting infected by HIV, and therefore were more able to enjoy sexual encounters.
As with other antiretroviral products, PrEP can have several side effects on the short term, such as nausea, fatigue, gastro-intestinal symptoms and headache. These side effects generally subside over time. However, some persons can experience kidney function problems, which is a good reason to be followed up by a healthcare provider.
Some persons might be taking more risks when they are using PrEP. It is always a good idea to discuss with a healthcare provider how you can lower your risks, if you are unsure about this.
PrEP is only a way to protect yourself against HIV and not against other STIs (e.g. gonorrhoea, syphilis or hepatitis C). It also does not protect against pregancy. Therefore, it remains important to also use a condom (and lube) when having sex.