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Home / STIs / Pre-exposure prophylaxis

Pre-exposure prophylaxis (PrEP)

Advice and help about pre-exposure prophylaxis

Pre-exposure prophylaxis or PrEP is a preventative medication for the human immunodeficiency virus (HIV). It is a course of tablets that can be taken daily, which protects you from infection if you are HIV-negative and at a higher risk of developing the virus.

You can order the PrEP medication online from HealthExpress. Simply start a free consultation. This could be delivered to your doorstep conveniently and discreetly. HealthExpress is committed to providing you with the best possible service and the safest, most effective treatment. Our ordering process is quick, discreet and tailored to your lifestyle needs.

We are currently not stocking Truvada but we are working on finalising the consultation and product soon.

What is pre-exposure prophylaxis (PrEP)?

Pre-exposure prophylaxis or PrEP is a medication that can prevent HIV in individuals under the classification of "high risk". It is either taken on a daily basis, or taken before and after sex to reduce the chances of contracting HIV. The prepfacts website offers this useful summary:

  • Pre = Before
  • Exposure = Coming into contact with HIV
  • Prophylaxis = Treatment to prevent an infection from happening

PrEP may also be referred to as antiretroviral medication. It is only used in those who are HIV-negative to reduce the likelihood of contracting HIV. When used as directed, clinical trials have suggested that PrEP can be very effective by preventing HIV by up to 92% when taken correctly.

PrEP comes in the form of a pill taken daily called Truvada, which contains the active ingredients emtricitabine and tenofovir and is currently the only PrEP medication available on the market. This medication stops HIV from establishing a permanent and incurable infection when exposed to the virus.

Whilst Truvada is classed as a preventative treatment to HIV, it can be used in conjunction with other medication to treat HIV as well at the discretion of your doctor. Here at HealthExpress, we offer PrEP medication in the form of Truvada used on a daily basis.

PrEP medication is different to PEP (post-exposure prophylaxis) as this is taken after exposure to the virus and is taken for approximately a month after you've been exposed to the virus. Another way to describe the differences between PrEP and PEP is the PrEP is comparing it to the contraceptive pill and morning after pill; the contraceptive pill PREVENTS pregnancy, whilst the morning after pill is taken AFTER the act to PREVENT pregnancy.

What is HIV?

HIV (human immunodeficiency virus) is a virus that attacks the cells within your immune system. This leads to damage and an immune system unable to combat the many infections that surround us. Over time, this damage will become more and more severe. The virus directly affects the CD4 lymphocyte cells that are used to combat infections or other germs.

HIV can be transmitted from person-to-person (often through sexual intercourse), however AIDS cannot. It is possible to have HIV for your whole life and not develop AIDS.

Whilst other viruses can be transported through the air (flu for example), HIV is only passed through blood and SOME bodily fluids making it difficult to get. This includes semen and vaginal fluids, blood (cuts, injections, etc), breast milk and the lining inside the anus.

You CANNOT get HIV through touch, saliva, sweat, sharing baths, towels, cutlery, toilets, swimming pools, kissing, spitting and urine.

AIDS (acquired immune deficiency syndrome) is the development from HIV, in fact, it is the last stage of HIV. It can also be referred to as late-stage HIV and advanced HIV infection. It is not a virus, however, and is classed as a syndrome. Being the final stage of HIV, AIDS can be very serious, resulting in death if not treated correctly.

It is possible to spread HIV without displaying any symptoms, especially during the first few weeks of being infected. In fact, it could take up to 10 years for symptoms of HIV to appear, making it important to get tested.

Like many viruses, there is currently no cure for HIV, however, there are many treatments and lifestyle choices that subdue the virus and allow you to lead a full and healthy life. Being diagnosed with HIV means that you need to take further care of your immune system, and you will have the support through online resources and NHS.

How does PrEP work?

The HIV virus directly affects the immune system making the body more likely to experience infections and diseases. The immune system cells that HIV targets are CD4 lymphocyte cells. Once the virus is in the system, it latches to the CD4 cells and multiples, which destroys a vast number of cells. This will progressively worsen if lifestyle choices and medications aren't appropriately used.

PrEP medications such as Truvada offer a barrier between these CD4 cells and the HIV virus. This drug is taken daily and fights the virus if you should come into contact with it, and kills it before it can take hold. This means it offers a fixed dosage of the active ingredients to offer continual protection, when used alongside safe sex practices.

The active ingredients in PrEP (emtricitabine and tenofovir) is the same as HIV-positive medications.

When do PrEP medications begin to work?

PrEP medications take various times to work depending on the need for the medication, and some of the timeframes are currently unknown. For example, for a homosexual male couple, the recipient is advised to avoid sex for the initial 7 days before the drug is effective, whilst statistics for the "insertive" is yet unknown. For drug use via injection or receptive vaginal sex, the time increases to 20 days before maximum effectiveness. Again, the insertive half of the couple is unknown.

Receptive vs insertive sex

These terms are used in relation to HIV more often than not, and in addition, in relation to vaginal intercourse and anal intercourse.

  • Receptive sex refers to the individual receiving. For example, the woman in vaginal sex or the man receiving in anal sex.
  • Insertive sex refers to the individual "inserting". For example, the man in heterosexual sex. This is the type where clinical studies are not conclusive as of yet.

Once you have completed the tests to ensure you are HIV-negative (see below), you can begin taking PrEP straight away. If, within the last 4 weeks, you have taken any risks in relation to the virus, you will need to take another test within the next 4 weeks. You are also required to take regular tests throughout the course (around every 3 months).

Who should take PrEP?

If you are in one of the risk groups associated with HIV and AIDS then it is advised that you consider all options that could prevent the virus. In the UK, the main cause of HIV is having unprotected sex with an infected person. Some of the categories that put you at a higher risk of infection include:

  • Having sex with someone who is HIV positive, regardless of the gender and nationality.
  • Having sex in an area of the world prone to HIV (developing countries such as sub-Saharan Africa) or with a person who is from these nations or used to live there.
  • Male-to-male sexual intercourse is the most likely scenario to contract HIV and AIDS.
  • Certain ethnicities are more susceptible to HIV including black Africans, regardless of the sexual orientation.
  • If you have another STI, you can become more prone to catching others including HIV.
  • From a mother to her child before or during birth, or through breastfeeding.
  • Sharing needles, especially recreational drug use, and a dependency on alcohol. Having sex with a person who uses infected needles.
  • Sharing other items such as toothbrushes and razor blades, although this is unlikely.
  • Having multiple sex partners without protection or acting responsibly (not wearing a condom).
  • HIV within the prostitution industry (exchanging sex for commodities such as money, food, shelter or drugs).
  • Incarceration (being in prison).
  • People who have "chemsex" (sex using certain drugs to heighten the experience, which can also lead to irresponsibility such as not using condoms).
  • Receiving a blood transfusion that is contaminated; whilst the risk is low in the UK, it is more common in developing countries.

Before you can take PrEP medication…

Before taking PrEP, you must undergo some tests to ensure you are HIV-negative. This includes a HIV test (a blood sample), a full STI screening and possibly a kidney function test (a blood sample and urine sample).

The HIV test and full STI screening can be booked at your local STI clinic, or they will provide you with walk-in times. There could be a wait, so head there early and book a half day or full day off work to allow time. You can always mention your interest in taking PrEP medication to your nurse so he/she will provide all the tests you need.

How effective is PrEP?

A number of trials have been completed in regards to the effectiveness of PrEP medication Truvada. These are fairly new trials and it's important to note that studies can vary, and none are 100% conclusive as of yet.

One common figure has shown a prevention rate of approximately 92%, which is very promising however, you must make sure you are using the tablet correctly for this to be the case.

Other studies have suggested that Truvada can be up to 99% effectiveness when taken correctly by high risk individuals. If you miss up to 3 pills a week, this can decrease to 96%, and missing 5 pills a week decreases the effectiveness to 76%. Another study suggests that the efficiency can dip to 42%.

As the trials of Truvada aren't final at this point, it is important to remember to take the drug everyday to avoid diminishing the medication's effectiveness. As this preventative is taken on a daily basis, this increases the chance of forgetting a dosage and lowering the efficiency rate.

Ordering PrEP medication

You can order the PrEP medication Truvada online from HealthExpress. Simply start a free consultation. This could be delivered to your doorstep conveniently and discreetly by tomorrow if approved.

These details will remain within your personal login for future orders.

Depending on your location in the UK will establish other methods to receive PrEP medication. In Wales and Scotland, this can be through the NHS, whilst in England, certain sexual health clinics may stock the pills but it is best to speak to the centre beforehand to make sure.

Regardless of where you have obtained your PrEP medication, the NHS will offer further support.

Sources