PrEP is highly effective at preventing HIV transmission when taken as prescribed. It might be an option if you find using condoms difficult and are worried about getting HIV through sex.
Key things to know
If you are worried about your HIV risk, you can get PrEP for free in Scotland from any NHS sexual health clinic.
- You can only use PrEP if you are HIV-negative, so you will have to take an HIV test before starting PrEP.
- HIV tests and routine sexual health check-ups are free at NHS sexual health clinics.
- PrEP can only prevent HIV, not other sexually transmitted infections (STIs). You should test for other STIs every 3 months if you take PrEP.
For further information on PrEP and to access your local sexual health services, visit www.prep.scot. We can also help you to access PrEP and answer any questions you might have.
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What is PrEP?
It is a pill that contains two different anti-HIV drugs. Taking PrEP before you are exposed to HIV means that there is enough medication in your body to protect you from getting HIV.
If you are concerned about exposure to HIV from sex you have already had, check out our information on PEP and HIV testing, or get in touch with us for advice and support.
Is PrEP for me?
PrEP is for anyone who is HIV negative and is concerned about their HIV risk.
You might have an increased risk of HIV if you:
- don’t always use a condom during sex,
- inject drugs,
- had an STI recently,
- have been prescribed PEP in the past,
- have a partner who is HIV positive and is not on treatment,
- take part in chemsex.
How do I get PrEP?
PrEP is free in Scotland and can be accessed via NHS sexual health services.
You can also buy PrEP online at the cost of around £50 for one month’s supply. If you get or intend to get your PrEP online, you can still get access to HIV testing and routine check-ups at sexual health clinics for free in Scotland. For more information about buying PrEP online, click here.
How do I take PrEP?
PrEP can be taken a few different ways, depending on the sex you are having. You should talk to the doctor at the sexual health clinic about how to best take PrEP for you.
Taking PrEP daily: This is where you take a single PrEP pill at the same time every day. This works for both vaginal/frontal and anal sex. Daily PrEP is recommended for women and trans people.
Event-based PrEP: This is where you take PrEP only when you plan to have sex. This only works for anal sex, not vaginal/frontal sex. This method depends on sticking to set timescales and not missing any pills, otherwise you will not have the correct level of protection.
Side effects of PrEP
You might experience side effects when taking PrEP, but normally they are mild and resolve within a few weeks.
- stomach cramps,
If you experience any side effects that last longer than a month, or are causing you concern, you should check-in with a doctor at the sexual health clinic.
Daily PrEP is safe for trans people on gender affirming hormones and is effective with any kind of sex.
However there is limited research on the efficacy of events-based PrEP. If you are trans and take oestrogen or are having types of sex other than anal sex, events-based PrEP is not recommended. You can still take daily PrEP, which is recommended for trans people having condomless sex.
In the UK, BHIVA/BASHH guidelines recommend taking daily oral PrEP (TD-FTC) for HIV-negative trans women and trans men having condomless sex. For trans people who are having only anal sex, on-demand PrEP could be used as it is likely to have the same efficacy as seen in clinical trials in cisgender men who have anal sex with men.
However, research findings provided by the charity NAM suggest that hormones taken by trans women appear to slightly lower the levels of the PrEP drug tenofovir, but not enough to affect the efficacy when taken daily. Therefore, daily PrEP is recommended for trans women taking oestrogen hormones.
If you stopped taking PrEP and have not had sex since then it is safe to restart PrEP.
If you are having anal sex, you can take events-based PrEP:
- Take a double dose of PrEP (i.e. two tablets) 2 to 24 hours before sex,
- Take a single tablet 24 hours after the first dose.
For vaginal/frontal sex – take a daily dose of PrEP for seven days before starting to have sex. You can then continue with daily dosing.
If you’ve had sex since stopping PrEP, and that sex involved a possible exposure to HIV, it’s strongly recommended to have an HIV test before restarting PrEP.
Many of the sites in UK that sell PrEP have been tested and verified by PrEPster and they found no evidence of fake PrEP being sold via reliable sellers.
The websites iwantprepnow.co.uk and prep.global/get-prep list a number of online pharmacies that have been checked and verified.
If you are thinking about buying PrEP online, you can also get in touch with us and we can offer you information and advice to make the right choice for you.
The following websites have lots of information about PrEP, including how to buy it online safely:
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If you are living with HIV and need support understanding a new diagnosis, treatment or navigating life with HIV, we are here to help. Get in touch with us by filling out our contact form.