PrEP is not suitable for everyone. The aim of PrEP is for it to be used for people who are HIV-negative and at high risk of HIV infection. This may include anyone who is in an ongoing relationship with an untreated HIV+ partner, as well as for people who are having risky unprotected sex who find it difficult to consistently use condoms as a prevention method.
People who inject drugs or have shared needles might also consider using PrEP. For example, if you engage in chemsex, PrEP will not protect you against hepatitis C and it is unclear how effective it is for preventing HIV infection from injecting.
If you have a partner who is HIV+ and you are considering getting pregnant, talk to your GP about PrEP. It may be an option to protect you and your baby.
PrEP involves taking medication regularly during periods of high risk and regular visits to a GP or other clinic for urine and electrolyte tests to monitor your kidney health, plus regular HIV screening tests.
PrEP should only be used for people who are at ongoing substantial risk of HIV infection. For people who need to prevent HIV after a single high-risk event of potential HIV exposure—such as sex without a condom, needle-sharing injecting drug use, or sexual assault—there is another option called Post-Exposure Prophylaxis after Sexual Exposure, or PEPSE, where treatment must begin within 72 hours of exposure. You can read more about PEPSE here.
It’s also important to remember that taking PrEP will not prevent you from getting other STIs, such as syphilis, gonorrhoea, hepatitis C and chlamydia, nor from becoming pregnant.
How well does PrEP work?
In the recent PROUD and IPERGAY studies, PrEP has been shown to significantly reduce the risk of HIV infection in people who are at high risk from anal sex by as much as 86%, overall. It is thought that the infections that did occur were in people who did not take their medication properly. There has been a report of someone on PrEP who became infected by someone with an antiviral-resistant virus.
PrEP is much less effective if it is not taken properly PrEP can be even more effective if it is combined with other ways to prevent HIV infection, such as condoms, drug treatment, and adherence to treatment for people living with HIV to further reduce the chance of HIV being passed on.
Read more about PrEP and the PROUD and IPERGAY studies here:
http://www.aidsmap.com/PrEP/cat/1623/
http://www.aidsmap.com/Pre-exposure-prophylaxis-also-stops-86-of-HIV-infections-in-Ipergay-study/page/2947854/
http://i-base.info/qa-on-prep-in-the-uk-and-changes-to-the-hiv-proud-study/
http://www.proud.mrc.ac.uk
Does PrEP have side effects?
Some people in clinical studies of PrEP had early side effects such as an upset stomach or loss of appetite and headache, but these are usually mild and go away within the first month. Some people had some kidney disturbance, but this did not lead to serious long-term kidney problems.
The medication used in PrEP has been used to treat people living with HIV for many years and has been shown to be at low risk of serious side effects. However, if you experience side effects of using PrEP, you should discuss this with the GP or clinic where you have your regular checkups. Ideally, you have a kidney function blood test and a urine test before you start and may need to repeat them if you remain on PrEP.
PrEP on the NHS (in Birmingham and Solihull)
From 5 October 2020, PrEP is available on the NHS in Birmingham and Solihull via Umbrella Health. Please note that this is with tenofovir disoproxil fumarate, and not the newer tenofovir alfenamide.
If you would like access PrEP on the NHS, please call Umbrella Health on 0121 237 5700. You may then be booked into a telephone clinic initially. You will need sexual health tests, and in particular a negative HIV test before you start PrEP.
If you have any other queries, please call Birmingham LGBT on 0121 643 0821 and ask to speak to a member of the sexual health team.
Can’t get PrEP on the NHS right now? Where can I get PrEP in the UK?
PrEP is now available on the NHS in the UK. Some people still choose, for various reasons, to purchase PrEP online.
NB: The NHS will only supply tenofovir disoproxil fumarate and not tenofovir alfenamide.
There are always risks in buying anything online, but we have included the following links for you to obtain more information if you are considering buying or acquiring PrEP:
Can I get PrEP privately in the UK?:
http://i-base.info/qa/10696
Where can I buy PrEP online and is it legal in the UK?:
http://i-base.info/qa/10734
https://www.iwantprepnow.co.uk/
How can I check that PrEP I buy from the internet is genuine?: http://i-base.info/qa/10695
How do I safely use PrEP if I buy it online?:
http://i-base.info/qa/10528
Recommended reading if considering buying PrEP online: www.iwantprepnow.co.uk and http://prepster.info/
What is the medication used in PrEP?
The pill used by people using PrEP for daily use who are at high risk of getting HIV infection is called Truvada®.
Truvada® is a combination of two HIV medications (tenofovir and emtricitabine). In other parts of the world it is available as a cheaper generic (non patented) product. Most commonly this is from an Indian company called Cipla. These medicines work by blocking important pathways that HIV uses to set up an infection. If you take PrEP daily, the presence of the medicine in your bloodstream can stop HIV from taking hold and infecting you with the virus.
Dosage is very important: If you do not take PrEP properly there may not be enough medicine in your bloodstream to block the HIV virus. If you become infected with HIV, the virus may then have some resistance to Truvada and may affect your later treatment.
Read more about PrEP and the PROUD and IPERGAY studies here:
http://www.aidsmap.com/PrEP/cat/1623/
http://i-base.info/qa-on-prep-in-the-uk-and-changes-to-the-hiv-proud-study/
http://www.proud.mrc.ac.uk
http://www.ipergaymtl.com/en/about-us.html
http://www.aidsmap.com/Pre-exposure-prophylaxis-also-stops-86-of-HIV-infections-in-Ipergay-study/page/2947854/
PrEP Clinics
Pleas see the ‘Our Clinics’ page or click here
PrEP information videos
Informational videos by iwantprepnow.co.uk click here
PrEP 4 Trans (Trans Men) information video here.
PrEP 4 Trans (Trans Women) information video here.
Umbrella Health PrEP information leaflet & website
To read the Umbrella Health ‘Pre-Exposure Prophylaxis (PrEP)’ leaflet click here.
To be directed to Umbrella Health’s PrEP website information click here.