closeup of a young caucasian man with a simulated PrEP pill in his hand

FAQ on PrEP

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PULSE Clinic

PULSE Clinic

Established in Bangkok, PULSE Clinic is a gay-owned private clinic whose mission is to promote and provide excellence in standards of care and education in sexual wellbeing, HIV and related infections, and to actively engage in the formulation of public health policy and research, with the aim of reducing HIV disease burden worldwide.

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Here are some basics for PrEP that you should know if you’re thinking about taking this drug:

What is PrEP?

PrEP stands for Pre-Exposure Prophylaxis, and it’s the use of anti-HIV medication that keeps HIV negative people from becoming infected. PrEP has been shown to be safe and effective. A single pill taken once daily, it is highly effective against HIV when taken every day. The medication interferes with HIV’s ability to copy itself in your body after you’ve been exposed. This prevents it from establishing an infection and making you sick.

Is PrEP for both tops and bottoms?

Yes, even though there is more risk bottoming, tops can also acquire HIV.  Uncircumcised tops have a slightly greater chance. It’s very true that tops can also experience anxiety about acquiring HIV. Being on PrEP certainly helps with that.

Are there long term effects from taking PrEP?

PrEP was approved in 2004, so it’s been around for more than a decade. Before it was used as PrEP, it was used as treatment for people infected with HIV or exposed to HIV (it contains molecules that are used in HIV drugs). The worst side effects that have been reported are one percent bone mineral density loss and reduced kidney function. Is it safe? Yes. To put it into perspective, they can’t tell if it’s any worse than just getting older. People in the USA have been taking it for years.

Your doctor will check your liver and kidney function as well as a HIV/STI screening every three months to make sure you’re ok. It’s a normal part of getting your updated script each time. If you are concerned about any effect from taking PrEP, then chat with your doctor.  

Someone told me PrEP could cause HIV to mutate?

That’s not true. PrEP works by stopping the virus penetrating the cell.  If it can’t get into the cell then it can’t multiply. Mutations occur when the virus reproduces. So essentially no infection means no mutation.  It’s important that you are not already HIV positive when you start PrEP. If the virus is already reproducing in your body then taking PrEP may cause some inconvenient problems with resistance and your doctor may have to try other medications. Your doctor will test to make sure you’re not HIV positive before you start.  

Should I tell people I’m taking PrEP?

It’s totally your decision to disclose if you’re taking PrEP. Some people are proud to say they are taking PrEP and in doing so they are helping break down stereotypes and showing that taking PrEP is a choice to look after their own health. Telling people that you are on PrEP also lets them know that protecting yourself against HIV is important to you. It’s important to respect where other people are at on their safe sex journey so if your partners prefer to use a condom then that’s their right. They don’t have to take your word for it that you are safe. Of course they could take PrEP themselves and then their safety is completely in their hands.

Can I get PrEP as an extra protection even though I consistently use condoms?

Yes. If you are anxious about situations like condoms breaking, slipping off, not being applied correctly or doing head jobs without a condom then PrEP is still good for reducing your fear and anxiety.  Some people just want an extra layer of protection and that’s fine. Some medical professionals also use PrEP to stop HIV infection if they get a needle stick injury. PrEP is incredibly effective and reliable. PrEP users report that they are letting go of fear they didn’t even know they carried.

What if I miss a PrEP dose?

Current studies are showing that PrEP works well even if you miss a dose.  It was shown that users who took PrEP at least 4 days out of 7 hadn’t acquired HIV.  We strongly recommend that you stick to one pill a day though. That gives maximum protection.  If you’re not consistent then that’s where you can miscalculate and undo all your good work. So one pill a day keeps everybody happy, secure and safe.

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