• Pre = before.
• Exposure = coming into contact with HIV
• Prophylaxis = treatment to prevent an infection from happening

Pre-exposure prophylaxis (PrEP) is a HIV prevention strategy where HIV-negative individuals take anti-HIV medications before getting exposed to HIV and, thus, reduce their risk of becoming infected.

• Post = after
• Exposure = coming into contact with HIV
• Prophylaxis = treatment to prevent an infection from happening

Post-exposure prophylaxis (PEP)1 is a short course of HIV medication taken soon after a possible exposure to HIV to prevent the virus from taking hold in your body.

PrEP is for people without HIV or HIV negative but maybe at risk for getting the virus from sex or injection drug use. PrEP can be taken by anyone, there are no guidelines as such, however PrEP must be considered for people who are HIV-negative who:

Have had anal or vaginal sex in the past 6 months and²:

• Have a sexual partner with HIV (especially if the partner has an unknown or detectable viral load) (or)
• Have not consistently used a condom (or)
• Have been diagnosed with an STD in the past 6 months

PrEP is also recommended for people who inject drugs and

• have an injection partner with HIV
• share needles, syringes, or other equipment to inject drugs (for example, cookers).

PrEP should also be considered for people who have been prescribed nonoccupational Post-Exposure Prophylaxis (PEP) and

• report continued risk behaviour (or)
• have used multiple courses of PEP

If you have a partner with HIV and are considering getting pregnant, talk to your doctor about PrEP if you’re not already taking it. PrEP may be an option to help protect you and your baby from getting HIV while you try to get pregnant, during pregnancy, or while breastfeeding.

The anti-HIV drugs in PrEP stop the virus from replicating in your body. If you get exposed to HIV, for example during sex without a condom, but have been taking PrEP correctly, there will be high enough levels of the drugs to prevent you from getting HIV.

If used consistently and correctly, PrEP will virtually eliminate the risk of you becoming infected with HIV. Several large, high profile trials undertaken across the world have continued to prove PrEP’s effectiveness. According to studies conducted by CDC³, it has shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily. Among people who inject drugs, PrEP reduces the risk of getting HIV by at least 74% when taken daily. Studies have also shown that PrEP is highly effective in preventing HIV if used as prescribed. PrEP is less effective when not taken consistently.

PrEP can cause side effects like nausea in some people, but these generally subside over time. According to CDC, no threatening side effects have been observed⁴. If you are taking PrEP, tell your health care provider about any side effects that are severe or do not go away

PrEP can be prescribed only by a health care provider in India as of now. You can take the prescription to your nearby pharmacy, which will be able to provide the drug. It is advisable to take PrEP daily for it to work. Also, you must take an HIV test before beginning PrEP to be sure you do not already have HIV and every 3 months while you are taking it. You will have to visit your health care provider for regular follow-ups.

You must take an HIV test before starting PrEP to be sure that you don’t already have HIV. If you have been diagnosed with HIV, PrEP may increase your chances of developing drug resistance, making the treatment less effective.

While you’re taking PrEP, you should visit your healthcare professional for regular check-ups (at least every three months).

Unlike HIV treatment, people do not stay on PrEP for life. PrEP, usually, is consumed for weeks, months or a few years when a person feels most at risk of HIV.

Condoms are an effective tool against HIV, but they aren’t perfect. Here are just a few reasons people give for struggling to use them consistently.

• Not having condoms handy and getting caught up in the moment.
• Assuming your sex partner shares the same HIV status as you.
• Doing things when drunk or high that we wouldn’t do under normal circumstances.
• Having reduced sexual pleasure or difficulty sustaining an erection.
• Feeling that condoms block emotional intimacy with a partner.
• Having a partner who refuses to wear condoms.
• Having a partner who threatens to end the relationship, terminate financial or housing assistance, or even use physical violence if condoms are insisted upon.

PrEP could offer another way for them to protect themselves from HIV.

No, you should continue to use condoms unless you are trying to get pregnant. PrEP will protect you from HIV, but it doesn’t give you any protection against sexually transmitted infections (STIs). Using a condom is the best way to prevent other STIs such as gonorrhoea, chlamydia and hepatitis C. Also, PrEP does not prevent pregnancy.

PrEP can prevent HIV infection during both vaginal and anal sex.

You must take PrEP daily for it to work. But there are several reasons people stop taking PrEP. For example,

• If your risk of getting HIV infection becomes low because of changes in your life, you may want to stop taking PrEP.
• If you find you don’t want to take a pill every day or often forget to take your pills, other ways of protecting yourself from HIV infection may work better for you.
• If you have side effects from the medicine that are interfering with your life, or if blood tests show that your body is reacting to PrEP in unsafe ways, your provider may stop prescribing PrEP for you.

As per CDC, people without HIV who have taken PrEP for up to 5 years show no adverse effects on their health.

We desperately need new tools in order to turn things around. PrEP is a new HIV prevention strategy that puts the power of prevention in the hands of HIV-negative people. Now that PrEP has been shown to be effective in clinical trials, the next step is to determine whether and how PrEP can be used to reduce HIV infections in communities

From researches done till now, we know that being on your period should not impact the effectiveness of PrEP.

No, you do not need to take this medication with food.

You should expect to see your doctor every 3 months for follow-up⁵.

Given PrEP is a prevention medication, there is no tangible way of knowing whether it is working or not. However, international health organizations such as WHO, and CDC have assured that if you are taking PrEP correctly and consistently, the drug is in your body, ready to fight HIV if you come into contact with it.

This varies from plan to plan and brand to brand. For a month PrEP may cost up to INR 2,500.

It’s crucial to take your pill every day, but it’s perfectly human to forget every now and then. If you routinely take your pill at night, for example, and remember when you wake up in the morning, it is fine to take your missed dose with breakfast. If you don’t remember until the next evening, it’s not necessary to take a double dose. The opposite scenario also works: If you usually take your pill in the morning but forget to do so, just take it when you remember that same day. If you don’t remember until the next morning, just pick up where you left off, and do your best to remember next time.

There’s no reason to double dose.