What is PrEP and Does it Work?

If there’s one thing the medical community is known for, it’s acronyms – and the latest to have got people talking is PrEP, which stands for pre-exposure prophylaxis. This is a type of medicine taken to prevent the transmission of HIV.

In the past two years, the discussion around PrEP has widened as more and more health institutions have come out in favour of the treatment. Earlier this month, the Kenyan government announced that they would be rolling out PrEP for HIV-negative people who are most at risk of infection. This is significant, as Kenya – along with many other sub-Saharan African countries – is still widely affected by HIV; in 2015, there were an estimated 1.5 million people living with HIV in Kenya alone.

Currently, PrEP is not available on the NHS, but it can be obtained privately from certain sexual health clinics. The good news is that the NHS will be carrying out a PrEP trial over the next three years – and if this is successful, we could see the treatment become available soon afterwards.

The question many people will be asking is: does PrEP really work? We put together a guide to answer that question.

An Introduction to PrEP

Pre-exposure prophylaxis works by interfering with the human immunodeficiency virus’s ability to multiply in the body. Taking PrEP every day should provide protection against HIV, even if you have been exposed to the virus. It must be taken for at least seven days (but in many cases, for three weeks) before it becomes effective.

Currently, one type of PrEP medicine is recommended by health bodies across the globe: Truvada. Truvada is a tablet which contains tenofovir and emtricitabine, antiretrovirals which are used to treat HIV as well as to prevent it.

According to the Centers for Disease Prevention and Control, PrEP (in the form of Truvada) can reduce the risk of HIV in high-risk HIV-negative people by up to 92%. However, this number is dependent upon consistent (i.e. daily) use. Inconsistent use of PrEP will not offer the same levels of protection.

In other words, PrEP can be extremely effective – provided it is taken as directed.

Reasons to Consider PrEP 

PrEP is only suited to people who are particularly high-risk for HIV infection. Typically, people taking PrEP will be in an ongoing sexual relationship with an HIV-positive person. It’s also recommended for people who inject drugs, as HIV can be transmitted through shared needles.

It’s important to bear in mind that taking PrEP does not mean it is safe to stop using condoms during sex. PrEP only offers protection against HIV, and not other STIs.

Interestingly, recent research has indicated that the administration of the antibiotic doxycycline after potential STI-exposure proves effective in men using PrEP. This research found that such use of doxycycline could help significantly lower the risk of chlamydia and syphilis, but not gonorrhoea. Condom use, in other words, remains vital.

HIV Prevention

Because PrEP is not available on the NHS, it’s important to be aware of other HIV prevention methods. The main way to stay safe is to always practise safe sex if you aren’t sure your sexual partner is STI-free. During sex you should always:

  • Use condoms
  • Avoid sharing sex toys
  • Be cautious about oral sex, following this guidance and using dental dams on the vagina or anus where necessary

Using water-based lubricants during sex can also help prevent transmission; this is because too much friction during sex can break the condom, or lead to vaginal or anal tears.

Good HIV prevention is also about getting regularly tested for HIV if you are at risk of exposure. It is recommended that men who have sex with men – a particularly high-risk group for HIV – get tested every three months if they are having unprotected sex with new or casual partners.

Lastly, be aware that other STIs such as chlamydia and gonorrhoea can actually increase your risk of contracting HIV. For this reason, it’s a good idea to get tested for these kinds of infections whenever you get screened for HIV.

You can get tested for chlamydia and gonorrhoea at NHS centres. Alternatively you can take an easy home test; visit The STI Clinic.