PrEP, or Pre Exposure Prophylaxis, is the name given to a treatment used to help prevent the transmission of HIV.
- Branded or generic treatment available
- Once daily tablet
- Reduces risk of HIV transmission
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PrEP is the shortened name for Pre Exposure Prophylaxis, which is a treatment used to help prevent transmission of the human immunodeficiency virus (HIV). Truvada is the branded form of this tablet medication, which contains antiviral agents and is taken once a day. The treatment works by stopping the action of an enzyme in the body, which the virus needs to sustain itself and reproduce.
It is important to note that while PrEP significantly reduces the risk of transmission, it doesn’t completely eliminate it. For this reason, people taking PrEP should still practice safe sex by using barrier contraception, to limit their risk of exposure.
What is HIV?
The human immunodeficiency virus, or HIV, is a condition which breaks down cells in the immune system, and renders it less able to fight off infections. Over time, this can develop into a condition called acquired immune deficiency syndrome, or AIDS, where very serious infections can occur and the immune system is too damaged to tackle them.
HIV can be transmitted via infected semen, vaginal fluid, anal fluid, or blood. It can also be transmitted from mother to baby before birth or through breast milk. The most common route of transmission in the UK is via unprotected vaginal or anal sex. But it is also possible to become infected through the use of shared syringes or needles.
The virus cannot be transmitted through saliva, urine or sweat.
It doesn’t cause any distinctly noticeable symptoms. Some might notice flu symptoms following the incubation period of the virus, but these can commonly be mistaken for other less serious illnesses. It is therefore possible for someone to carry the virus for several years and not know, until they eventually contract an illness they cannot fight off.
Can I get a HIV test?
HIV is diagnosed through a blood test. This can often be done as part of regular STI screening at sexual health clinics, or through self-testing kits available from clinics or online. (You can read more on our page about buying HIV test kits online.)
What treatments are there for HIV?
Presently, there is no cure for HIV, but there are treatments available. These are typically given in the form of antiretrovirals, which aim to stop the virus from developing. HIV treatments need to be taken every day. The virus does have the capacity to adapt to individual HIV medicines and find a way around them. However, taking a combination of HIV drugs will significantly reduce the likelihood of this happening.
How to prevent HIV
There are several ways to reduce the risk of the virus being transmitted. The most effective is by using barrier contraception (condoms). Water-based lubricants (lube) can also help, by lowering the risk of tears inside the anus or vagina.
In addition to safe sex practices, PrEP can also help to decrease a person’s risk of contracting the virus. Truvada is an antiviral treatment, containing two ingredients: emtricitabine and tenofovir disoproxil. These work by preventing the action of reverse transcriptase, a type of enzyme called a DNA polymerase. The virus needs this enzyme to replicate its own cells and grow. By restricting the action of the enzyme, the virus therefore does not develop.
Em/Tenofovir is the generic version of Truvada.
Can I get PrEP online?
Yes. We provide a quick and easy prescription service for patients who want to order PrEP treatment online. All you need to do is select your treatment and take our questionnaire. Each order is checked by a GMC-registered doctor, and approved prescriptions are sent directly to our UK-based pharmacy. Once dispensed, orders are shipped by tracked courier, and in most cases delivered in one working day.
Numerous different treatments are available to treat HIV. These help suppress the virus in someone who already has HIV, helping them to stay healthy and also reducing the chances of them passing it on to someone else.
Some of these HIV treatments can also be used in people who do not have HIV: if they think they have been exposed to HIV either through sex or sharing needles; or healthcare workers who are accidentally injured from needles. This is known as Post Exposure Prophylaxis (PEP). These are antiretrovirals, and prevent the development of the virus by inhibiting the function of an enzyme which it needs to reproduce.
PrEP is a newer type of treatment used to prevent someone who hasn’t got HIV but has a high risk of being exposed to it.
Truvada, and the generic version, Emtricitabine/Tenofovir disoproxil (often shortened to Em/Tenofovir), are the only treatments currently licensed for use in pre-exposure prophylaxis for HIV.
Safe sex practices should also be used in combination with PrEP to ensure it is effective as possible.
How do they work?
Medicines used in PrEP contain some of the same active ingredients, antiretrovirals, used in post-exposure treatments. They work by limiting the function of an enzyme (reverse transcriptase), which the virus needs to develop.
What are the side effects?
Commonly associated side effects of PrEP include diarrhoea, feeling or being sick, rash and weakness, amongst others. Consult the patient information leaflet for more details.
Can I take them with other medications?
It depends on the other medications being taken. You’ll need to let your doctor know during consultation if you are taking any other prescription, non-prescription or remedial treatments, as some may interact with Truvada or Em/Tenofovir.
What’s the difference between Truvada and other HIV treatments?
Whereas other HIV treatments are intended to be used after someone has been already exposed to or contracted the virus, Truvada is used as pre-exposure prophylaxis. This means that someone who isn’t HIV positive but is at increased risk of exposure can take it to lower their likelihood of picking up the infection.
Do I need to take PrEP?
It depends on what you've used before, who you have sex with and what your preferences are. Truvada (the branded version) and Em/Tenofovir (the generic version) are both licensed in the UK for use as PrEP by men or women who have unprotected vaginal or anal sex when either is taken every day.
Although studies have shown Truvada to be effective at preventing HIV transmission in men who have anal sex with men when it is taken ‘on demand’, it isn't licensed for this, so using it in this way would be ‘off label’. For more information, read our page on the different ways of taking PrEP.
Are there different side effects?
The side effects listed in the respective leaflets are the same for both medicines (they are bioequivalents). However, you should still read this information thoroughly before taking either, so that you are aware of the possible side effects and know what to look out for.
How well does PrEP work?
PrEP has been shown to work very well at preventing the spread of HIV in men or women who have sex with someone: who has HIV; or who doesn’t know whether they have HIV or not. It works best when taken every day, or in certain cases when taken ‘on demand’ as described on our using PrEP page.
If PrEP isn’t taken in the recommended way it still helps prevent HIV transmission but it isn’t as effective.
There's a chance I may have been exposed to HIV, should I take this treatment?
No, under no circumstances should PrEP be used like this. There are different ways of taking PrEP, and you can read more about them here. Only in those ways should it be used. It is also often taken in conjunction with other treatments, to help those who are already diagnosed with HIV. If you believe you’ve become infected or exposed to HIV, we strongly advise you seek advice from a specialist sexual health nurse or doctor. They might recommend Post-Exposure Prophylaxis (or PEP). Contact your local GUM clinic or A&E department as soon as possible. Do not leave it longer than 48 hours.
How can I get PrEP online?
You can order PrEP from our online pharmacy. Orders are reviewed by registered doctors and dispensed and delivered in most cases the very next working day.
If you have not taken PrEP before, it is recommended that you speak to your GP or a sexual health doctor or nurse to first to make sure it is suitable. They will also need to give you instructions on how to take it, and offer some guidance on safe sex practices. Read our page on what you need to do before you take PrEP for more info.
If you are already taking this treatment or have used it before, and are looking to buy or renew PrEP online, you can do so using our secure consultation facility. Orders are reviewed by registered doctors and dispensed at our UK-based pharmacy. The majority of parcels are delivered the very next working day.
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