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PrEP

In need of some extra confidence? If you’re looking for highly effective protection from HIV, pre-exposure prophylaxis (PrEP) is it!

WHAT IS PREP?

PrEP is a medication regimen that HIV-negative people can take to prevent HIV. It is a course of a once-daily pill containing the medications tenofovir disoproxil fumarate and emtricitabine, taken under the supervision of a doctor.

PrEP reduces the risk of HIV transmission through sex by up to 92%1 when taken properly, allowing you to enjoy sex with your partners better knowing that you are at minimal risk of getting HIV.

HOW DOES PREP PROTECT ME?

PrEP is up to 92% effective in protecting you from HIV through sex when it’s taken correctly. When coupled with condom use, you can be very sure that you are at an extremely low risk of catching an STD or STI!

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When used consistently, PrEP is also up to 70% effective in preventing HIV through intravenous drug use (‘slamming’).2

Because you’re taking these pills to prevent HIV instead of treating it, you don’t have to be on them for life – you can stay on them for as long as you feel that the extra protection is necessary. That could be weeks, months, years, or even during short periods of time where you know you will be having bareback sex.

PrEP only works if you are HIV negative, which is why you will need to do a test before going on it. Your initial consultation for PrEP will include a HIV test that confirms your status before you are provided a prescription for the medication.

While PrEP is very effective in protecting you from HIV, it doesn’t protect you from other STDs and STIs such as gonorrhoea, syphilis or chlamydia. That’s why regularly using condoms is very important, even if you’re already taking PrEP.

PrEP is not a “morning-after” pill for HIV – in the event of suspected or accidental exposure, it’s post-exposure prophylaxis (PEP) that you should look for. Read more on PEP here.

Interested? Find out where you can get PrEP using our Clinic Finder.

PREP ON DEMAND

Some people may not want to take PrEP daily, but still want the extra protection when they know they’re going to have anal sex. If you find yourself in such a situation, an on-demand course of PrEP may do the trick for you.

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Using a ‘2-1-1’ dosage timeline – two pills between 2 to 24 hours before sex, one pill 24 hours the first pill, and a final pill 24 hours later – PrEP is shown to give protection against HIV that is as effective as daily PrEP.

If you’re considering PrEP On Demand, It is extremely important not to miss any doses when you’re taking it. If this is something that is likely to happen, discuss with your doctor or counsellor about going on daily PrEP instead.

PrEP On Demand only protects you from HIV exposure through anal sex. If you think you may engage in activities such as chem fun (CF), a course of daily PrEP will work better to protect you.

Fancy going on PrEP On Demand? The Take Charge Fun Pack includes a course of PrEP On Demand, a condom, and a counselling session with a Take Charge Advocate. Get in touch with us via live chat or e-mail hello@take-charge.today if you’d like to get your hands on a Fun Pack.

FREQUENTLY ASKED QUESTIONS

My partner is HIV positive, but I'm HIV negative. Can I use PrEP?

Yes. In fact, it’s recommended that you do so for the extra protection – especially if your partner is still infectious.

If I use PrEP, do I still need to use condoms?

While PrEP protects you from HIV, it does not offer protection from syphilis, gonorrhoea and other STDs. This is where condoms come in – when PrEP is taken together with regular condom use, you can be sure that you are at a very low risk of exposing yourself to STDs.

What drugs are used for PrEP?

A PrEP tablet contains two antiretroviral drugs: tenofovir disoproxil fumarate and emtricitabine.

This drug combination is known by many names – the most widely known brand name, Truvada (Gilead Sciences), is currently unavailable in Malaysia, but generic brand names such as Tenvir-EM and Teno-Em are available in Malaysia, and are just as effective in preventing HIV.

What is PrEP dosage like?

If you’re taking it daily, your dose will be one tablet daily throughout your course.

If you’re taking PrEP On Demand, you will follow the ‘2-1-1’ rule: two tablets between 2 to 24 hours before sex, one 24 hours later, and a final one 24 hours after that.

Is PrEP really effective in preventing HIV?

PrEP is highly effective in preventing HIV infection in HIV-negative people. It is up to 92% effective in preventing HIV infection through anal sex, and up to 70% effective in preventing infection through intravenous drug use (‘slamming’). A number of large-scale clinical trials have confirmed this.3

3Prevention Centers for Disease Control and Prevention (CDC)

How long does PrEP take to become effective?

For daily PrEP to become effective in preventing HIV, the medication has to build up in the body. This is estimated to take up to 7 days for anal sex. Afterwards, the medication has to be continually taken once daily in order to maintain its
effectiveness.

If you’re taking PrEP On Demand, it’s very important that you stick to the ‘2-1-1’ dosage plan for it to be effective. Take note that PrEP On Demand is only effective for anal sex – protection from HIV for any activities other than anal sex can be obtained through daily PrEP.

What should I do if PrEP gives me side effects?

While PrEP is well tolerated by most people, there may be some initial side effects as your body gets used to the medication. If this happens, you may choose to take your daily dose before bedtime, when you can sleep as the side effects wear off.

If the side effects are intolerable or last longer than a month, seek immediate advice from your monitoring doctor.

Does PrEP have any long-term side effects?

The medication used for PrEP is thought to have no side effects with long-term use. However, you will still need to work closely with your doctor to identify any side effect that may occur.

Although this is rare, some people may experience decreased kidney and liver function on PrEP. Your doctor will perform a baseline function test, and if the results show that you are experiencing impaired kidney and liver function, blood tests will be done every now and then for monitoring purposes.

I take medication for other conditions. Can I still use PrEP?

PrEP has been shown not to interact with most medications. However, it’s best to tell your doctor or pharmacist that you’re taking it before you are prescribed other medications.

I consume alcohol and/or use recreational drugs. Can I still use PrEP?

In research, PrEP has been shown not to interact with the use of alcohol or recreational drugs. However, do bear in mind that being under the influence of alcohol or recreational drugs may cause you to miss your scheduled doses, affecting your adherence and decreasing the effectiveness of your treatment.

How much does PrEP cost?

A reasonable cost for a 30-day supply of PrEP may cost between RM120 to RM800, depending on the clinic or dispensary. This may not include fees for medical consultations or tests.

To cater to your spur-of-the-moment sessions and long weekends, The Take Charge Fun Pack is available and includes a course of PrEP On Demand, a rapid HIV test kit, a condom, and a counselling session with a Take Charge Advocate.

Can I get PrEP on my private health insurance plan?

Unfortunately, PrEP is currently not covered under private health insurance plans in Malaysia.

How do I maintain my adherence?

PrEP ideally should be taken at the same time every day to maintain a steady level of the medication in the body.

In order to do this, it is necessary to make taking your pills into a habitual action. Use alarms or reminders, and bring a spare dose with you for when you’re not at home.

What do I do if I miss a dose?

If you miss a dose of daily PrEP, just continue to take them at your usual time. A missed dose every now and then will have minimal impact on PrEP’s effectiveness. There is no need to take two doses to make up for the missed one.

If you’re taking PrEP On Demand, it’s extremely important that you do not miss any doses. Failure to stick to the 2-1-1 plan will reduce its effectiveness.

I'm going to be travelling. When do I take my pills when I'm at my destination?

PrEP can be taken at the same time as you would at home, regardless of the time zone difference.

Can I take my pills with me when I'm travelling?

Like any prescription medication for personal use, PrEP can be brought along with you when you travel. Keep the pills stored in their original, labelled container, and carry a prescription or doctor’s letter with you in case of inspection by customs. Make sure you bring enough with you for the entire trip, plus some extras in case of delays.

What are the side effects of PrEP?

In the first few weeks of starting daily PrEP, some people may complain of headaches, dizziness, fatigue, or gastrointestinal side effects such as nausea, diarrhoea and stomach cramps. These side effects subside over time as your body gets used to the medication.

PrEP may affect kidney function in a very small number of people. Blood tests for kidney function may be included as part of your monitoring regime.

If you are concerned about side effects or are experiencing them, discuss them with your doctor at your check-up appointments.

Where can I find PrEP?

You can find PrEP at private sexual health clinics and a number of community health centres. Find one near you using our Clinic Finder.

If you’d like to go on a course of PrEP On Demand, get in touch with us via email or live chat and we’ll organise delivery of a Take Charge Fun Pack for you.

What do I have to do if I want PrEP?

Before you can obtain PrEP, you will have to be assessed if you are suitable for it. This is done in a few simple steps at the clinic.

Step 1: Get a blood test done at a sexual health clinic that prescribes PrEP. They’ll test you for HIV, liver and kidney function. The results will be returned to you in about a week.

Step 2: Your doctor or counsellor will discuss your test results with you to see if you can go on PrEP.

Step 3: If you’re eligible for PrEP, you will be given a prescription. If the clinic does not dispense PrEP medication, they may suggest a pharmacy you can fill your prescription at.

Can I find PrEP at government healthcare facilities?

PrEP is currently not indicated for HIV prevention use by the Ministry of Health. However, some government clinics may prescribe PrEP based on a risk assessment. This is done under the doctor’s discretion, and there is no guarantee that you will be able to get a prescription. Do note that government facilities can only prescribe, but not dispense PrEP – instead, you will have to obtain the medication at
a pharmacy.

Can I share PrEP with other people?

As with any other medication, sharing your prescription with other people is not advisable. A medicine that works for you may not work for someone else.

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