SAN ANSELMO, CA - NOVEMBER 23: Bottles of antiretroviral drug Truvada are displayed at Jack's Pharmacy on November 23, 2010 in San Anselmo, California. A study published by the New England Journal of Medicine showed that men who took the daily antiretroviral pill Truvada significantly reduced their risk of contracting HIV. (Photo Illustration by Justin Sullivan/Getty Images)

WHAT IS PREP? Pre-exposure prophylaxis is a term used to describe the use of medications used to prevent the spread of disease in people who have not yet been exposed to a disease-causing agent, usually a virus.

The term typically refers to the specific use of antiviral drugs as a strategy for HIV/AIDS prevention.

You can also say PrEP:   Is the use of anti-HIV medication that keeps HIV negative people from becoming infected. PrEP is approved by the FDA and has been shown to be safe and effective.


Who should use PrEP?
Currently, there are only two FDA-approved medications for PrEPPrEP is prescribed to HIV-negative adults and adolescents who are at high risk for getting HIV through sex or injection drug use.
Is PrEP safer than condoms?
Even when condoms are used consistently, they can fail. With the low number of HIV cases among people actively taking PrEP we are now talking about greater than 99 percent effectiveness, in other words, the pill is more effective at preventing HIV than condoms.
Can I infect someone while on PrEP?
No, taking PrEP does not prevent you from contracting sexually transmitted infections such as gonorrhea or syphilis.
It is important for you to be regularly tested for these infections and to be treated promptly if you find out that you are infected.
How long should I take PrEP?
The amount of time it takes may vary from person to person. For people taking daily PrEP who engage in anal intercourse, the medication must be taken each day for 7 days to reach the level needed for full protection.
Cis-gender MSM who are taking on-demand PrEPmust take two pills, 2-24 hours before having sex.
Does PrEP work after 72 hours?
You will have to take the medication for a month but if you start taking it within 72 hours of being at risk, it may prevent you from becoming infected with HIV.
Can I test positive while on PEP?
After a course of PEP you need to wait 28 days before testing for HIV. This is because PEP can delay infection.
How long should I take PrEP after exposure?
Generally speaking, cis-gender men taking on-demand PrEP should continue taking the PrEP medication for at least 2 days after any possible exposure.
Anyone taking daily PrEP should continue taking the medication for 28 days after the last possible exposure.
Can I drink alcohol while on PEP?
Do not drink alcohol while taking this medication. Women under the age of 20 should not take this medicine. Keep these medications out of the sight and reach of children.
Is PrEP more effective than pep?

There are insufficient data about PEP’s effectiveness to prevent HIV infections from nonsterile injection drug use.

For persons who inject drugs and experience many exposures, PrEP is likely to be a better prevention strategy than PEP.
What causes pep failure?
PEP failure, when it occurs, is usually attributed to delayed initiation, transmitted drug resistance, or suboptimal medication adherence.
What is the success rate of pep?
Adherence to a full 28-day course of ARVs is critical to the effectiveness of the intervention. Recent evidence shows PEP uptake has been insufficient: only 57% of the people who initiated PEP have completed the full course and rates were even lower at 40% for victims of sexual assault.
While most people’s bodies tolerate PrEP (pre-exposure prophylaxis) well, like all medications it can have some side effects.

Everyone is different which makes it difficult to know how one’s body will react to a drug regimen until they start using it.

It’s usual that everyone will not experience the same side effects when they take the same medication.

Yes, there are some side effects associated to PrEP use but a lot of people don’t experience any of them, and if they do it’s usually for a short period while their body adjusts to the drug.


Short term side effects are often the most noticeable, though usually occur at the commencement of your medication and often for a short period.

Side effect 1: nausea

One possible side effect of PrEP can be nausea, which can be a feeling of queasiness, unease or discomfort in the stomach and sometimes with the urge to vomit.

If you are experiencing this, it most usually will pass after the first few weeks of taking PrEP (Mostly the effects last just for the first two weeks).

As some PrEP users have found, taking the tablet during or soon after a meal can reduce the nausea.

Side effect 2: headaches

Headaches can be caused by a number of different things, such as being dehydrated or a lack of sleep, but headaches can also be triggered by certain medications.

If you experience headaches after starting PrEP that persist, are severe or if you are concerned for any other reason, you should talk to your healthcare provider.

Your prescribing doctor may recommend you take a form of paracetamol to assist in alleviating headaches.

Otherwise, they usually subside within a few weeks to a month after your first dose.

Side effect 3: diarrhoea

Though uncommon, some guys may find a need to go to the toilet more frequently and when doing so it may be looser or runnier than normal.

If this occurs, it should subside in around three to four weeks. Again, if severity increases then you should get in touch with your healthcare provider.

Some people find it better to take the tablet with a meal. Experiment with the time of day you take it to see what works best for you.


While much less common, there are some side effects that might impact you as you take PrEP over an extended period.

Side effect 1: liver health

In rare cases, taking PrEP can affect your liver health.

If you notice your skin or the white parts of your eyes turning yellow, dark ‘tea-coloured’ urine, light coloured stools or loss of appetite for several days or longer you should mention this to your prescribing doctor immediately.

Side effect 2: kidney health

While uncommon, PrEP can also affect your kidney health. So it is important for your doctor to examine your kidneys at the time of starting PrEP especially if you have some other underlined conditions.

If you take gym and exercise supplements with creatine, they may interfere with your kidney function test by showing what looks like high levels of creatinine.

This, however, is artificial and not a true indication of your kidney health. If you are taking any supplements, you should inform your doctor.

Side effect 3: loss of bone density

In some rare cases, PrEP may cause some loss of bone density, which can lead to a higher chance of bone fractures.

Should this occur, you can cease taking PrEP and your bone density will recover over time.

Part of the PrEP program ensures that you visit your PrEP prescriber regularly for repeat HIV and STI testing, as well as regularly checking bone density, kidney and liver function.

NOTE: If you have existing kidney, liver or bone complications such as osteoporosis, or you are taking any other medications, you should inform your doctor before commencing on prEP.

Others might EXPERIENCE SOMETHING ELSE not mentioned above

While some people have described other side effects such as an increase or decrease in body weight, or changes to libido and energy levels, a lot of these have been reported at an anecdotal level.

So while these experiences should not be discounted, PrEP may actually not be the root of the cause.

Connect with groups like PrEP’d For Change to learn about other peoples’ experiences with PrEP, and always consult with your doctor if you encounter any changes in your body that don’t feel right.


If you are a Trans person interested in taking PrEP and also using gender-affirming hormones, there are no known interactions.

You should discuss this with your doctor or other hormone prescriber prior to starting PrEP.



Importantly, by choosing PrEP as your way to prevent HIV, it can unlock a feeling of independence and provide a sense of security.

Meanwhile, as we continue being optimistic that HIV vaccine will be discovered soonest than later, we are privileged to have PrEP and we have come a long way to get it.

It’s ours for the taking, for our own health and for those we love and our community.


Elves Delz
Author: Elves Delz


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