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Everything you need to know about PrEP Medication

Only a few decades ago, those with HIV faced a high risk of developing a potentially life-threatening condition called AIDS. Then, treatment options were discovered to not only prevent complications but also improve quality of life. Now, it’s possible to live a longer and healthier life with PrEP medication that is easily accessible. 

People at risk of HIV can take a prevention pill to help decrease the chances of getting infected. With the advent of the internet and widespread support, it’s easy to buy PrEP online from reputable sources. That way, those who may be at risk can be intimate, without the stress. 

Let’s take a closer look at PrEP medication for HIV so you can learn everything you need to know.

What is PrEP?

PrEP, also known as pre-exposure prophylaxis, is a daily HIV prevention pill that decreases your risk of getting HIV. Without prevention or treatment, HIV can infect the body’s immune cells and weaken the immune system. The weakening of the immune system over time can increase the risk of serious infections and AIDs. 

You can take PrEP medication to decrease the risk of infection during sex or injection drug use, and it is commonly taken daily as a combination pill. This combination pill, known by the brand name Truvada, contains tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC). 

A newer form of this drug, called Descovy, contains slightly different ingredients: tenofovir alafenamide (TAF) and emtricitabine (FTC). Descovy may not yet be approved in all parts of the world. However, generic PrEP tablets are available to purchase. 

There are also generic formulations available from different manufacturers that contain the same ingredients as the brand-name versions. If you are comparing different generic and brand-name medications, such as Teno-Em vs Truvada, just know that these drugs contain the same ingredients and work the same way. You are not sacrificing any quality or effectiveness by using a generic over a brand-name drug. 

How does PrEP work?

The active ingredients in PrEP pills work directly inside the cells of the body. PrEP medication acts as a shield to prevent HIV from entering the cells and replicating. If HIV cannot enter the cells, there is no infection and spread of the virus to other parts of the body. 

Normally, the virus converts its genetic material, called RNA, into DNA with reverse transcriptase. Inside a cell, the virus then uses DNA as an instruction manual to create other viruses. The body’s immune cells become factories for HIV to grow and spread. Tenofovir and emtricitabine work in similar ways to block HIV reverse transcriptase, an enzyme necessary for the virus to replicate. 

What is the difference between PrEP and PEP?

PrEP, or pre-exposure prophylaxis, is a prevention pill for people who are at high risk of getting HIV. It is typically taken on a daily basis for as long as the risk of getting HIV remains high. PEP, or post-exposure prophylaxis, is a treatment that is given if you think you might have been exposed to HIV. PEP should be taken within 72 hours of the suspected exposure. It should not be taken if you are regularly exposed to HIV. 

Starting PrEP after PEP?

You can transition from taking PEP to PrEP. In fact, you can start taking PrEP right after PEP if you want to. PrEP may be an appropriate option for you after taking PEP if you believe that you’ll be continually exposed to HIV on a regular basis. Still, the same precautions apply to starting PrEP after PEP and starting PrEP in general. The main precaution you’ll want to take is ensuring that you don’t have HIV before starting PrEP by getting tested. Oftentimes, the medication used as PEP is included in the regimen for PrEP, so you should know how the medication works for you regarding side effects. 

Testing while on PrEP

Before starting PrEP, you should get tested for HIV and other STDs. A fourth-generation HIV test is preferred over other tests, like a finger-prick test, since this test can more accurately assess whether you have HIV or not. If you’ve engaged in risky behaviors before getting the test done, you may want to get tested for HIV again four weeks after the previous test to make sure you don’t have HIV. You should also refrain from starting PrEP if you’ve recently experienced flu-like symptoms, as these symptoms could indicate an HIV infection. 

Tests you’ll need before starting PrEP medication:

  • HIV
  • STIs
  • Kidney function tests
    • Creatinine 
    • eGFR
    • Urine protein analysis
  • Hepatitis B

PrEP should not be taken if you are HIV positive due to the risk of viral resistance. You may also need to get a test to evaluate your kidney function and to see whether you have hepatitis B. Some people may experience kidney problems while on PrEP, so it’s important to monitor kidney function before starting treatment. PrEP medication can also fight hepatitis B, so it’s important to see if you also have hepatitis B so you can use PrEP in the safest and most effective way possible. 

Is PrEP effective?

Taking the PrEP HIV prevention drug can help reduce the chances of getting HIV to almost zero. But how effective is PrEP exactly? When taken daily for seven days a week, PrEP tablets can reduce the risk of HIV by 99%. PrEP medication can also reduce the chances of getting HIV by 70% in people who inject drugs. 

Increasing The Effectiveness of PrEP

This risk of getting HIV may be further reduced with PrEP medication by taking other precautions. These precautions include:

  • Using condoms 
  • Never sharing needles 
  • Taking PrEP at or around the same time every day
  • Not skipping doses of PrEP

It’s important to take PrEP medicine for HIV as prescribed. Otherwise, the risk of getting HIV can increase, especially if PrEP tablets are not being taken daily. You are fully protected from HIV during anal sex (bottoming) after around 7 days of initially taking PrEP. You are most protected from HIV during receptive vaginal sex and injection drug use after 21 days of taking PrEP daily.

Can you infect someone while on PrEP? 

One of the requirements before starting treatment with PrEP medication is that you are not currently infected with HIV. If you are HIV-negative, you can start treatment with PrEP. This also means you can’t infect someone with HIV while on PrEP. However, if you have another STI and you don’t use condoms, you may potentially spread another STI to someone else during sex even if you are on PrEP. That’s why it may be recommended to use other means of protection while on PrEP. 

PrEP and STIs

PrEP is an effective HIV prevention drug, but it does not protect against sexually transmitted infections (STIs) like gonorrhea, chlamydia, or syphilis. You may still have to use other methods of protecting against STIs, such as male condoms or internal (female) condoms. Using condoms can also help lower the risk of getting viral STIs, like herpes and genital warts.

How expensive is PrEP?

The cost of PrEP medication can vary depending on where you buy it from, including the country, pharmacy, and manufacturer. Previously, PrEP was only accessible in the UK for those enrolled in the IMPACT trial. With the trial coming to an end, PrEP medication may start to become available in NHS sexual health clinics. However, private prescriptions of PrEP from a doctor can cost up to £400 or more per month. In some cases, PrEP is more affordable when purchased elsewhere. 

It is legal to buy PrEP pills online from overseas for personal use in the UK. Online suppliers may offer a month’s supply at a cheaper cost than the PrEP cost with an in-person doctor’s visit. Other countries may also allow overseas purchasing of PrEP medications. Generic versions of PrEP medication are available and are usually available for a lower cost than the brand-name versions. 

Should I take PrEP?

You may benefit from the use of PrEP if you are HIV negative and at risk of contracting HIV. You may want to take PrEP if you have had anal or vaginal sex in the past 6 months, and if you:

  • Are not regularly using condoms during sex (bareback)
  • Have been diagnosed with an STD in the past 6 months
  • Have a sexual partner with HIV (even if they have an undetectable viral load)

PrEP medication may also be recommended for people who inject drugs as these people are 22 times more at risk of getting HIV than the general population. Certain people are at risk of getting HIV if they do not inject drugs but their sexual partner does. You should also take PrEP if you regularly share syringes, needles, or other injectable tools. 

If you’ve been prescribed PEP (post-exposure prophylaxis) medications, you may be recommended to take PrEP if you are engaging in at-risk behavior. You may also be recommended PrEP if you have taken more than a couple of courses of PEP in the past.

Women who are pregnant and have a partner with HIV can protect themselves and their baby from getting HIV with PrEP medication. You can further discuss with a healthcare provider whether PrEP may be right for you if you are pregnant and have a partner with HIV. Women can also take PrEP if they are trying to get pregnant or while breastfeeding, as these medications have been shown to be safe during pregnancy and breastfeeding

Event-based PrEP

Also known as on-demand PrEP medication or the 2-1-1 schedule, event-based PrEP is a type of HIV prevention method that allows more flexibility with the treatment regimen. Event-based PrEP involves taking two tablets 2 to 24 hours before having sex. Then, one tablet is taken 24 hours after the double dose was taken prior of the sexual activity. Then, one more tablet is taken 24 hours after that. This method of taking PrEP medication is optimal for those who do not wish to take daily PrEP dosing and who can anticipate when they are going to have sex. This type of PrEP dosing is just as effective as regular PrEP daily dosing.

Does PrEP have side effects?

As with all medications, there may be some side effects associated with PrEP. Although many people do not experience any side effects while on PrEP medication, some people may experience short-term PrEP side effects, such as nausea, diarrhea, and stomach discomfort. However, side effects are often temporary and go away on their own as your body gets used to the medication. Common side effects of tenofovir and emtricitabine include:

  • Nausea
  • Diarrhea
  • Headache
  • Feeling tired
  • Dizziness
  • Insomnia
  • Unusual dreams 
  • Rash

In rare cases, PrEP treatment can cause kidney problems or worsen current kidney problems. Before and during PrEP treatment, it is recommended to monitor laboratory values that assess kidney function, including serum creatinine and creatinine clearance, as well as protein and glucose in the urine. Your doctor may recommend you get these lab tests done on a routine basis. 

The use of PrEP medication may also cause a decrease in bone mineral density (BMD). Studies have shown that those taking PrEP consistently experience a 1.2% decrease in BMD in the spine and a 0.5% decrease in BMD in the hip. Still, this decrease in BMD is not significant enough to cause severe adverse effects for most PrEP users. Certain people at risk of bone fractures may need to monitor their BMD regularly. 

This may not be a complete list of side effects. You may want to discuss other possible side effects, drug interactions, and precautions with a healthcare provider before starting PrEP treatment.

Other frequently asked questions (FAQs) about PrEP

Who needs PrEP medication?

People who are at risk of contracting HIV may want to take PrEP medication. Those who may benefit from PrEP include HIV-negative adults and adolescents who engage in sex without a condom or who use injectable drugs. There is a 10-times higher risk of contracting HIV through anal sex than with vaginal intercourse.

Is PrEP better or safer than condoms?

For the prevention of HIV, PrEP is better than condoms, and there is greater effectiveness with PrEP medication than condoms. However, condoms may still be recommended to protect against other STIs, like gonorrhea or chlamydia, which PrEP does not protect against. PrEP may also come along with side effects, although side effects are generally mild and temporary.

Does PrEP make you tired?

PrEP is generally safe to take. Tiredness, or fatigue, can occur in a small percentage of people taking PrEP on a daily basis. However, everyone may react to PrEP medication differently. You may feel more tired than usual while taking PrEP, or you might not feel any side effects.

Can you drink alcohol on PrEP?

There are no known interactions between alcohol and PrEP. However, it’s important to take PrEP daily. Excessive consumption of alcohol may interfere with your ability to adhere to your treatment regimen and thus, alcohol may affect PrEP effectiveness indirectly.

Do I have to take PrEP medication forever?

PrEP effectiveness is associated with how the drug is being taken. PrEP medication needs to be taken daily in order to be the most effective at preventing HIV. Some people may decide to stop taking PrEP because they are no longer engaged in risky behaviors; they tend to forget to take their pills; they prefer not to take a daily pill; they are experiencing severe side effects from the pill; or the pill has become unsafe for them in any way.

Can I take PrEP with other medicines?

Very few medications are known to interact with PrEP. The use of NSAIDs may need to be monitored or avoided while taking PrEP since these medications can put pressure on the kidneys and increase the risk of kidney problems. Other drugs that can affect the kidneys include Zovirax (acyclovir), Valtrex (valacyclovir), and Cytovene (ganciclovir). You may want to talk to a healthcare provider for other possible drug interactions associated with PrEP.

Trans people who take PrEP do not have to worry about PrEP interacting with hormone replacement treatment. 

What should I know before taking PrEP medication?

Before taking PrEP medication, you may need to take certain tests to make sure you are a good candidate for this treatment. These tests are performed by a healthcare provider to ensure you are in the right condition to be receiving PrEP and make sure treatment goes smoothly.

Can you take PEP if you are on PrEP?

The same medication for PEP and PrEP is typically the same. The difference is in how the medication is administered for PEP vs PrEP. PEP, or post-exposure prophylaxis, is recommended if you believe you have been exposed to HIV through sex or sharing needles. People usually take PEP as a precautionary measure. If you know you will be continually exposed to HIV in the future, you can take PrEP, or pre-exposure prophylaxis, to lower your risk of getting HIV.

What is the best PrEP drug?

The best PrEP drug is the one that works for you. Currently, generic PrEP medication is available and contains a combination of tenofovir and emtricitabine. These ingredients work together to decrease the chances of an HIV infection. A doctor will determine the appropriate PrEP dosage based on your overall condition.

Is it safe and legal to buy PrEP medication online?

If you live in the UK, it’s 100% safe and legal to buy PrEP online from reputable sources. It is also legal to buy PrEP medication in countries that allow the buying and importation of medications like PrEP. You’ll want to check the laws and regulations of your country before purchasing PrEP online. 

If you’re looking for PrEP online, DeliverDose makes it easy for you to find high-quality medications at the cheapest price. Plus, all medication purchases include free delivery. Once you purchase the medication you need, you can have it shipped directly to your door, for free. 

All medications are shipped in discreet packaging to protect your privacy. After all, your health and privacy are a priority. 

Find out more about how you can get PrEP shipped to your door

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