PrEP (Pre-Exposure Prophylaxis)

PrEP stands for pre-exposure prophylaxis. It is a daily tablet that reduces your chances of getting HIV through sex by almost 100%, if you don't already have it.

PrEP and PEP (post-exposure prophylaxis) are two different medications.

• You should take PrEP daily if you have a high risk of getting HIV to protect you from this. See if you have a high risk, below (‘Patient safety information’). Meanwhile, anyone can take PEP after sex if they believe they have been exposed to HIV.
• You can take PrEP for as long as you believe you’re at a high risk of getting HIV. However you need to take regular tests to check that it's still safe for you. If you want to stop PrEP or take a break, you should speak to your doctor before doing so. PEP is normally prescribed for 30 days and must be taken right after exposure to protect you from getting HIV (ideally within 24 hours).
• You need to get a prescription for PrEP. Start a consultation to order PrEP and get this delivered to you (once approved by one of our doctors). You can also get PrEP on the NHS through a sexual health clinic. PEP is available from sexual health clinics too, or from A&E if it’s outside clinic working hours.

PrEP works by stopping the virus from making copies of itself and getting into other cells in the body.

The tablet contains two active ingredients called emtricitabine and tenofovir disoproxil. These antiretrovirals are used to treat HIV infections. PreP medication is not a treatment for HIV and is for pre-exposure prohylaxis only.

We prescribe unbranded (generic) emtricitabine and tenofovir disoproxil medication for PrEP.

Before you start PrEP

Yes, before you start taking PrEP, you need to make sure:

• you are HIV negative
• your kidney function is normal

Also, you may need to check your hepatitis status depending on your circumstances. Check your:

• hepatitis B status if you’re not vaccinated for this or don’t know this
• hepatitis C status if you are a man or a trans woman and you have sex with other men

It’s also recommended that you check for sexually transmitted infections (STIs) with a full screen test before you start PrEP.

PrEP testing through Asda Online Doctor

You can order our PrEP test kits to carry these tests out at home. Choose our:

• basic profile test to check your HIV status and kidney function only
• advanced profile test* to check all of the above (HIV status, kidney function, and hepatitis status)

We also offer a kidney function test if you only need to check this.

When your results are ready, our doctors will send you a message through your account with these plus any follow up advice.

You can order PrEP through us if you’ve not taken these tests yet but you must complete these and have your results before you start taking PrEP medication. If you receive your medication before then, please wait until you have your test results to begin taking this. You can take these tests through your GP or another provider, if you wish.

* You should wait 8 weeks after a hepatitis B vaccination before taking a hepatitis B test. Taking a test before 8 weeks have passed may give a false positive result.

While taking PrEP

For your safety and wellbeing, you need to continue taking the tests mentioned above at various stages once you begin taking PrEP. You can order our home test kits above for this.

Every 3 months, you need to take a HIV test. It’s recommended that you regularly test for all common STIs too.

Then every 12 months, you need to take a HIV test and a kidney function test. If you have a high risk of kidney disease, you should take a kidney function test every 6 months instead.

You need to check your hepatitis B and C status at this stage too if either applies to you (see above).

If you test positive for hepatitis, we will advise you to see your GP who will refer you to a liver specialist. If your test shows abnormal kidney function, we will ask to repeat the test to check if it normalises.

In clinical trials, PrEP has been shown to work when taken:

• daily where you take one tablet every day
• on demand

Daily PrEP

We recommend daily PrEP as this is simple and effective for all type of sex (anal, vaginal, or frontal). When you first start taking daily PrEP, it can take 4 days for men to become protected, or 7 days if you have a vagina or cervix. It’s best to take PrEP around the same time every day. You can take this with or without food.

On demand PrEP

On demand or ‘event based’ dosing should only be used for anal sex. It does not offer protection from HIV if you have frontal or vaginal sex.

Follow these steps to take on demand PrEP. You must take all of the tablets required.

• 2 to 24 hours before having sex: take 2 tablets (your 'first dose')
• 24 hours after your first dose: take 1 tablet
• 48 hours after your first dose: take 1 tablet

If you have sex over several days (for example, over a weekend), take 1 tablet every 24 hours after your first dose regardless of how many times you have sex each day. Don’t forget to take a tablet 24 and 48 hours after you stop having sex.

You should take these tablets at the same time each day.

Example:

If you have sex every day from Monday to Friday, you would take:

• 2 tablets on Sunday (or 24 hours before having sex for the first time)
• 1 tablet daily from Monday to Friday (at the same time as your first dose)
• 1 tablet on Saturday
• 1 tablet on Sunday

If you have any questions about taking PrEP, you can message our doctors through your account.

PrEP is not available over the counter and can only be prescribed by a doctor. PrEP is available on the NHS from sexual health clinics. Alternatively, you can get a prescription from one of our doctors and treatment delivered to your door with our online service.

Although PrEP is generally safe to take, you may get side effects while taking this.

Some common side effects of PrEP include:

• nausea (feeling sick)
• headaches
• diarrhoea
• feeling tired
• stomach pain
• itchy skin

Some less common side effects of PrEP include:

• yellowing of the eyes or skin
• change of colour in stool or urine
• fast or abnormal heartbeat
• shortness of breath

These side effects should get better after a couple of weeks, if you experience any at all. If they continue or you cannot tolerate them, contact our doctors through your account or speak to your GP.

If you’re worried about any uncommon side effects, you can seek urgent medical help (for example, go to A&E).

PrEP is only suitable if you have a higher risk of getting HIV, but are currently HIV negative.

You might be at a higher risk of getting HIV if you are:

• a man and you have sex with other men
• a woman and you have sex with bisexual people
• a transgender person and you have sex with men
• a sex worker
• injecting drugs using syringes or needles, and share those with others
• having sex with somebody who is from a country with high rates of HIV

There may be other reasons that you are at a higher risk of getting HIV. If you're not sure if you are, you can message one of our doctors through your account. Otherwise, speak to your GP or local sexual health clinic.

While PrEP is highly effective at preventing HIV, there are several reasons why it may not be suitable for you. In addition to not having a high risk of getting HIV, you should not take PrEP if you have tested positive for HIV or show symptoms of HIV infection.

PrEP may also not be suitable if you:

• have kidney disease
• have liver disease
• are allergic to the active ingredients, emtricitabine or tenofovir disoproxil
• are pregnant, breastfeeding or trying to have a baby
• have certain health conditions
• are taking certain medications

Our doctors will let you know if it is safe for you to use PrEP based on your medical history when you complete our consultation.

Before we can prescribe PrEP to you, we will ask you about any medications you are currently taking or have recently stopped. Certain medicines may lower the protection PrEP provides for HIV.

These include:

• some painkillers
• some antibiotics
• medications for treating hepatitis C
• drugs for treating viral or fungal infections
• cancer medication

PrEP is unlikely to interact with alcohol or recreational drugs, but you should drink in moderation while taking PrEP to ensure your liver is healthy.

Even though PrEP is very effective at preventing HIV, it will not protect you from other STIs like herpes, gonorrhoea, or chlamydia. It’s important you attend regular STI screenings every 3 months if you are using PrEP. If you are pregnant or breastfeeding and are at a high risk of getting HIV, it is always best to speak to your doctor first before taking PrEP.