- In case you are not eligible for PrEP because of health issues. Check step 2 in our guide to check if you are eligible.
- In case your sexual activities don’t fit the categorization of “high-risk sexual activity”.
- In case you want to have additional protection against other STD’s we recommend using condoms.
- In case you don’t have the ability to purchase prep and you meet the criteria, we recommend using condoms.
- In case you have any
Condoms are able to protect you from HIV and other STD’s in 97% of the cases, PrEP was proved to work in 92-99% of cases in clinical trials.
PrEP can protect you from HIV throughout an antiviral effect due to the high concentrations of the drug in the blood/tissue barriers (anal, vaginal).
Condoms provide non-specific mechanic protection. In other words, they prevent body liquid exchange. This prevents HIV infection. Furthermore, this mechanic barrier can prevent other sexually transmitted diseases. Among these diseases are Syphilis Gonorrhea, mycoplasma, and more.
Therefore, Condoms provide wider protection. PrEP is HIV specific.
It depends on your country, some countries provide subsidized PrEP to citizens that are eligible. However, in most cases, the criteria are very strict and people need to undergo a tiring process of applying and visiting various doctors to get the application approved. Many reports show that in many Eu countries it is difficult and almost impossible to get Prep.
Some reports state that around 500 thousand eligible candidates for Prep in the Eu among the homosexual community are not able to access it.
However, you can get assistance to get Prep from various NGOs, LGBT organizations, and non-profit support organizations.
Moreover, for a constant supply, you can check online pharmacies that can provide you the product for affordable prices.
To read more about the challenges of acquiring PrEP you can read our article:
How to Buy PrEP: the methods and obstacles to Buy PrEP in 2020?
For uninsured US citizens, you might contact NGO’s, governmental plans and LGBT organizations for support to get Prep.
Here are some examples of such plans:
In the USA Truvada producer Gilead has a program called: Gilead’s Advancing Access, check here if you are eligible.
The San Fransisco Aids Foundation offers free HIV testing and helps with PrEP therapy.
The US government runs a free PrEP program called: Ready, Set, PrEP.
In the UK you can access PrEP via the Impact Clinical Trial.
Alternatively, you can access PrEP throughout international online pharmacies that provide PrEP for affordable prices.
PrEP should be taken daily according to the first researches (IPERGAY, PROUD, and iPrex ).
However, researches showed proper protection rates even in participants that took PrEP 4 times in a week ( protection rate reached 94%). Such a regimen is possible.However, if you forget any dose here you are in danger.
PrEP On Demand or The 2:1:1 Method
This regimen is for gay males that have frequent anal sex, Top or bottom.
in this protocol, PrEP is taken 24 hours before sex and then 2 hours before sex, this way you gain the desired protection. Afterward, PrEP is continued on 2 separate doses. “1” is 24 hours from the first dose and the other is 48 hours after the first dose.
Please note that the 2:1:1 regimen was not proved for vaginal or “front hole sex”. Furthermore, people on hormones (estradiol or testosterone) should refrain from 2:1:1 regimen and stay on the daily regimen as this regimen is the only one proved safe for them.
Overall the answer is no, governmental insurance programs don’t provide PrEP. however, you can apply for help through the HHS program “ Ready, Set and Prep” to provide you support for PrEP therapy. For free programs for PrEP in the US check here.
To check if your insurance programs cover PrEP check our article:
Buy PrEP: the methods and obstacles to Buy PrEP in 2020?
We recommend you discuss the option with your general practitioner that might be able to help you with accessing PrEP.
Alternatively, you can check online pharmacies that can provide you the product for affordable prices.
You need to consult your medical provider. It depends on your country. Many EU countries have governmental programs that provide PrEP for free or for a subsidized fee. In Africa, there are free subsidized programs for PrEP.
In the USA, programs vary, and their free programs as well. Check If you are eligible for free PrEP.
Furthermore, Gilead Pharmaceutical the producer of one Prep Medication (Truvada) says on its webpage to give financial support for privately insured patients depending on their income (up to 7000 USD for year, monthly therapy cost is between 1000-2000 USD).
Please check the detailed costs of each insurance program in the US covered in our article:
Buy PrEP: the methods and obstacles to Buy PrEP in 2020?
Alternatively, you can check online pharmacies that can provide you the product for affordable prices.
For most people, PrEP doesn’t cause any major side effects but rather is well tolerated.
However, Like any medication, PrEP can cause side effects.
In one of the most famous Prep clinical trials, iPrEx side effects have been assessed.
Among the side effects:
Headaches- A slightly higher percentage of headache cases was observed in the Prep group (4.5%) compared to placebo (3.3%)
Weight loss – Weight loss was considered if more than 5 percent of weight was lost. A slightly higher percentage of Weight loss cases was observed in the Prep group (2.2%) compared to placebo (1.1%)
Nausea- A slightly higher percentage of Nausea cases was observed in the Prep group (9%) compared to placebo (5%), this difference disappeared after the first month.
Creatinine- prep caused a mild increase in blood creatinine in 0.3% of the population without any major kidney side effects on later follow up, furthermore in many cases later this increase disappeared.
For more information regarding side effects read our relevant section on our PrEP guide.
The iPrEx trial proved that PrEP reduces the risk of HIV infection among gay men, bisexual men, and transgender women.
Furthermore, the Partners PrEP, and TDF2 displayed a reduction in HIV infection among heterosexual men and women following PrEP administration. Moreover, The Bangkok Tenofovir Study showed that PrEP is effective in 74% of the cases in needle HIV transmission.
There are many ongoing studies examining other regimens for PrEP.
The answer to this question is complexed. Due to its high price, few governments, subsidize PrEP for the population.
Furthermore, there are many NGO’s and programs that cover PrEP for free. Check here some of them.
This leaves many people unable to purchase PrEP due to its high prices reaching 2000 $/ month in some countries.
Read our article here to check the exact cost and coverage for PrEP according to insurance Programs in the US.
How to Buy PrEP: the methods and obstacles to Buy PrEP in 2020?
A recent study demonstrated that out of 1 million people that are eligible for PrEP in the United States, only 120 K is able to buy it.
Fortunately, as a joint effort of community influencers, NGOs, and human rights organizations there is an online Pharmacy that provides the product.
PrEP is a pill that is absorbed in our digestive system. After some metabolism, the active compound is absorbed in our bloodstream.
Many of HIV infections occur due to the exposure of mucosal areas to the virus during Sex. The mucosa is exposed to high viral loads, and the virus reaches the bloodstream. Afterwards, the virus infects the CD4 lymphocytes.
If our blood at the mucosal areas has high concentrations of PrEP, the virus won’t be able to infect the CD4 cells in our blood. Therefore, the infection won’t be established.
PrEP is most effective upon daily usage as research suggests.
As suggested by the IPREX clinical trial, the protection increases when the therapy is consistent.
Protection for a male to male sex was 99% effective when patients took the drug on a daily basis for one week.
For participants in this trial that took PrEP 4 times per week the protection was 96%.
While participants that took the medication only twice a week the protection dropped to 76%.
Obviously, there is an additive protective power for taking prep every day. This additive power has minor statistical significance. However, it increases the safety margins of the regimen. Forgetting to take the medication for one or 2 days in this regimen is not so dangerous as with the 4-day regimen.
Protection drops significantly if PrEP is taken for less than 4 days.
As for needle injection transmission, the research suggests that prep can be protective in 74% of the cases.
For more information, Check Our guide on How to take PrEP, Step 3.
We recommend you take PrEp at least one to three weeks before engaging in any high-risk sexual activity (depending on the nature of the activity).
If you are the receptive to an MSM activity, taking PrEP one week before the activity is enough for optimal protection. Research shows that blood anal levels of PrEP peak around 1 week.
If you are active in an MSM activity or in a heterosexual activity, taking PrEP three weeks before the activity should be enough for optimal protection. There is no research on penile protection following PrEP, thus, in this case, we recommend 3 weeks.
If you are a female in heterosexual sex, taking PrEP three weeks before the activity should be enough for optimal protection. Research shows that blood vaginal levels of PrEP peak around 3 weeks.
You should take PrEP at the same time every day
You can take PrEP before or after food.
It is recommended not to take PrEP with alcohol as it might increase some side effects. However, there is no proof of interactions between PrEP and alcohol or recreational drugs.
To reach maximal needed prep concentration in the rectal tissue it takes 7 days.
To reach maximal needed prep concentration in the vaginal tissue it takes 21 days.
To reach maximal needed prep concentrations in the blood it takes 21 days.
There Is no research regarding the concentrations in the tissue of the penis. Therefore, we recommend you to take PrEP for at least 3 weeks before sex.
In case you are eligible for prep, there are ways to get prep. Many human rights organizations, LGBT organizations, and NGOs worldwide can provide you Prep.
Among the Free Programs in the USA:
In the USA Truvada producer Gilead has a program called: Gilead’s Advancing Access, check here if you are eligible.
The San Fransisco Aids Foundation offers free HIV testing and helps with PrEP therapy.
The US government runs a free PrEP program called: Ready, Set, PrEP.
In the UK you can access PrEP via the Impact Clinical Trial.
For a constant supply, you can check online pharmacies that can provide you the product for affordable prices.
PrEP usually uses TDF-FTC, which is contra-indicated for kidney patients. However, you can take TAF-FTC (TAF-FTC; Tenofovir Alafenamide 25 mg-Emtricitabine 200 mg) which has a safe kidney profile and has been proved in clinical trials as an efficient PrEP therapy. However, it can also have some side effects on its own. TAF-FTC protocol can cause dyslipidemia and weight gain.
In such a case, we recommend, frequent follow up for lipids: HDL, LDL, and triglycerides. Moreover, BMI follows up as well as a metabolic screen is needed.
For more information on kidney safety please check step 2 in our PrEP guide.
Modern western medicine consists of many therapeutic fields. One of the main fields is preventive medicine, with preventive medicine we have been able to eradicate major epidemics like measles, mumps, rubella, and more. Introducing PrEP enables us to slow the spread of HIV and aspire to eradicate it. We believe that providing prevention is essential in the overall battle against HIV and is complementary to the parallel effort in treating existing patients.
For more information regarding costs of PrEP therapy vs Traditional HIV therapy, read our article:
Buy PrEP: the methods and obstacles to Buy PrEP in 2020?
The answer to this question is complicated.
In case we speak about HIV the protection rate of both is similar and is above 95% of the cases if both are taken in optimal protocols.
Many groups can’t or don’t use condoms for many reasons:
- cannot reach the optimal sexual experience using condoms thus not using them many times.
- Sex workers.
- People that use drugs and are not in full awareness while having sex.
Other reasons are:
- People that have an HIV positive sexual partner can benefit from using PrEP.
- People involved in certain sexual activities that might often cause the rupture of condoms.
- People involved in IV drug abuse, needle sharing, etc.
Prep is a combination of antiviral drug combinations that have been proved to be efficient for HIV prophylaxis.
Some of the PrEP approved medications:
1- Tenofovir/Emtricitabine also known as Truvada. Truvada was the first approved PrEP. There are many generics forms of Tenofovir/Emtricitabine (FTD-TFC) available around the world.
2- Emtricitabine / Tenofovir alafenamide also know as Descovy.
3- Tenofovir/Lamivudine is also an approved antiviral combination.
Anti-viral therapy is the equivalent of antibiotic treatment. However, while antibiotics target bacteria and parasites, anti-virals are drugs that target viruses in different mechanisms. There are many families within this group of drugs. Unlike antibiotics, antiviral Don’t destroy the pathogen, but rather prohibit its development and replication within the organism. For this reason, antivirals tend to have a much smaller profile of side effects when compared to antibiotics.
PrEP is a term that stands for pre-exposure prophylaxis.
This term is used to refer to antiviral regimens used to prevent viral infections. The most famous PrEP therapy today is PrEP for HIV.
PrEP for HIV is usually a combination of 2 medications: TDF/FTC.
Furthermore, PrEP was proved to prevent HIV infection if taken consistently in 99% of the cases.
Many countries have approved PrEP use for certain groups.
If you want to know what PrEP contains check here.
To check if PrEP is for you, visit our 3 Step PrEP guide.
The cost of PrEP in the USA is around 1300 USD -2000 USD per month depending majorly on the insurance plans.
In Europe, the Prices of Truvada are between 400-1000 USD per month, while Generics are sold for 30-200 USD a month.
However, there are special plans around the world, that provide PrEP for free.
Furthermore, it is possible to obtain PrEP online at lower prices.
To see more details about the pricing around the world, please check our article:
How to Buy PrEP: the methods and obstacles to Buy PrEP in 2020?
PrEP stands for Pre (before) exposure prophylaxis.
PrEP is a daily preventive treatment taken to Prevent HIV.
PEP stands for Post (After) exposure prophylaxis.
PEP is a medication that is administered to HIV negative people that have been in a high-risk encounter (high-risk intercourse) within the last 72 hours.
To make it easier to understand, PrEP is like an oral contraceptive. PEP is the day after pill.
You should take PrEP at the same time every day
You can take PrEP before or after food.
It is recommended not to take PrEP with alcohol as it might increase some side effects. However, there is no proof of interactions between PrEP and alcohol or recreational drugs.
We recommend you continue taking prep at least 4 weeks after the last high-risk encounter.
Research has shown that condoms have not been able to eradicate HIV from the world. This is due to the fact that condoms are not practical in many cases thus not used or used but don’t provide the desired effect.
Among these cases:
• Sex industry workers many times are required to be involved in unsafe sexual intercourse.
• MSM, in many cases condom usage is not “community acceptable” thus many unsafe sexual intercourses take place.
• Couples that one of them is HIV positive and the other is negative.
• Sex while under drug effect (methamphetamines for example).
• Break of condoms during intercourse and thus unsafe sex.
• Noncompliance for example due to compromised sexual experience with condoms.
For more details about PrEP, check our 3 step PrEP guide.
PrEP is preventive medicine for people that are in a high-risk group acquiring HIV in the near future. This group of people benefits from preventive treatment thus it is recommended for them to take prep daily in order to lower the risk to acquire HIV. If you want to check your eligibility for PrEP therapy you can check our 3 step guide that will help you decide.