What is pre-exposure prophylaxis (PrEP)?

PrEP – pre-exposure prophylaxis – is the use of an HIV/antiretroviral drug by an HIV-negative person for preventive purposes, i.e. to prevent HIV infection. Truvada® is the main drug used in PrEP.

PrEP contains two substances that are also used to treat HIV: Tenofovir disoproxil and Emtricitabine.

PrEP is different from PEP (post-exposure prophylaxis), which is an emergency treatment for HIV taken after possible exposure to the virus.

How does PrEP prevent HIV infection?

The anti-HIV medications in PrEP stop the virus from replicating in your body. If you’re exposed to HIV, for example during unprotected sex, but you’ve taken PrEP correctly, you’ll have a sufficient level of medication in your body to prevent HIV infection.

How effective is PrEP?

If used consistently and correctly, PrEP will practically eliminate the risk of getting HIV.

A number of high-performance studies conducted worldwide have repeatedly demonstrated the effectiveness of PrEP.

If I’m taking PrEP, can I stop using condoms?

This will depend on the circumstances in which you’re using PrEP. PrEP protects you from HIV, but it doesn’t provide any protection against other sexually transmitted infections (STIs). Using condoms is the best method to prevent other STIs such as Gonorrhea, Chlamydia, or Hepatitis C.

Who can take PrEP?

PrEP is intended for HIV-negative individuals who are at high risk of HIV infection. PrEP can be used by both men and women, both transgender and cisgender.

PrEP might be a good option for you if:

  • You are in a sexual relationship with an HIV-positive partner who does not have an undetectable viral load.
  • You are gay or bisexual, have multiple sexual partners, and do not always use condoms.
  • You are gay or bisexual in a new sexual relationship, but you do not yet know your partner’s HIV status and do not always use condoms.
  • You do not use condoms with partners whose HIV status is unknown and who are at high risk of HIV infection (for example, they use injectable drugs, have multiple partners, or have bisexual partners).
  • You work in the sex industry or receive money/goods in exchange for sex.
  • You have shared injecting equipment or have been in a program for injectable drug use treatment.

Is PrEP effective for anal and vaginal sex?

Yes. PrEP can prevent HIV infection during both anal and vaginal sex, but there are different recommendations for how to take PrEP, depending on your gender and the type of sex you practice.

How do I take PrEP?

There are two ways to take PrEP:

One pill a day

This option is recommended for:

  • Gay or bisexual men
  • Men who have vaginal or anal sex with women
  • Women (both transgender and cisgender)
  • Transgender men who have vaginal/frontal sex with other men.

You will need to take PrEP for 7 days before you start being protected and then every day as long as you want to be protected.

Event-based (on-demand), where you take PrEP before and after planned sex

This option is recommended for:

  • Gay and bisexual men

This option will work for you if you can plan sexual encounters at least two hours in advance or if you can delay sexual encounters by at least two hours.

There are different types of event-based PrEP depending on each individual, their sexual activity, so make sure to discuss all options with a specialist.

How can I start PrEP and how long do I take it?

You need to take an HIV test before starting PrEP to make sure you don’t already have HIV. If you have HIV, then taking PrEP may increase the likelihood of developing drug resistance, making HIV treatment less effective.

While taking PrEP, you need to undergo regular testing and check-ups (at least every three months).

Unlike HIV treatment, people don’t stay on PrEP for life. PrEP is typically taken for a few weeks, months, or a few years when a person feels most at risk of HIV infection. This can happen during specific relationships, after coming out of a relationship and meeting new people, when planning a vacation where you know you’ll be sexually active with new people whose status you may not know, or if you use drugs.

Where is PrEP available?

Currently, PrEP is not available everywhere in the world, not even in Romania, and even in countries where it is approved, it may not be easily accessible for several political or resource-related reasons.

In some countries, PrEP is available for free or subsidized as part of the national healthcare system, in other countries it must be paid for within the private system.

The good news is that all international guidelines now recommend that PrEP be made widely available, so even if it’s not yet available in Romania, we hope it will be an option in the near future.

If you’re interested in taking PrEP, contact a doctor or counselor who will provide you with the necessary information. Additionally, doctors can advise, monitor, and assist you throughout PrEP treatment to ensure you’re fully protected.

There are also websites that can help you purchase PrEP. However, taking PrEP without medical counseling and monitoring is risky for your health, so we insist you consult a specialist before buying PrEP online.

Does PrEP have any side effects?

In some people, PrEP can cause minor side effects such as nausea, vomiting, fatigue, and dizziness, but these usually go away over time.

In rare cases, PrEP can also affect kidney or liver function, or it may cause decreased bone density.

If you are taking PrEP and experience any side effects (severe or not), notify your doctor immediately.