PrEp for sex to prevent HIV

Updated: Mar 2

By Makwena Manaka


Photo by Makwena Manaka

Young people in South Africa between the ages of 15 to 25 are, according to the South African Department of Health (DoH), at the highest risk of contracting HIV. South Africa became the first country on the African continent to implement oral Pre-Exposure Prophylaxis (PrEP), outside of studies and demonstration projects, at clinics across South Africa on 1 June 2016.


PrEP is a daily drug that can be taken by HIV negative people to prevent them from being infected with the virus. It can prevent HIV infection by up to 99% even if the virus enters the body through an exchange of sexual fluids or from an injection.


You need at least 20 days of daily dosing after initiating PrEP for the drug to be effective. PrEP should be used alongside other protective methods, such as female and male condoms, as it does not protect against other sexually transmitted infections nor is it a contraceptive.


PrEP targets populations that are regarded as high risk - sex workers (SW) and men who have sex with men (MSM), adolescent girls and young women (AGYW).


PrEP is absorbed differently in vaginal and rectal tissues and there are different guidelines on how to take it. PrEP is ten times higher in rectal tissues than vaginal tissues. If you receive vaginal sex you need to take PrEP every day for protection. If your HIV risk comes from anal sex, then there is more leniency on dosing (studies show 4 doses per week may be sufficient) and even dosing only at the time of sex is enough (as shown in the ipergay study) .


The most common side-effects seen in the studies of PrEP include headaches, nausea, vomiting, rashes and loss of appetite.


PrEP is not treatment for HIV, although it uses similar drugs, and should not be shared with people who have not tested HIV negative. PrEP users will have to regularly test for HIV to ensure that they are switched onto a three-drug regimen of ARVs should they contract HIV to avoid drug resistance.


The prescription intervals are as follows:

· At initiation – provide 1-month supply

· At 1 month – repeat HIV test and provide 3-month prescription (for collection every month)

· Every 3 months – repeat HIV test and provide 3-month prescription (for collection every month)

· HIV testing is also required when restarting after a discontinuation.


If you are in South Africa and interested in PrEP go to your nearest clinic or phone the national AIDS helpline free of charge at: 0800 012 322.

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