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James Kearslake
Small business owner,
writer, trans, mental
health advocate
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Health advice warning
While I’m fully educated on PrEP, its benefits and side effects, please always consult with your sexual health clinic before starting PrEP. The reasons are two-fold, and very important:
- You need to know that you are HIV negative before taking PrEP – if you have HIV and are unaware, you need to start HIV medication. PrEP is to prevent HIV so will not prevent those with HIV from transmitting the infection
- PrEP can be damaging to the kidney – the consultant needs to take your bloods before you take PrEP and a few weeks after starting PrEP to monitor potential impact to your kidney.
What is PrEP?
PrEP stands for pre-exposure prophylaxis.
PrEP is a preventative measure to transmitting HIV when having unprotected or high risk sex.
It is a pill that is taken daily or can be taken on demand around your sex life. This means ‘loading’ a few days before you expect to have sex, ensuring a sufficient quantity of the drug is in your body before sexual activity.
Loading can be useful if you don’t want to take the pill every day, and you know you will likely be having sex with someone else.
For those with a more spontaneous sex life, taking PrEP daily ensures you’re never at risk of having unprotected sex without sufficient quantities of the drug in your system.
PrEP is now available on prescription through the NHS, but not everyone is signed off to receive PrEP. For example I know many tops who haven’t been prescribed PrEP because their transmission risks are lower.
As a bottom, even though I don’t have a sexually promiscuous life (anymore), I was signed off for PrEP without issue after all checks.
What ingredients make PrEP?
According to iwantprepnow.co.uk, one pill is approved for use as, PrEP – the branded drug Truvada or its generic equivalent | iwantprepnow.co.uk (1)
Truvada contains:
- Tenofovir Disoproxil TD
- Emtricitabine FTC.
Whereas in the US the branded drug Descovy or its generic equivalent has been approved for PrEP:
- Tenofovir Alafenamide TAF
- Emtricitabine FTC
How does PrEP work?
PrEP works by stopping HIV from getting into your body and replicating itself.
If you do not have enough PrEP within your body it will not stop HIV from infecting your body. It’s therefore critical to load properly before sexual activity | NHS (2)
What are the side effects of PrEP?
The most common side effects are:
- nausea and/or vomiting
- diarrhoea
- headaches
- Indigestion or stomach pains
- dizziness or feeling faint
- disturbed sleep
PrEP can adversely affect the kidney. It’s important to always consult with your sexual health practitioner before going on PrEP so that they can monitor the effect on your kidneys in the first few weeks.
In some cases people have severe allergic reactions to PrEP and you should call for emergency care.
Can I have unprotected sex on PrEP?
Yes you can have unprotected sex on PrEP.
PrEP is designed to prevent HIV transmission through bodily fluid that occurs during unprotected or high risk sex.
However, HIV does not prevent other STI’s therefore condoms should still be used to prevent other sexually transmitted infections.
Can I have unprotected sex with my partner on PrEP if one of us is HIV positive?
If one partner within a relationship is HIV positive, the most important step to take is for that person to start HIV treatment as quickly as possible. HIV treatment can reduce the viral load within the person and they become undetectable, which means their viral load is reduced to a point that they cannot transmit HIV to others. You can find full information on that here at THG.org.uk.
The U=U campaign promotes awareness that Undetectable = Untransmissible.
You therefore first need to understand the partner’s viral load and that they’re taking medication consistently.
It is recommended that the other partner also take PrEP for additional precaution. PrEP is the best chance we have of preventing HIV transmission.
These two combined methods allow you and your partner to have unprotected sex with a very unlikely transmission risk.
Can I take PrEP if I'm HIV positive?
No you should not take PrEP if you are HIV positive. PrEP is a preventative drug that will prevent HIV transmission within the body.
If you are HIV positive you need to access HIV treatment through your local sexual health clinic.
Is PrEP safer than condoms for preventing HIV?
PrEP is considered safer than condoms for preventing HIV transmission but only when it is taken properly, therefore anyone with doubt on drug levels within their system should always use a condom Medical professionals continue to recommend using PrEP and a condom to prevent the spread of all STI’s.
Does PrEP stop me from getting other STIs?
PrEP is designed to prevent HIV transmission through bodily fluid that occurs during unprotected or high risk sex.
However, HIV does not prevent other STI’s therefore condoms should still be used to prevent other sexually transmitted infections.
Do I need PrEP if I always use condoms?
This is a decision each individual needs to make themselves. PrEP is considered safer than condoms for preventing the transmission of HIV but only when doseage is strictly adhered to. PrEP does not prevent the spread of other STIs.
Does PrEP work for tops?
PrEP is effective for everyone irrespective of sexual position, sexual identity, or gender. However tops are less likely to be prescribed with PrEP on the NHS due to the lower transmission risks associated with their sexual role.
Should trans women and non-binary people take PrEP?
There is a misconception that PrEP is only for gay men. If you are a transgender woman or non-binary person having unprotected or high risk sex it is recommended you take PrEP.
Should trans men and non-binary people take PrEP?
There is a misconception that PrEP is only for gay men. If you are a transgender man or non-binary person having unprotected or high risk sex, it is recommended you take PrEP.
Should straight people take PrEP?
If you are a straight man who has sex with gay men, transgender men or women, or non-binary people, even if infrequently, you are recommended to take PrEP due to the higher rates of HIV within our community.
The risk of infection between women and women, or women and transgender men is extremely rare.
According to AidsMap, gay women who are HIV positive may have acquired HIV through injecting drug use or sex with men.
Is PrEP available on the NHS?
PrEP is now available on prescription through the NHS but not everyone is signed off to receive PrEP. Tops are not always prescribed PrEP because their transmission risks are lower.
The NHS rejected me for PrEP, what can I do?
If you believe that you are at a higher risk of transmission than the NHS has concluded, you are entitled to ask them to reconsider their decision.
If the NHS will not prescribe PrEP to you, you can purchase it from reputable retailers through iwantprepnow.co.uk.
We recommend always using retailers from their website as many other retailers online sell scam or fake drugs which can put you at risk of being infected with HIV.
Where can I purchase PrEP in the UK?
PrEP is available to purchase at some UK pharmacies including Lloyds Pharmacy, Asda Online, and Superdrug.
You can also purchase PrEP from reputable retailers through iwantprepnow.co.uk.
We recommend always using retailers from their website as many other retailers online sell scam or fake drugs which can put you at risk of being infected with HIV.
Where can I purchase PrEP online?
You can purchase PrEP from reputable retailers through iwantprepnow.co.uk.
We recommend always using retailers from their website as many other retailers online sell scam or fake drugs which can put you at risk of being infected with HIV.
Sources
iwantprepnow.co.uk (1) | www.iwantprepnow.co.uk/about/
NHS.UK (2) | About Pre-Exposure Prophylaxis (PrEP)
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