P.102 How to take PrEP

First of all, there are so many ways to take PrEP, how you take PrEP depends on

1. How often do you have sex
2. Do you plan to have sex well in advance?

Clinical Practice Guideline of the United States (since 2013) and HIV Prevention Guidelines of Thailand (since 2014) provided comprehensive information that suggests we use daily oral PrEP to reduce the risk of acquiring HIV infection in adults.

Our advice around PrEP is based on the results of 2 European studies. The 2 studies looked at different ways of taking the prevention.

PROUD Study1 DAILY DOSE 

How to take PrEP daily

-Take a leading dose of PrEP once a day ideally at the same time for 7 days (without condomless sex) to provide enough protection level in the rectal tissue (for anal sex) and in vaginal tissue (for vaginal sex - if you have one)

-You can take it with or without food.

-If you miss one or two pill once in a while, don't freak out! you still have enough protection.

-No one taking the Truvada correctly caught HIV in this study.

-This is the officially recommended way to take PrEP since 2013!!

-This is how PULSE clinic recommends guys, girls and transgirls who have sex often to take PrEP for their protection. Some people don't have sex very often, and PrEP in Western countries is very expensive (that's why they come to get PrEP at PULSE) so here comes PrEP on demand.

Taking PrEP ON DEMAND (2+1+1) IPERGAY Study2  

- Take 2 Truvada pills between 2-24 hours BEFORE sex. Then take one Truvada pill every day until 2 days have passed after the last time you have sex.

- This regimen is for ANAL SEX ONLY, and not recommended for vaginal sex. 

- This method is also called 2+1+1 or On-Demand PrEP, it's good for you if you know you might have sex 24 hours in advance:

 take 2 PrEP pills 2 – 24 hours before sex

 take 1 PrEP pill 24 hours after the first dose

 take 1 more PrEP pill 24 hours after that

Continue taking PrEP until you have taken 2 doses after your last sex.

Remember, it’s really important not to miss any dose. 

If you’re having sex for more days, perhaps over a few days or a weekend, continue to take ONE pill every 24 hours until you have 2 days without sex.

NOTE: Not recommended for gay people who enjoy chemsex or do not plan to have sex very well, because there is already evidence that many people forget to take the third and the fourth pill.