Written by Dr.Deyn Natthakhet Yaemim (Founding Director) on 6 June 2016, Last updated 20 January 2023

Pre-PrEP checklist: How can I get PrEP at PULSE Clinic?

1. Do you already have the prescription?
   
   • If you already have a prescription for PrEP, you can show us your prescription and buy the medication.
2. If not, do you have health check-up results from the last 3 months?
   • If you already have one, you can get a 12-month supply at PULSE.
   • If you do not have recent health check-up results, you can get tested at PULSE and receive a 12-month supply of PrEP.
   • You can also get fewer than 12 bottles and have the rest delivered to your door.

PrEP FAQ

PrEP, or pre-exposure prophylaxis, is a medication in the form of a pill or injection designed for individuals who are HIV-negative but at high risk of contracting the virus, possibly due to sexual activity or intravenous drug use. It works as a preventive measure to stop the virus from establishing itself in the body and spreading before infection occurs. What do you need to know about PrEP?

For more information about the medication and ordering process,

please email pulseliving@pulse-clinic.com or chat on your preferred platform. 

 +66-84-226-2569    @pulserx         PulseClinic

What is PrEP?

PrEP means Pre-Exposure Prophylaxis, and it’s the use of anti-HIV medication that keeps HIV-negative people from becoming infected. PrEP is safe and effective. A single pill taken once daily is highly effective against HIV when taken every day. The medication interferes with HIV’s ability to copy itself in your body if you’ve been exposed. This prevents it from establishing an infection and making you sick.

Is PrEP for both top and bottom?

Yes, even though there is more risk of bottoming, tops can also acquire HIV. Uncircumcised tops have a slightly greater chance again. Indeed, people can also experience anxiety about acquiring HIV. Being on PrEP certainly helps with that.

Should I consider taking PrEP?

You should consider PrEP if you are a man or woman who sometimes has sex without using a condom, especially if you have a sex partner who you know has HIV infection,  if you don’t know whether your partner has HIV infection but you know that your partner is at risk (for example, if your partner inject drugs or is having sex with other people in addition to you) or if you have recently been told by a health care provider that you had a sexually transmitted infection. If your partner has HIV infection, PrEP could be an option to help protect you from getting HIV infection while you try to get pregnant, during pregnancy, or while breastfeeding.

Truvada for PrEP provides 92%-99% reduction in HIV risk for HIV-negative individuals who take the pills every day as directed. If a daily dose is missed, the level of HIV protection may decrease. It only works if you take it. People who use PrEP correctly and consistently have higher levels of protection against HIV.

How effective is PrEP?

According to data analysis from the iPrEx study that found PrEP to be effective:

• PrEP is highly effective for preventing HIV.
• For people who take 7 PrEP pills per week, their estimated level of protection is 99%
• For people who take 4 PrEP pills per week, their estimated level of protection is 96%
• For people who take 2 PrEP pills per week, their estimated level of protection is 76%.
• PrEP reduces the risk of getting HIV from sex by about 99% when taken as prescribed.
• Although there is less information about how effective PrEP is among people who inject drugs, we do know that PrEP reduces the risk of getting HIV by at least 74% when taken as prescribed.

What are active ingredients of PrEP?

The world's first approved PrEP, was the one blue pill branded drugTruvadaor its generic equivalent made in Thailand such as Teno-Em, made in India, such as Ricovir-Em and Tenof-Em. Generics contain the same ingredients as branded drugs and work in the same way.

Truvada and the generics contain two drugs: Tenofovir Disoproxil Fumarate (TDF), Emtricitabine (FTC)  

Today, a second pill has been approved for use as PrEP—the branded drugDescovy or its generic equivalent, they contain:
Tenofovir Alafenamide (TAF), Emtricitabine (FTC). You can buy generics Descovy when you have prescription.

Are there long-term side effects from taking PrEP?

PrEP was approved in 2004, so it’s been around for more than a decade. Before it was used as PrEP, it was used as treatment for people infected with HIV or exposed to HIV (it contains molecules that are used in HIV drugs). The worst side effects that have been reported are one percent bone mineral density loss and reduced kidney function. Is it safe? Yes. To put it into perspective, they can't tell if it's any worse than just getting older. People in the USA have been taking it for years. Your doctor will check your liver and kidney function with an HIV/STI screening every three months to make sure you're ok. It's a normal part of getting your updated script each time. If you are concerned about any effect from taking PrEP, then chat with your doctor.

Who is PrEP for?

PrEP is an approved preventive measure for adults and adolescents weighing at least 77 pounds who are at risk of contracting HIV. Some types of PrEP are specifically designed for protection during anal sex. It’s essential to consult with your healthcare provider to determine the type of PrEP that suits your needs.

For Individuals Who Have Used PEP: People who have used post-exposure prophylaxis (PEP)—a 28-day medication course started within 72 hours of potential HIV exposure—may be good candidates for PrEP. We advise those who have taken PEP more than once to consider transitioning to PrEP for ongoing protection.

For People Who Inject Drugs: We recommend PrEP for individuals who inject drugs and either share injection equipment or have an HIV-positive injection partner, especially if these activities occurred within the last 6 months.

For Couples Planning Pregnancy: If one partner is HIV-positive and the other is not, PrEP can be part of a strategy to conceive safely without transmitting the virus. While antiretroviral treatment can suppress the viral load of the HIV-positive partner to undetectable levels (eliminating the risk of transmission through sex), PrEP adds an extra layer of protection for the HIV-negative partner.

Before getting PrEP for the first time?

• PrEP is for HIV-negative people to take to prevent HIV and keep their status HIV-negative. So you have to know for sure you are HIV negative; that's by getting tested.
• Taking PrEP long-term may cause side effects on kidney function in 3% of PrEP users, so you have to know that your kidney function is normal, that's by getting tested.
• You also have to get tested for Hepatitis B virus antigen
  
  

How to take PrEP?

There are many ways to take PrEP, How to take PrEP?
Once started, you can stop. You can restart again. You don't have to take it forever.

What if I missed a dose?

Current studies are showing that PrEP works well even if you miss a dose. It was shown that users who took PrEP at least 4 days out of 7 hadn't acquired HIV. We strongly, and I mean strongly, recommend that you stick to one pill a day though.  That gives maximum protection. If you're not consistent, then that's where you can miscalculate and undo all your good work. So one pill a day keeps everybody happy, secure, and safe.

Who should take PrEP?

A recommendation from the U.S. Preventive Services Task Force that urges doctors to prescribe a daily pill for all people with known risk factors for HIV could significantly raise awareness about an effective yet little used drug. 

PrEP may be right for you if you test negative for HIV, and any of the following apply to you:
You have had anal or vaginal sex in the past 6 months and you

• have a sexual partner with HIV (especially if the partner has an unknown or detectable viral load),
• have not consistently used a condom
• have been diagnosed with an STD in the past 6 months.

You inject drugs and you

• have an injection partner with HIV, or
• share needles, syringes, or other equipment to inject drugs (for example, cookers).

You have been prescribed PEP (post-exposure prophylaxis) and you

• report continued risk behavior, or
• have used multiple courses of PEP
  
  
  

Pulse Clinic now operates 20 branches across Thailand, Hong Kong, Malaysia, and Singapore, open 7 days a week to serve your healthcare needs. If you're unable to visit our clinics in person, you can conveniently purchase PrEP online from our licensed clinics.

Important Steps for Online PrEP Orders:

• Ensure we have your prescription or lab results before placing an order.
• Provide a copy of your passport and lab results from your doctor or lab, or send us a prescription from your healthcare provider.
• Once we verify your results, we can supply you with 3 to 6 months’ worth of PrEP each time.

 

PULSE Clinic now offers online PrEP medication refills. For more information about the medication and ordering process, please email pulseliving@pulse-clinic.com or chat on your preferred platform. 

 

Medication	Price
	Descovy (Latest Version of PrEP) 5,450 THB for 1 Bottle (30 Tablets)
	Generic Descovy (Mylan) 2,650 THB for 1 Bottle (30 Tablets)
	Taficita (ARV for HIV Treatment) 3,000 THB for 1 Bottle (30 Tablets) Also check out Poz and Proud: Get HIV Care from PULSE Clinic for more information about HIV treatment
	Teno-EM (Generic HIV PrEP) 1,300 THB for 1 Bottle (30 Tablets)
	Tenof-EM (Generic HIV PrEP) 1,1000 THB for 1 Bottle (30 Tablets)

 

 +66-84-226-2569    @pulserx         PulseClinic

PrEP and condom use?

If condoms work for you, absolutely continue to use them! But because it is a fact that condoms do fail, you can still take PrEP for double protection.

If someone doesn‘t use condoms but takes PrEP to protect themselves from HIV, that‘s already quite something! Also, for a new PrEP prescription, you have to go to see your doctor every three months, where they will test not just for HIV but other STIs as well. With PrEP, people engaging in high-risk behaviour would go to see a doctor regularly, and other STIs would be detected and treated early. This might even reduce the spread of other STIs.

Is PrEP safer than condoms?

Even when condoms are used consistently, they can fail. With the low number of HIV cases among people actively taking PrEP we are now talking about greater than 99 percent effectiveness, in other words, the pill is more effective at preventing HIV than condoms.

Can I get PrEP as an extra protection even though I consistently use condoms?

Yes. If you are anxious about situations like condoms breaking, slipping off, not being applied correctly, or doing head jobs without a condom then PrEP is still good for reducing your fear and anxiety.  Some people just want an extra layer of protection, and that's fine.  Some medical professionals also use PrEP to stop HIV infection if they get a needlestick injury. PrEP is incredibly effective and reliable. PrEP users report that they are letting go of fear they didn't even know they carried.

PrEP and STI?

PrEP only protects you against HIV. You need to take other precautions to reduce your risk of contracting other sexually transmitted infections (STIs) such as gonorrhoea, chlamydia, syphilis and hepatitis C.

We recommend regular STI testing; the best STI/STD test nowadays is DNA test for 28 infections.You also need to do an HIV test every three months.

Can I get STI vaccinations?

Yes, you can. Ask our doctor about vaccinations for hepatitis A, hepatitis B and the HPV vaccine.

HPV is the virus that can cause some cancers in the throat and your lower parts (penile cancer and anal cancer) but it can be prevented by three shots of painless HPV vaccine available at our clinics.

Should I tell people I’m taking PrEP?

It’s totally your decision to disclose if you’re taking PrEP. Some people are proud to say they are taking PrEP, and in doing so they are helping break down stereotypes and showing that taking PrEP is a choice to look after their health. Telling people that you are on PrEP also lets them know that protecting yourself against HIV is important to you. You're not legally or morally required to tell anyone. It's important to respect where other people are on their safe sex journey, so if your partners prefer to use a condom, then that's their right. They don't have to take your word for it that you are safe. Of course, they could take PrEP themselves, and then their safety is completely in their hands.

Someone told me PrEP could cause HIV to mutate?

That's not true. PrEP works by stopping the virus penetrating the cell.  If it can't get into the cell then it can't multiply.  Mutations occur when the virus reproduces. So essentially no infection means no mutation.  It's important that you are not already HIV positive when you start PrEP. If the virus is already reproducing in your body then taking PrEP may cause some inconvenient problems with resistance, and your doctor may have to try other medications.  Your doctor will test to make sure you're not HIV positive before you start.

Where Can I Get PrEP?

PrEP is available at PULSE Clinic, and we deliver worldwide if you are not in Thailand. You can order from PULSE, Fast and easy delivery to your doorstep.

For more information about the medication and ordering process,

Please email pulseliving@pulse-clinic.com or chat on your preferred platform. 

 +66-84-226-2569    @pulserx         PulseClinic

Why PULSE CLINIC?

PULSE is the first licensed private medical practice in Asia to prescribe and provide PrEP since 2015.
PULSE clinic is working with iWantPrEPnow, UK, to provide PrEP ONLINE to countries allowed by law. For people who have prescription and re-visitors of PULSE clinic, now you can submit your prescription/blood test result from your doctor and order PrEP online HERE. by prescription only.

Without blood tests, should I get PrEP?

That is a black market, we DO NOT SUPPORT BLACK MARKET. If you take PrEP without knowing that you are HIV positive, it can lead to drug resistant HIV infection. What we are trying to provide for our community is a smart and proper way to be protected by PrEP.

Is it a good idea to buy PrEP from pharmacy without getting tested or prescription?

Buying medication over the internet or from the pharmacy is a bad idea unless you can be sure that the supplier is legitimate or unless you buy from our online pharmacy. Otherwise, there is a risk that you may be given pills that do not work or that cause you harm. And if side effects or complications happen, those suppliers will not be able to and will not take care of you. It is also important that anyone being prescribed PrEP has medical supervision for this to happen. Because continuous care is important as long as you're taking PrEP,

Worried that the drugs you've bought aren't the real thing?

PULSE CLINICS provides a blood test to check the correct drugs are present in your body; this is called Therapeutic Drug Monitoring (TDM). You need to have taken a pill in the 24 hours before the test. 

 +66-84-226-2569    @pulserx         PulseClinic