HIV PrEP can be taken in several different ways depending on your unique lifestyle. The most common and effective way to take it is with a daily dose – a single tablet taken at around the same time every day. In medical studies, this has been shown to provide the best level of protection against HIV. Also, this schedule is easy to remember and adhere to, thereby reducing the chance of consuming the wrong amount of medication at the wrong time.

The medication currently recommended for HIV PrEP has also shown to be safe and effective for long-term use and rarely causes any significant side effects.

Because no prevention strategy for sexually active people is 100% effective, individuals taking PrEP are still encouraged to use other effective prevention strategies to maximally reduce their risk, including:
• Using condoms consistently and correctly
• Getting HIV and STD testing with partners
• Choosing less risky sexual behaviours, such as oral sex or mutual masturbation
• For people who inject drugs, getting into drug treatment programs and using sterile equipment

The more prevention options patients choose, the greater their protection. Some HIV prevention strategies, such as using condoms, can also provide protection against other STDs, which PrEP does not prevent.

Also Read: 7 FAQs on Pre Exposure Prophylaxis (PrEP)

HIV PrEP is recommended for HIV-negative individuals who belong to a high-risk group for HIV infection.

HIV High-Risk Groups:

• Someone who has an HIV-positive partner
• Someone who has multiple sex partners, a partner with multiple partners, or a partner whose HIV status is unknown and does not practice safe sex
• Someone who has sex with commercial sex workers
• Someone who has recently had a sexually transmitted disease (STD)
• Someone who injects drugs, or has unprotected sex with someone who injects drugs

1.) Daily PrEP

Daily PrEP Regimen: 

• Lead in time 7 days.
• Taken daily at the same time  +/- a few hours ok

Type:

• Anal, Vaginal/Frontal sex

Considerations:

• Can be taken anytime of the day with or without food
• In the event a pill is missed, adequate protection is still conferred.

2.) On Demand PrEP (Event Based Dosing)

On-Demand PrEP Regimen: 

Planned condomless sex 24 hours in advance:
Strictly:

• take 2 pills 2 – 24 hours before sex
• take 1 pill on the day of sex
• take 1 pill 24 hours later

If having sex for an extended period of time, perhaps over a few days or a weekend, continue to take a pill every 24 hours until you have 2 sex-free days.

Type: 

• Only for Anal sex
• More studies required to show effectiveness in Vaginal/Frontal sex

Considerations:

• This option is not recommended if you have an active hepatitis B infection. The drugs in PrEP also suppress the hepatitis B virus and so starting and stopping HIV PrEP can potentially cause viral flare-ups and liver inflammation.

HIV PrEP is the so-called “Event Based PrEP.” This regimen is for people who have decided that they do not want to take HIV PrEP daily and only want to take it prior to an event.

The regimen requires the the individual to take 2 tablets of the HIV PrEP medicine between 2 to 24 hours prior to the event, followed by 1 tablet on the day of sexual intercourse, and a final tablet 1 day after after sex. Medical studies show that the protection provided against HIV for this regime is not as good as if the medicine is taken daily.

Furthermore, this regimen is more complex and therefore increases the risk of the individual taking the wrong amount of medication at the wrong time.

Descovy (brand name) is a FDA approved new drug combination of tenofovir alafenamide (TAF) + emtricitabine for use as HIV PrEP, which has shown to be equally effective in preventing HIV infection whilst touting an improved safety profile for renal and bone toxicity.

Descovy is currently available in all Dr Tan & Partners (DTAP clinics) in Singapore. It is a prescription only medication and must be prescribed by a doctor. Speak to our doctors for more information about Descovy and find out if a HIV-1 treatment that contains Descovy is right for you.