From November 4, HIV pre-exposure prophylaxis (PrEP) is available free of charge through the HSE to those who are at substantial risk of contracting HIV through sex.

by Caroline Hurley, HSE Sexual Health & Crisis Pregnancy Programme

WHAT IS PrEP?

PrEP stands for pre-exposure prophylaxis. It is taken by HIV negative people before having sex (pre-exposure) and after sex to prevent HIV (this is called prophylaxis). If you decide to use PrEP, it’s important that you do so with support from a healthcare provider and that you understand how to take PrEP correctly.

WHAT IS THE DIFFERENCE BETWEEN PEP AND PrEP?

PEP (post-exposure prophylaxis) is the use of treatment after exposure to HIV, to reduce the risk of HIV infection. PEP must be started within 72 hours after a possible exposure to HIV, and the sooner you take it, the better. PEP is only available following an assessment by a healthcare professional.

PrEP (pre-exposure prophylaxis) is the use of HIV treatment before exposure to HIV to prevent HIV infection. For PrEP to be most effective, the medicine needs to be at protective levels at the time you may be exposed to HIV, which means PrEP needs to be taken both before sex and for several days afterwards. PrEP can be taken every day (daily PrEP) or taken around the time of sex (event-based). Your healthcare provider will help you decide what is best for you. PrEP has been shown in many studies to be 99 percent effective in preventing HIV.

AM ELIGIBLE FOR FREE PrEP?

PrEP is available through the HSE free of charge to those who are considered to be at substantial risk of contracting HIV through sex and meet the eligibility criteria.

To avail of free PrEP through the HSE you need to:

• Test negative for HIV

• Be able to attend a check-up at least every three months.

YOU ALSO NEED TO MEET AT LEAST ONE OF THE FOLLOWING ELIGIBILITY CRITERIA:

• You are having sex without condoms with HIV-positive partners who are not on HIV treatment, OR are on treatment but not virally suppressed.

• You are a man who has sex with men (includes transgender MSM) or a transgender woman who has sex with men, who meets any one of the following: Had anal sex without condoms with more than one partner in the last six months, had a sexually transmitted infection (STI) or used HIV post-exposure prophylaxis (PEP) in the last year, used recreational drugs for sex in the last six months.

WHERE CAN GET PrEP?

The list of approved providers is available on

www.sexualwellbeing.ie/getprep.

WHAT DO NEED TO DO TO GET PrEP?

Attend an approved PrEP service for a clinical assessment. If you are eligible, you will be provided a prescription and can collect the medication through a community pharmacy free of charge. You will need a medical card or drug payment scheme (DPS) card to access free PrEP through the HSE.

WHAT IF I’M NOT ELIGIBLE FOR FREE PrEP?

You can decide to pay for PrEP yourself through community pharmacies with a prescription. The doctor in the STI clinic or your GP can give you a prescription.

BEFORE STARTING PrEP

There are a number of tests you need to have. These include testing for HIV, hepatitis B and other STIs. You will also have a blood test to check your kidney function.

If it’s your first time taking PrEP, you may be offered an appointment after one month. Once you’ve started, you’ll need to go for a check-up every 3 months. This is to test for HIV and STIs, and to check your kidney function.

WHAT HAPPENS IF TAKE PrEP INCORRECTLY?

For PrEP to be most effective, the medicine needs to be at protective levels at the time that HIV exposure may happen. This means PrEP needs to be taken both before sex and for several days afterwards. If you take PrEP incorrectly, you may not have the protective level of drug in your system. Discuss this with your healthcare provider.

WHAT IF MISS DOSES?

This depends on what type of sex you’re having and if you’re taking PrEP every day or taking event-based PrEP. If you miss doses and have had condomless sex, you may need PEP and should discuss with your healthcare provider immediately.

For further information on PrEP, PEP and how to access them, visit www.sexualwellbeing.ie/prep or man2man.ie/prevention/pep.