PrEP (Pre-Exposure Prophylaxis) is a drug, taken before sex, that can prevent you from getting HIV.
Pre-Exposure means that it must be taken before having sex. If you are concerned about exposure to HIV from sex you have already had, check out our information on PEP or contact your local sexual health services or organisations.
PrEP is only for those who are HIV negative. For information on living well with HIV have a look at our information here.
PrEP is available on the NHS in Scotland, and is provided through local sexual health clinics.
When you visit a clinic, you’ll have the chance to speak with a sexual health adviser who will discuss what taking PrEP could mean for you - this will include a HIV test to confirm that you are HIV negative.
During your consultation, they will access your suitability for PrEP based on the type of sex you have and the chances of you becoming HIV positive.
In Scotland organisations that work in sexual health have produced information to help you understand how your eligibility for PrEP will be decided by a clinician. You can find out more at prep.scot
If the sexual health clinician thinks you are suitable for PrEP, you will receive a supply of tablets from them and be invited to attend routine health check-ups to monitor your health and ensure that PrEP is working for you. You will also be encouraged to have regular screening for other STIs.
If, for any reason, you are unable access PrEP through the NHS, there are other options available to you. Some people choose to buy PrEP online, which can come in at a cost of around £20 for a month’s supply.
If you get, or intend to get you PrEP online, you can have health monitoring done at sexual health clinics in Scotland. They will also give you advice on how to take PrEP and whether it is a suitable option for you.
UK community websites have lots of information about PrEP and how to buy it online:
We cannot state that there is absolutely no risk if you choose to buy PrEP online because the PrEP is not sourced directly from the manufacturers. At SX, our health improvement team can help you understand what is involved in self-supplying PrEP. Get in touch here.
If you are self-sourcing PrEP you should discuss this at your sexual health appointments and make sure you routinely check for STIs
What should I know before starting PrEP?
Prior to starting PrEP you will need to test negative for HIV. This means that you have sexual health screening prior to taking PrEP.
If you test HIV negative via a self-testing kit or a test with non-NHS staff and wish to access PrEP on the NHS, you will still need to have your test result confirmed by a sexual health clinic.
It is important to remember that PrEP is only effective in preventing HIV. It does not protect you from other STIs like syphilis or gonorrhoea. The best way to reduce your risk of HIV and other STIs is to use condoms and lube correctly, especially when fucking.
To learn more about what PrEP may mean for you, check out our Risk Tool.
How do I take PrEP?
There are a number of ways that PrEP can be taken effectively, and your clinician can help talk you through the options that will work for you.
This is where you take a single PrEP pill at the same time every day. Daily PrEP provides consistency and reassurance that you have a high level of protection against HIV at all times. It also means that even if you accidentally miss a pill you will still have an adequate level of protection to HIV.
This is where you take a set amount of PrEP before and after sex. This method means that you can plan in advance of having sex, whilst ensuring you have the correct amount of protection. Event based PrEP involves taking 2 pills at least 2 to 24 hours before the first sex you have, then continuing to take PrEP until 24 hours after the last sex you’ve had. This method depends on adhering to the timescales, meaning you can’t miss a single pill, otherwise you will not have the correct level of protection.
The name refers to Tuesday, Thursday, Saturday and Sunday. What this means in practice is if you take a pill 4 days in a week, you will have an adequate level of protection to prevent you becoming HIV positive. Again, this method depends on adhering to the timescales, meaning you can’t miss a single pill.
Trans men and PrEP
Trans men can use PrEP in the ways described above. However, if you’re a trans guy and the sex you are having includes the penetration of your front hole, then event based PrEP and Ts&Ss won’t give you adequate levels of protection against HIV. This is because protection provided by PrEP takes longer to development in the tissue in your front hole. If you are having front hole sex you will need to take daily PrEP to ensure adequate levels of protection.
How can I make PrEP work for me?
If you are thinking of starting PrEP, it is important to consider how it will fit into your current lifestyle. If you are unable to access NHS PrEP the cost will come into that as well. To use PrEP effectively you need to follow the advice above.
Are there any side effects of PrEP?
As with any medication there are always possible side effects.
Fortunately, most men experience few, if any side effects to PrEP - and where they do occur they tend to be mild and resolve in a matter of weeks.
However, if you experience side effects that last longer than a month, or are causing you concern, you should check in with a sexual health advisor or clinician.
The most common side effects are
Some men have noticed that taking PrEP with or without food can lead to certain side effects. Your clinician can talk to you about how to take PrEP and it is important to follow their recommendations. If you having problems adhering to recommendations, discuss this with your sexual health advisor who will be able to help.
What else do you need to know?
U=U - People living with HIV, who are on treatment and have an undetectable viral load confirmed by their HIV clinician cannot pass on the virus through sex.
Condoms - Using condoms and lube correctly remains a very effective method of HIV prevention and is the best way to preventing other STIs too.
Testing - It is recommended that men who have sex men should test for HIV and STIs regularly, at least every 3 months if you have new or multiple partners
Does PrEP prevent other STIs?
No, PrEP will only reduce the chance of you becoming infected with HIV. The best way to reduce your risk of HIV and other STIs is to use condoms and lube correctly, especially when fucking.