6 Things To Think About Before You Start PrEP
After the initial celebrations to mark the PHARMAC’s funding of HIV prevention drug PrEP, there’s going to be a lot of Kiwi men who have sex with men wondering whether they should join the 600-plus PrEPsters in the country.
With the funding, the PrEP prescription is down to $5 for a three month supply; and with its efficacy at reducing the transmission of HIV by up to 99% when taken daily, there’s clearly an interest for many Kiwis to join up.
But PrEP isn’t a magic pill – it requires a commitment for it to work effectively and it pays to know how it works best to suit your lifestyle.
So, what do you need to know before you visit a doctor to ask if you should start taking PHARMAC-funded PrEP?
1. Is PrEP right for you?
The term Pre-Exposure Prophylaxis refers to the drugs in Truvada (or generic versions of PrEP), which help reducing the risk of HIV acquisition from sex by up to 99%.
It's most beneficial for those at high risk of acquiring HIV, i.e. those having regular condomless anal sex with people whose HIV status is unknown.
People having condomless sex with a partner living with HIV are also eligible for funded PrEP - so long as their partner has a detectable viral load. If their partner is undetectable, there is usually no need for PrEP, as UVL protects against HIV transmission.
As we understand that PrEP is not always right for everyone, we've made a short quiz to help you determine whether it's a good option for you.
2. You’ll need to test
You’ll need to test for HIV before qualifying for PrEP and should continue to test every three months while you’re on it. If you're unaware of your status and are living with HIV, taking PrEP can cause the virus to develop resistance, which can reduce your options for future HIV treatment.
3. How it works relies on you
Taking PrEP is a commitment; to benefit from the full protection of PrEP, the pill has to be taken daily . Additionally, PrEP takes 7 days to reach a high enough level of protection for receptive anal sex (bottoming) and 20 days for insertive anal sex (topping).
If you want to stop PrEP, you'll need to continue taking it for 28 days after your last significant exposure - so you'll need to make sure you have enough pills to cover this time period.
4. There’s a process to obtaining PrEP
New Zealand's funding for PrEP comes with regulated criteria. It means that you must first talk through your qualification with a GP or doctor with experience in sexual health, who must then consult with a specialist before you can pick it up at a pharmacy. Don’t worry, it’s not a long-winded process – just a few hoops that need to be jumped through. But it’s also important to remember that not everyone in New Zealand qualifies for subsidised drugs. To find out if you qualify for the subsidy, you can check the requirements here. If you don't qualify, there is also a process to obtaining generic versions overseas via the internet and importing them into the country (usually around $50 a month).
5. Sexual health isn’t just about HIV
Ending HIV is focused on reducing and preventing new HIV infections in New Zealand and PrEP is a vital weapon to winning that battle. But we’re going to continue to push for the use of condoms too, because of the risk of other STIs – some of which can increase the possibility of HIV infection. PrEP works, and it works incredibly well, but maintaining good sexual health while being as sexually active as you want means knowing the risks, and reducing them through regular testing, as well as maintaining condom use.
6. There’s a world of trusted, first-hand information out there
What about side effects? Or potential downsides? How easy is it to find a doctor to talk to about PrEP? You don’t have to explore PrEP alone – in fact with the cacophony of news and reports around, it can be daunting and incredibly confusing to simply dive head-first into the internet in search of information about PrEP.
Our website has plenty of advice and news about Kiwi-specific issues; alternatively, the PrEPing NZ group on Facebook brings together all threads of New Zealand’s PrEP community – such as experts, doctors, users and those who want to find out more about PrEP and its role in preventing the onward transmission of HIV – to discuss questions, offer qualified advice, and share personal insights and experiences in a safe network.