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All you need to know about PrEP

Pre-Exposure Prophylaxis (PrEP), is a game-changer for HIV prevention. It refers to the use of particular medications by HIV negative people to prevent HIV infection. 

If you want to learn more about this incredible little blue pill - and find out how to get it - you've come to the right place. Make your way through this tool to help you with your journey. This is a guide only, if you wish to start on PrEP you should make this decision with the help of your doctor or sexual health physician

If you're having trouble you can always reach out to us directly with questions.

Reasons PrEP might be right for you

PrEP is an HIV prevention method where people take a pill to reduce their risk of HIV by up to 99% (if taken as prescribed). Currently there are only two ways of taking PrEP that have been recommended: daily PrEP and event-driven PrEP.

Some of the top motivators for starting and continuing PrEP include:

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  • Condomless sex
  • Don’t have to worry about HIV
  • Spontaneous sex

Condomless sex

With up to 99% effectiveness at preventing HIV acquisition when taken as prescribed, PrEP is your own personal bodyguard - PrEP does not prevent other STIs, so condoms are still an important prevention tool.

Don’t have to worry about HIV

PrEP is an HIV prevention option that can be considered by anyone who is at risk of acquiring HIV. If taken as prescribed PrEP is 99% effective at preventing the acquisition of HIV from sexual partners.

Spontaneous sex

If taken as prescribed, PrEP is proven to be highly effective at preventing HIV acquisition - which means you can make the most of the heat of the moment. PrEP does not protect you against other STIs, so condoms are still an important prevention tool.

Common concerns about PrEP

Maybe you’re not completely sold on this new HIV prevention strategy. You think it’s a hard pill to swallow and not all it’s cracked up to be.  

Some common concerns people have voiced when considering PrEP are:

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  • Side effects
  • The costs
  • Talking to your GP about sex
  • Taking a medication when I'm healthy

Side effects

While most people will breeze through taking PrEP without noticing anything, some may experience side effects. Some reported side effects can include: gas, bloating, diarrhoea, low energy and nausea. Some people only experience these side effects for a short period while their body adjusts to the drug. 

If you’d like to know more, we’ve pulled together more information about potential side effects which you can access here.

The costs

If you're eligible for funded PrEP the cost of the medication should be $5 + the cost of a GP visit every three months.  

As of March 1, 2018, PrEP is funded by PHARMAC. This means it is available to eligible patients in pharmacies throughout New Zealand at a maximum cost of $5 per three-month supply. 

In addition to the initial GP visit/s and prescription fee, PrEP requires three-monthly check-ins for HIV and STI testing, and prescription renewal - so, this will involve a standard GP visit fee. 

Remember, if you are not eligible for publicly-funded PrEP, there are options available to you that are still affordable, including a scheme that offers free PrEP for low income New Zealanders and international students. 

Talking to your GP about sex

Though a doctor might not be high on the list of people you want to talk to about your sex life, it’s really important to be open and honest with them in order for you to get the best health outcomes. 

Being prepared for what they might ask you may take some of the awkwardness out of the situation. They need to ask you questions about your current sexual practices to determine if you are eligible for PrEP, they might ask you about who you have sex with, how often and if you’re using condoms. Remember, health professionals are required to keep the information you provide them confidential.

We recommend being as open as you can with your doctor, as eligibility for funded PrEP is determined by the kind of sex you’re actually having. Our map of PrEP-friendly doctors lists doctors who have reached out to us to let everyone know they welcome conversations about PrEP and can prescribe it. 

If you do encounter homophobia or PrEP-shaming attitudes from your doctor, you have every right to find another doctor. Getting the best healthcare is often about finding the right fit and the right professionals that meet your needs.

PrEP being a medication and therefore seen as “bad for you”

Taking a medication like PrEP does not imply you're not healthy. It's a preventative measure to keep you safe if you are likely to be having condomless anal with casual partners. 

The potential side-effects are experienced by a small proportion of individuals and  the risk of HIV acquisition is greater than the risk of side-effects. Side-effects are usually mild and go away after the first month on PrEP.

PrEP Eligibility

If you think you might be interested in using PrEP, there are two ways you can access it - either through public funding or by funding it yourself. Which option is for you will be determined by whether you meet the PHARMAC eligibility criteria. 

Eligibility can be a little confusing, so we’ve made it easy for you.

Click below to find out if you are eligible for funded PrEP and what your options are. 

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  • Are you living with HIV?
  • Are you eligible for NZ funded healthcare?
  • Are you eligible for funded PrEP?
  • What If I'm not eligible for funded PrEP?
  • Can't afford to self-fund PrEP?

Are you living with HIV?

Do not use PrEP. PrEP is for people who are HIV-negative to prevent HIV acquisition. If you are on effective treatment, there is no risk of HIV being transmitted through sex (U=U).

Are you eligible for NZ funded healthcare?

In order to access funded PrEP you will need to be eligible for publicly funded healthcare in Aotearoa. This includes New Zealand citizens and residents. If you don’t know if you are eligible for funded healthcare you can find out here.

If you’re eligible for funded health care then select "Am I Eligible for funded PrEP?" 

If you’re not eligible for funded healthcare in Aotearoa and still think you want to access PrEP there are options available to you. To understand these options select ‘Not eligible for funded PrEP?’.

Are you you Eligible for funded PrEP?

If you are not living with HIV and are a cis male or transgender person who has condomless anal sex with men and at least one of the below applies to you, then you’re probably eligible for funded PrEP:

  • You have bottomed without condoms with a casual partner in the last three months
  • You have been diagnosed with a anal/rectal STI in the last three months
  • You have used methamphetamine in the last three months
  • You are having anal sex without condoms with someone who is living with HIV who is not on treatment or does not have an undetectable viral load

If you think you’re eligible for funded PrEP then your next step is to visit a doctor for a PrEP consultation. The doctor will make sure that the PrEP is the right choice for you by having a conversation about what it does and if you think you'll be able to fit PrEP into your daily routine and commit to regular check-ups.

Check out our online map that shows PrEP-friendly doctors in New Zealand. This will involve some tests and can take a little time, so please be patient. Once everything is approved, you will be able to get a three-month supply of PrEP for only $5

Not eligible for funded PrEP?

The first step of sourcing PrEP on your own is to get a prescription. Check out our online map that shows you doctors around New Zealand who know how to prescribe PrEP, this will involve a conversation about whether PrEP is right for you and some tests. 

Going to the doctor to get a prescription will mean you will have to pay a standard fee for the initial GP visit/s. Also, PrEP requires three-monthly check-ins for HIV and STI testing, and prescription renewal, so you’ll need to be prepared to pay for this every three months. 

Once you have got your prescription there are some options for you to access PrEP:

Importing PrEP

With a prescription, you can import generic versions of PrEP from overseas for personal use. This involves uploading a prescription for PrEP from your doctor in New Zealand, and purchasing the drug online. Currently, this costs around $50 - $80 per month, plus delivery and money conversion costs.  

It is important when importing your own supply to purchase PrEP from a legitimate website - we can recommend the following:

Purchasing directly from a pharmacy

With a prescription, you can purchase PrEP direct from a pharmacy at market price. We expect this price will be around $70-$130 per bottle, with pharmacy mark-up. Contact your closest pharmacy to see if they have stock.

Can't afford to self fund PrEP?

The cost of self funding PrEP can be prohibitive for some people who need PrEP, which is why a free coupon system has been created. 

If you have a valid PrEP prescription you may be eligible to receive a free order of PrEP from Green Cross Pharmacy if you also:

  • earn under the living wage of $21.15 (as of April 1, 2019) before tax

This will supply you with 90 tablets - enough to last three months. You can apply online using the form at the bottom of this page.

Learn more and apply here for a coupon here

Accessing PrEP

Click below to explore the different ways you can access PrEP in Aotearoa, depending on whether you are:

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  • Eligible for funded PrEP
  • Purchasing directly from a pharmacy without funding
  • Importing PrEP from overseas without funding
  • Seeking Free PrEP as a low income New Zealanders and International Students

Eligible for funded PrEP

Our online map shows doctors in New Zealand who have experience prescribing PrEP would be happy to talk to you about it.

The doctor will make sure that the PrEP is the right choice for you by having a conversation about what it does and if you think you'll be able to fit PrEP into your daily routine and commit to regular check-ups.

This will involve some tests and can take a little time, so please be patient. Once everything is approved, you will be able to get a three-month supply of PrEP for only $5 (when you’re eligible for funded PrEP).

Purchasing directly from a pharmacy without funding

With a prescription, you can purchase PrEP direct from a pharmacy at market price. Contact your closest pharmacy to see if they have stock. We expect this price will be around $70-$130 per bottle, with pharmacy markup. 

Going to the doctor to get a prescription will mean you will have to pay a standard fee for the initial GP visit/s. Also, PrEP requires three-monthly check-ins for HIV and STI testing, and prescription renewal, so you will need to be prepared to pay for this every three months.

Importing PrEP from overseas without funding

With a prescription, you can import generic versions of PrEP from overseas for personal use. This involves uploading a prescription for PrEP from your doctor in New Zealand, and purchasing the drug online. Currently, this costs around $50 - $80 per month. 

It is important when importing your own supply to purchase PrEP from a legitimate website - we can recommend the following:

Going to the doctor to get a prescription will mean you will have to pay a standard fee for the initial GP visit/s. Also, PrEP requires three-monthly check-ins for HIV and STI testing, and prescription renewal, so you will need to be prepared to pay for this every three months. 

Seeking Free PrEP as a low income New Zealanders and International Students

The cost of self funding PrEP can be prohibitive for some people who need PrEP, which is why a free coupon system has been created. 

If you have a valid PrEP prescription and: 

You may be eligible to receive a free order of PrEP from Green Cross Pharmacy. This will supply you with 90 tablets - enough to last three months. You can apply online using the form at the bottom of this page.

Learn more and apply here for a coupon here

I’m on PrEP, now what?

Basically just enjoy your life and keep to your three-monthly doctor's appointments. Make sure you keep them in the loop with any changes or concerns. It's their job and goal to look after you and your health - they're on this journey with you. 

Keep in mind that many formulations only have a shelf life of 30 days once the bottle had been opened, and after that the remaining pills should be discarded – check with your doctor if you are not sure about this, especially if you intend to use Event-driven PrEP.  

Also you can join 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 – to discuss questions, offer qualified advice, and share personal insights and experiences in a safe network.

Explore below to find out more about taking PrEP:

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  • What do I need to know?
  • Side Effects
  • Taking PrEP

What do I need to know?

Know what PrEP does and doesn’t do

As awesome as PrEP is, don’t be that guy that forgets it only protects from HIV and no other STIs. Condoms are still a great idea for casual sex, even if you’re on PrEP – and make sure you’re getting tested for STIs regularly. That way, if you do pick up something like syphilis, gonorrhea or chlamydia, you can get it treated quickly and prevent it passing on to anyone else.

Respect your partners

If a partner wants to keep condoms in the mix, don’t try and talk them out of it. They’re entitled to their preferred prevention method and if you can’t meet in the middle, then you can both politely decline the encounter and go your separate ways.

You may get some questions

You may find that as a user of this shiny new prevention option, you could be the first person on PrEP that someone encounters. Questions are natural, and you may well enlighten some people (plus, if the questions are too hard you can link them to us).

Side Effects

Some people get side effects when taking PrEP. Symptoms are usually mild and go away after the first month on PrEP. You might experience gas, bloating, diarrhoea, low energy and nausea.

 If you experience symptoms related to your stomach, here are some things to try:

  • Take your pill with food
  • Take your pill at night before you go to sleep

Go to your prescriber if the effects continue beyond a few weeks or continue to worsen.

Taking PrEP

Currently there are only two ways of taking PrEP that have been recommended: daily PrEP and event-driven PrEP.

Daily PrEP

Daily PrEP is the most common way to take PrEP. It involves taking a pill every day. If you accidentally miss a dose, take is as soon as you can, unless more than 12 hours passed – if that’s the case, skip this dose and resume your usual dosing time.

PrEP should be taken for 7 days before providing sufficient protection for an exposure for cis women, heterosexual men, and trans people. Cisgender gay and bisexual guys can also start it with a double dose (two pills at once, and continue with single pill every 24 hours), and the protective effect should kick in after two hours.

Pros

  • Taking PrEP every day is the best option if you want protection without having to anticipate when your next sexual encounter may be. It’s also great if you are going to be having sex quite frequently (twice per week or more often on average).
  • Daily PrEP helps you to keep a routine. Many people find it easier to take PrEP every day and not worry about planning (or delaying!) sex.
  • If you accidentally miss a dose, daily PrEP still provides very high levels of protection

Cons

  • Taking medication everyday can seem like a chore to some people
  •  Working PrEP into a daily routine can be a challenge
  • If you travel a lot, or have very irregular lifestyle can make taking PrEP everyday more difficult

Event-driven PrEP is taking PrEP only around the times that you are having sex. Some people also call it PrEP on-demand, PrEP 2+1+1, or PrEP 211. For it to work, you need to know when you are going to be having sex in advance, so it is suitable for people who can predict, plan or delay their sexual activity for at least two hours. Research has only shown it to be effective among men who have sex with men.

Event-Driven PrEP

For event-driven PrEP, the timing of when you are taking the pills is extremely important. We know that this way of using PrEP can be much less effective if you don’t do this right every single time. Make sure you are discussing it with your prescribing GP to ensure you understand the timing of the pills.

  1. Take two PrEP pills together at once – a double dose – between 2 to 24 hours before you have sex
  2. Take one more PrEP pill 24 hours after your first dose
  3. Take one final pill 24 hours after the second dose

If you keep having sex then keep taking a PrEP pill each day. After you’re done having sex, keep taking a pill each for two days after the last episode of sex.  

Pros

  • Taking event-based PrEP can suit people who have infrequent sex (less than twice a week), or who plan to have sex without condoms for a short period of time (e.g. a weekend, a holiday).
  •  Good if you don’t like taking daily medication,
  • Some people may find that they experience less side effects from event-driven PrEP use.

Cons

  • If you find yourself having sex more often than one a week anyway or find the event-driven dosing schedule too difficult to follow, taking PrEP every day might be a better option.
  • Event-driven PrEP is less “forgiving” than daily PrEP. It may lose its protective effect even if you miss just a single dose
  • There is not enough evidence that event-based PrEP works for cis women, trans people or heterosexual men.

PrEP

Rongoa ī mua te huranga

PrEP is an HIV prevention method where people take a pill to reduce their risk of HIV by up to 99% (if taken daily). Currently there are only two ways of taking PrEP that have been recommended: daily PrEP and event-driven PrEP.

For more information about why PrEP might be right for you, use our interactive tool above.

Eligibility

If you think you might be interested in using PrEP, there are two ways you can access it - either through public funding or by self funding. Which option is for you will be determined by whether you meet the PHARMAC eligibility criteria. 

Eligibility can be a little confusing, so we’ve created an easy tool to find out if you're eligible for funded PrEP. Remember, you are not eligible there is still other ways you can access PrEP.

Access for people eligible for funded PrEP

If you think you’re eligible for funded PrEP then your next step is to visit a doctor for a PrEP consultation. The doctor will make sure that the PrEP is the right choice for you by having a conversation about what it does and if you think you'll be able to fit PrEP into your daily routine and commit to regular check-ups.

Check out our online map that shows PrEP-friendly doctors in New Zealand. This will involve some tests and can take a little time, so please be patient. Once everything is approved, you will be able to get a three-month supply of PrEP for only $5. 

Access for people not eligible for funded PrEP

The first step of sourcing PrEP on your own is to get a prescription. Check out our online map that shows you doctors around New Zealand who know how to prescribe PrEP, this will involve a conversation about whether PrEP is right for you and some tests. 

Going to the doctor to get a prescription will mean you will have to pay a standard fee for the initial GP visit/s. Also, PrEP requires three-monthly check-ins for HIV and STI testing, and prescription renewal, so you’ll need to be prepared to pay for this every three months. 

Once you have got your prescription there are some options for you to access PrEP:

Importing PrEP

With a prescription, you can import generic versions of PrEP from overseas for personal use. This involves uploading a prescription for PrEP from your doctor in New Zealand, and purchasing the drug online. Currently, this costs around $50 - $80 per month, plus delivery and money conversion costs.  

It is important when importing your own supply to purchase PrEP from a legitimate website - we can recommend the following:

Purchasing directly from a pharmacy

With a prescription, you can purchase PrEP direct from a pharmacy at market price. We expect this price will be around $70-$130 per bottle, with pharmacy mark-up. Contact your closest pharmacy to see if they have stock.

Can't afford to self fund PrEP?

The cost of self funding PrEP can be prohibitive for some people who need PrEP, which is why a free coupon system has been created, find out more here.

Taking PrEP

Use our tool above to get the best information to guide you on your journey of taking PrEP including the differences between daily PrEP and Event-driven PrEP. 

I’m a clinician

If you are a clinician interested in learning more about PrEP, check out this information for PrEP prescribing clinicians.

If you're already prescribing PrEP and would like to be added to the doctor map, get in touch with us at [email protected].

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