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If you're already taking PrEP - that's great! You've taken an important step in protecting your own health, and in helping us end new HIV transmissions in New Zealand for good.

If you're having any specific issues with your PrEP regime, the best person to speak to is your prescribing doctor. Alternatively, get in touch through our Chat With Us service and we'll give you the best information we can.

I want to talk to other PrEP users

In New Zealand there are around 2000 people who are currently taking PrEP to protect themselves from HIV. Connecting with other PrEPsters is a great way to discuss any questions you might have, or even to become a source of knowledge for people who are interested in getting started.

PrEPing NZ is New Zealand's biggest online community for PrEP users, so if you're looking to get connected, this is the best place to get started.

Other online groups include Australia's PAN (PrEPaccessNOW) and PrEP'd for Change.

 

I want to take a break

Everyone goes through different phases in their sex lives - sometimes you might be having sex with fifty people a month, and sometimes it could be zero. There might come a time when you realise you don't need to be taking PrEP at that particular moment. So how do you stop safely?

For cisgender men who have sex with men, PrEP can be safely discontinued by taking the tablets for two consecutive days (48 hours) after your last condomless sex – it doesn’t matter if you take it daily or on-demand (2-1-1).

If you are not a cisgender man who has sex with man, the current guidelines recommend to continue taking PrEP for 28 days since your last condomless sex before it can be discontinued. It is important to remember that you'll need to get an HIV test before you restart PrEP - even if you have pills remaining from the last time you refilled your prescription.

 

Negotiating sex when your partner isn't on PrEP

A big part of owning your sexual health is making sure you make a choice about what prevention methods works best for you and your circumstances. If that choice is PrEP, that's your right - but it's important to remember that your partners will have made their own choices, and sometimes that'll be to use condoms.

If someone you're hooking up with wants to keep condoms in the mix, don’t try and talk them out of it. Your prevention method is for you only - they need to keep themselves safe and it's not fair to ask them to rely on someone else's PrEP regime. Your partners are entitled to their chosen prevention method and if you can’t meet in the middle, there are plenty more dicks and butts in the sea.

If you can't agree on a prevention method, you can still have some non-penetrative fun (oral sex and mutual masturbation are some good alternatives) – or you can both politely decline the encounter and go your separate ways. This might sound like a downer, but it can be done respectfully, and there's nothing wrong with deciding not to go through with things. It's more important for you and your partners to stay true to how you've decided to keep yourselves - and your other partners - safe.

 

What's PrEP 2-1-1?

Currently there are only two recommended ways of taking PrEP:

  • Daily PrEP, and
  • PrEP 2-1-1 (also known as event-driven PrEP or on-demand PrEP).

Both ways are similarly effective, provided you stick to using them exactly as prescribed. For most people, daily PrEP is the simplest solution, but PrEP 2-1-1 provides an option for people in different situations - for example, those who are having infrequent sexual encounters or who only need to take PrEP for a short time.

PrEP 2-1-1 is currently only shown to be effective for cisgender gay and bisexual men. People having receptive vaginal or front-hole sex will need to use a daily PrEP regime.

So how would you use PrEP 2-1-1?

Daily PrEP or PrEP 2-1-1?

Currently there are only two recommended ways of taking PrEP: Daily PrEP, and PrEP 2-1-1 (also known as event-driven PrEP or on-demand PrEP). Both ways are similarly effective, provided you stick to using them exactly as prescribed. See the differences below.

  Daily PrEP PrEP 2-1-1​​

who can use it

Anyone can take Daily PrEP

Gay and bisexual cis-men. Not shown to be effective for receptive vaginal or front-hole sex.

When to use it?

Take one pill every day

Every time you have sex, with specific dosing before & after sex you should use it

Ease of use

Take one pill every day

Requires planning and reminders to take 2-1-1 doses

Ideal for

Frequent sex, or infrequent sex if you prefer not to plan or delay sexual activity

Infrequent sex (less than twice a week) and if it is easy for you to plan or delay sexual activity

Planning

No planning needed around sex

Need to take the first dose at least 2 hours before sex

Missing doses

Not advised, but may be OK if you take at least 4 or more pills per week for anal sex

Extremely important not to miss doses

Side effects

Same as PrEP 2-1-1. More info here.

Same as daily PrEP

Hepatitis B

Can take daily with chronic hepatitis B

Potentially dangerous to use with chronic hepatitis B

Cost

May be more expensive than PrEP 2-1-1

May be less expensive than daily PrEP


Tips for using PrEP 2-1-1

Making sure it works

  • Taking the pills as recommended is crucial to making 2-1-1 dosing work for you – use reminders and alarms.
  • Use 2-1-1 with all sexual encounters. Don’t just pick and choose when to use 2-1-1.
  • Continue taking 2-1-1 for as long as you’re sexually active.
  • Switch to daily dosing if it’s going to be a better fit for you. Make sure you do this in consultation with your prescriber and have the required tests for HIV, STIs and kidney function first.
  • Always make sure to take the last 2 doses after your last sexual encounter.
  • If you miss a dose, immediately take 2 PrEP pills and contact your prescribing doctor/nurse.


Working with your prescribing doctor / nurse

  • Never start PrEP (whether daily or 2-1-1) without first testing for HIV. Discuss with your PrEP prescriber before switching from daily PrEP to PrEP 2-1-1 or vice versa.
  • If you’re unsure if PrEP 2-1-1 is the best option for you, you can start with daily PrEP for 3 months and keep a "PrEP diary", noting down the days you had PrEP-requiring sex and whether you were able to plan or delay sex. Bring the diary to your first follow-up PrEP appointment and discuss with your PrEP prescriber whether PrEP 2-1-1 could be good for you.
  • Even if you are on PrEP 2-1-1, the requirement to test every 3 months for HIV, STIs and kidney function remains the same. The fact that you might not need a new prescription because you have plenty of tablets using PrEP 2-1-1 does not mean you should delay your PrEP follow-ups.

 

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