‍1. What is PrEP?

PrEP (short for Pre-Exposure Prophylaxis) is a medication that prevents HIV. It works to prevent HIV from establishing infection inside the body.

HIV PrEP contains drugs that are also used as treatment by people who have HIV. Although PrEP prevents HIV, it does not prevent other STIs, like syphilis, gonorrhea, chlamydia, etc.

It’s important to understand PrEP is part of what’s called ‘combination prevention’, which is the best method to prevent HIV and STIs. Combination prevention involves the use of multiple strategies that have each been proven to work. These include:

  • Pre-Exposure Prophylaxis (PrEP)
  • Post-Exposure Prophylaxis (PEP)
  • HIV treatment
  • Sexual health education
  • Needle distribution programs and safe consumption sites
  • Anti-poverty work, housing efforts
  • Sex work decriminalization and protections
  • Condom use

2. How does it work?

Rather than a physical barrier such as condoms, PrEP is a chemical barrier. It prevents the HIV virus from replicating in the body, leading it to die out and not get a hold of a person’s immune system. Essentially, PrEP works by preventing the HIV virus from reproducing, thereby preventing HIV transmission. 

Like any barrier, PrEP needs to be strong enough before it can prevent HIV. Usually that means being on PrEP for 7 days for anal sex and 21 days for vaginal sex. These timelines allow PrEP to be absorbed by different tissues in the body. However, PrEP does not prevent other sexually transmitted infections, so it's important to use it with other prevention methods.

3. How effective is PrEP?

PrEP is around 99% effective when taken as prescribed.

Some choose to take PrEP differently, opting for ‘on-demand’, or ‘event-based’ PrEP. This is nicknamed  PrEP on-demand. This method is also effective, but it requires strictly adhering to your pill schedule. It is also only approved for anal sex, not vaginal sex.

4. Is PrEP right for me?

It very well could be! PrEP is recommended for people with the highest risk of acquiring HIV, including (but not limited to):

  • Men who have sex with men
  • Trans and non-binary people, if their sex partners were born with a penis (and still have one) and their other sex partners were born with a penis (and still have one)
  • People from countries or communities with high HIV rates
  • People who inject drugs and their sex partners
  • People whose sex partners have detectable HIV

So all in all, PrEP should be considered by those who are HIV negative and at higher risk for HIV. The decision to be on PrEP is made between patient and healthcare provider. A clinician will assess your HIV risk, and ask questions about your sexual and drug-use behaviour to determine if you’re a suitable PrEP candidate. It’s important to be aware that PrEP may have potential risks, and ongoing medical monitoring is necessary. All kinds of people can be on PrEP, for all kinds of reasons!

Some exams (bloodwork and urine) are required prior to initiating PrEP. These tests are necessary to ensure you remain HIV negative, that your body is tolerating PrEP well, and that you’re being tested and treated for STIs. If you decide to book a consultation through Freddie, your clinician and care coordinator will support you through all of the steps of your PrEP experience through check-ins and reminders

Learn more about whether PrEP is right for you in our article “Is PrEP right for me?”.‍

5. Side Effects 

PrEP may present some short term side effects like nausea, headaches, and stomach aches. In general, less than 10% of PrEP patients experience any side effects, and if they do, they tend to cease after a week.

With regards to long term side effects, PrEP has been shown in some patients to lead to a decrease in bone mineral density, as well as kidney function - however they don’t cause complications unless patients have a pre-existing condition (which would be screened through lab work before PrEP initiation). The risk of these kidney and bone side effects is low. A recent study of 14,000 PrEP patients found 0.9% had these problems. The levels of bone and kidney health also return to normal levels after somebody stops PrEP.

That’s why PrEP requires lab testing every three months - just to make sure your body is tolerating PrEP well. If there are any issues, your clinician will help you manage them to keep you safe.‍

6. Thinking about PrEP?

If you are thinking about PrEP, why not schedule a free phone call with one of our affirming clinicians? Don’t worry, having a consultation doesn’t mean you automatically have to go on PrEP! We’re here to help you understand if PrEP is for you, because it isn't for everyone. And if you’re on the fence, that’s okay – the best place to get your questions answered is one-on-one with an experienced healthcare professional who knows the ins and outs of life on PrEP. With Freddie, you’ll have your very own dedicated Care Coordinator assigned to you; if you hate calling customer service lines and waiting on hold, this is especially fantastic news for you because you can quite literally just text your Care Coordinator directly with your questions and concerns, and they will figure out exactly what you need behind-the-scenes and get back to you in a timely manner.