What is PrEP? PrEP is an acronym for Pre-Exposure Prophylaxis, a daily pill that helps prevent people from contracting HIV when taken correctly. This method of protection currently comes in three types of approved pills (Truvada, generic Truvada, & Descovy medication). All of which offer a similar level of protection when taken daily (99%). PrEP on-demand is a breakthrough in HIV prevention, so far it has only been approved and studied among people who are having anal sex and/or men who have sex with men.
Where daily PrEP requires once a day dosage, PrEP on-demand does not require daily intake. This is ideal for someone who can’t access a sufficient supply of PrEP, has fluctuating sexual behaviour, or is forgetful. Some refer to these types of PrEP regimen as on-demand, intermittent use, non-daily doses, and off-label prescription.
What does the dosing for on-demand PrEP look like? To take PrEP on-demand, most use a 2-1-1 dosing schedule, which includes:
If you take PrEP on-demand, it's important to adhere to the prescribed dosing guidelines. This is because taking PrEP less frequently decreases the drug's protective effects against HIV.
When taken as described, PrEP on-demand has an overall efficiency of 86% in preventing HIV among men who have sex with men.
A few patients experience side effects from PrEP on demand. The most common side effects are nausea and diarrhea. These symptoms might be mild or severe. Other possible side effects include headaches, dizziness, and abdominal pain or cramps (in the stomach). Although these are experienced more frequently among PrEP on demand than daily PrEP medicine users, the amount of patients that experience side effects is still generally low.
If you are worried about side effects, you may want to consider Descovy for PrEP, which has a slightly lower report of side effects.
Whether you choose to take PrEP on-demand or daily is your choice. It’s important to understand that most providers in Canada will choose to prescribe daily PrEP as it’s more effective in preventing HIV and more regulated.
However, if you are considering on-demand PrEP and think it would better suit your current situation, feel free to have a chat with your PrEP provider. They should be able to best advise you on best dosing schedule and how to best continue preventing HIV in a way that works for you.
For HIV-negative patients having anal sex, PrEP on-demand can be a good way to take preventive action and stay safe. Remember that it is not 100% effective but does provide an additional layer of protection.
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