While condoms remain the surest way to keep yourself safe from HIV and many other STIs, PrEP (Pre-Exposure Prophylaxis) is another option for preventing HIV for those who struggle with condom use.
PrEP is an HIV medication called Truvada that is taken if you are HIV negative. When taken on a daily basis, PrEP builds up in your system and significantly reduces the chances of HIV infection.
Going on PrEP is a commitment and is best done under the guidance of a doctor with good knowledge of HIV and sexual health. There are a few key things to be aware of when it comes to PrEP:
- PrEP works by maintaining a certain level of drug in the body that can prevent HIV establishing an infection. This means that you have to take the pill every day to maintain this level of drug. Studies have shown that if it is taken every day as prescribed it reduces the risk of getting HIV by at least 92%.
- PrEP does not provide protection from any other STIs like syphilis or gonorrhoea which can increase the possibility of HIV infection. So it’s important to keep condoms in the mix and test at least every three months for these other STIs.
- It’s important to test for HIV before you start PrEP and every three months while you’re on it – if you use PrEP when you already have HIV it can cause the virus to develop resistance and reduce your options for HIV treatment.
- PrEP can affect your kidneys, and also has other potential side effects. You need to have your kidneys checked before you go on PrEP and regularly once you start the medication
NZ PrEP is a study developed by Auckland Regional Sexual Health Service, in collaboration with NZAF and others. The study will test the effectiveness of PrEP in our local context, adding to the evidence from other jurisdictions, including Australia. The findings of the New Zealand PrEP pilot study will be used to support the case for funding of the drug here.
If you're interested in participating in the study you can make an appointment to discuss with Auckland Regional Sexual Health Services on 0800 739 432.
If you are considering PrEP, you should discuss this with a doctor with experience in HIV and sexual health to help decide if it is right for you.
If your doctor agrees that PrEP is right for you, they can prescribe Truvada.
You could then take your prescription to a local pharmacy to be fulfilled. Because Truvada hasn’t yet been funded by PHARMAC for this use, the cost is approximately $1000 for a 30-day supply, which will be too expensive for many people.
Another option is to purchase a generic version of Truvada from an overseas supplier and import it to New Zealand. Generics are copies of brand name drugs. The cost of generic Truvada is much less than the brand-name and would be approximately $60-100 per month, which will still be too expensive for some, but an option for others.
Obtaining Generic Truvada Online For PrEP
You can legally import into New Zealand most medicines for your personal use. This involves arranging from within New Zealand for a medicine to be sent to you from an overseas supplier. The medicines are only to be used by you and must not be supplied to any other person.
It is important to note that such medicines may not be approved for supply in New Zealand by Medsafe; and there are no guarantees about their safety or quality. You should be careful about the supplier source that you choose, and your doctor may ask you to sign a consent form to acknowledge that you understand the risks associated with importing a medicine from overseas. Subject to satisfying various conditions you may import a 3-month supply (at the maximum dose recommended by the manufacturer).
Medicines ordered over the internet require a New Zealand-issued prescription from your doctor. To purchase or import a generic version of Truvada into New Zealand, you must first get a valid New Zealand issued prescription to accompany the medicine being imported.
The New Zealand-issued prescription must contain the scientific names of PrEP (Tenofovir DF 300mg once daily plus Emtricitabine 200mg once daily as a combination tablet), not the brand name. It must cover a maximum of 90 days, without repeats.
A PrEP advocacy group in the UK has developed a resource for those looking to purchase PrEP from overseas: https://www.iwantprepnow.co.uk/buy-prep-now
Note that this website says you do not need a prescription to buy PrEP from some of the sellers listed, but this information is specific to the UK. In New Zealand, Medsafe requires that all medicines imported to New Zealand are accompanied by a prescription. So you should upload your prescription with your order.
It is important for everyone, including those who use condoms, to understand how PrEP works so that they can effectively negotiate how to protect themselves from HIV and other STIs during sex.
People who use PrEP to protect themselves against HIV are not required to tell their sexual partners that they are using PrEP.
If someone says they’re taking PrEP there is no way (unlike when condoms are used) for their sexual partner to verify its use, or to know if it has been taken correctly. So it's important to respect other people’s decisions; if sexual partners prefer to use a condom then that's their right.
Nobody should have to take someone else’s word for it that they are safe. To end HIV in New Zealand it’s important that HIV-negative people are taking action to protect themselves during sex through the use of condoms or PrEP. Putting your health in someone else’s hands is not recommended.