PrEP, aka Pre-Exposure Prophylaxis, is a game-changer for HIV prevention. If you want to learn more about this incredible little blue pill - and to find out how to get it - you've come to the right place.
*Please note that accessing PrEP is now even easier than it was at the time of recording the video above. Keep reading below to find out more.
How do I get on PrEP?
To simplify things right down - you need to:
- Find out if PrEP is the right prevention tool for you
- Check you are HIV negative - confirmed by a blood test with your doctor
- Get a prescription - after running tests and discussing whether it is right for you
- Use the prescription to either get publicly funded or self-funded PrEP
There are a few terms and conditions and it can take a little bit of time, but if it's the right option for you - it really is that simple.
Make your way through the relevant sections below to help you on your journey - if you're having trouble you can always reach out to us directly with questions.
Take our quick quiz to find out whether PrEP is the right prevention option for you:
Healthcare eligibility can be a little confusing, so let's stick to the basics.
First of all, you need to see if you're eligible for publicly funded healthcare in Aotearoa - head over the Ministry of Health's guide to eligibility and click through to see what category best describes you to find out more.
Remember, if you aren't eligible for publicly funded healthcare in Aotearoa, there are still options available to you. Click on the "What if I'm not eligible for funded PrEP" below to find out more.
If you are eligible for funded healthcare, then it's time to see if you fit the PHARMAC criteria for funded PrEP - check out the two statements below to find out.
In simple terms:
If you have tested negative for HIV and one or both of the below statements describes you - you're eligible!
- If you are male (cis or trans) or trans and have anal sex with men - often bareback - and have either bottomed without condoms with a casual partner, been diagnosed with a rectal STI or used methamphetamine in the last three months
- Or, if you are male (cis or trans) or trans and have anal sex with men and are not consistently using condoms with a partner who is living with HIV who is not on treatment or has a detectable viral load
If you are eligible then talk to your doctor - or visit one of the PrEP-friendly doctors listed on our site - about getting a prescription and beginning your PrEP programme.
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.
If you are not eligible for publicly-funded PrEP, there are still options available to you.
The first step to sourcing PrEP on your own is to get a prescription. You will need a prescription to be able to order PrEP from overseas or purchase direct from the pharmacy.
Speak to your doctor or contact one of the PrEP-friendly doctors listed on our site about getting a prescription. This will involve some tests and can take a little time, so please be patient with your doctor. Ensure that the prescription is issued with the scientific names of the medicines used as PrEP - Tenofovir Disoproxil and Emtricitabine - taken once daily as a combination tablet
Once you have a prescription for PrEP you are able to purchase PrEP from a pharmacy or import your own supply from a trusted overseas supplier.
Purchasing direct from a pharmacy
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 $90-130 per bottle with pharmacy markup.
With a prescription, it is legal to import generic versions of PrEP from overseas for personal use.
It is important to purchase PrEP from a legitimate website - there are three suggestions below:
Can't afford to fund your own PrEP?
We have partnered with Green Cross Pharmacy to help provide generic PrEP to those who cannot afford to import it. Find out more about free generic PrEP for people on low incomes.
Our map of PrEP-friendly doctors lists GPs who have let us know they are happy to have conversations about PrEP and prescribe it.
Let's address some common concerns people have voiced when thinking about starting PrEP:
I'm worried about PrEP not being as reliable than condoms
- With up to 99% effectiveness at preventing HIV when taken daily, PrEP is your own personal bodyguard - PrEP does not protect you against other STIs though, so condoms are a still an important prevention tool.
I'm worried about side-effects
- Everyone reacts differently to medication - some people will get side effects from taking PrEP, and some will breeze through it without noticing anything. Some reported side effects include diarrhea, low energy, nausea etc. Here are some other potential side effects if you want to know more!
I don't like the idea of needing to take medication when I'm already healthy
- It's a matter of perspective - like taking an anti-nausea tablet before getting on a boat or taking the female contraceptive pill, 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.
I'm worried that PrEP doesn't prevent other STIs
- It's definitely a good thing that you're thinking about this. PrEP doesn't protect against other STIs, so it's something to keep in mind. You can keep having conversations with sexual partners about testing and whether keeping condoms in the mix is the best option for that encounter.
I'm worried about talking to my doctor about sex in order to get PrEP
- This is totally fair, and we know that some of us haven't talked with our doctors about sex. Though we recommend being as open as you can with your doctor, as it means they can provide the best care to you by knowing all the factors, we understand this is not possible for everyone. Our map of PrEP-friendly doctors lists doctors who have reached out to us to let everyone know they are happy to have conversations about PrEP and 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.
I'm worried about interactions with other medications/drugs
- It's a good idea to be aware of what's going into your body and what effects they might have when taken together. Check out this helpful tool from the University of Liverpool for checking known interactions between PrEP and other medications and drugs (including recreational chems).
Want to know the nitty gritty, or just curious how it actually works? Read on!
PrEP (or Pre-Exposure Prophylaxis) refers to the use of particular HIV medications by HIV negative people as a preventative tool.
Emtricitabine with tenofovir disoproxil are what make up the medications we call PrEP.
PrEP works by building up amounts of the medication in your system, to the point where if becomes effective at preventing the replication cycle of HIV. This reduces the chance that it will take hold in your body.
Studies have shown that seven days is the best amount of time to build up defenses in rectal tissue and and 20 days for penile tissue or the vagina. So if you're bottoming, you're protected after 7 days of taking PrEP, but if you're topping or having vaginal/front-hole sex, you'll need to wait 20 days before being fully protected.
PrEP is most effective when taken once daily, as prescribed.
Because using PrEP relies on maintaining an ideal level of the drug in your system, inconsistent use will lead to your level of HIV protection being lessened.
When the correct level of PrEP is in your system, it is up to 99% effective at preventing HIV.
If you do encounter homophobia or PrEP-shaming attitudes from your doctor, you have every right to find another doctor. You can also let us know and we can send them information about PrEP in an effort to educate them.
Sometimes it's just a matter of your doctor not getting it - no matter how many times you try to explain. Again, you have the right to change doctors and find someone who makes the effort to understand your situation and isn't going to dismiss your lifestyle.
Getting the best healthcare is often about finding the right fit and the right professionals that meet your needs. So don't feel guilty about looking elsewhere.
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.
Beyond that, here are a few tips to prepare you for your PrEP adventures:
- 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 😊).
- Remember to try and take it as prescribed
Set up a recurring reminder on your phone, leave your medication in a place you will come across every day or whatever works for you – PrEP is most effective if taken consistently. Doing it at the same time every day will also help you remember, especially if you’ve just started.
If you do choose to take PrEP differently - it's absolutely essential that your doctor is in the loop and making recommendations accordingly. You should also never take PrEP from someone else's supply or without a prescription.
Learn about some of the other known PrEP usage strategies below:
Another way to take PrEP for people who are at highest risk of contracting HIV only during a specific time or life event (for example, going on a gay cruise) is episodic PrEP. To ensure maximum protection, you should start PrEP at least 7 days before the exposure to risk, continue it daily during the episode of exposure, and then for another 28 days after the last possible exposure (staying with our example, from 7 days before boarding the ship, through to the whole duration of the cruise, and for 28 days after the last time you had anal sex without condoms).
You may have heard of non-daily dosing for PrEP (also known as ‘on-demand’ or ‘event-based’ dosing).
This involves taking:
• Two pills 2-24 hours before sex
• One pill 24 hours later
• One more pill 24 hours after that
There is evidence that event-based dosing is effective if you’re using it regularly (for example if you’re having sex weekly). If you’re using is less often (for example, once every month or two), then the evidence of effectiveness is less clear. We recommend daily dosing as the most effective way of using PrEP. Non-daily PrEP is not recommended if you have an active hepatitis B infection. The drugs in PrEP also suppress the hepatitis B virus, so starting and stopping PrEP can cause virus flare-ups and liver inflammation. If you choose to take non-daily PrEP, it’s important to still see your PrEP prescriber every three months for HIV and STI testing, even if you have spare pills left over.
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 for their sexual partner to verify its use, or to know if it has been taken correctly (unlike when condoms are used). So it's important to respect other people’s decisions; if sexual partners prefer to use condoms, then that's their right.
A huge part of ending HIV in Aotearoa is making a choice about what prevention tools work for you and taking actions to protect yourself and others. No one should be forcing you to use a tool that you haven't chosen - it's important to own your own sexual health rather than relying on other's choices.
Consent always involves a conversation. If your sexual partners are into using condoms, that’s their choice and you make yours - either of you can exercise your freedom to respectfully decline the encounter if you can’t agree on a prevention method that works for you both/all.
Remember, PrEP only protects against HIV. Not every STI has symptoms and having one can increase the risk of getting others - this means regular testing is a big part of being a good PrEPster.
If you are a clinician interested in learning more about PrEP, check out this information for PrEP prescribing clinicians by the New Zealand AIDS Foundation.
If you're already prescribing PrEP and would like to be added to the doctor map, get in touch with us at [email protected].