PrEP-ING YOU WITH THE BASICS
If you have some knowledge of HIV, there's a chance that you've heard of this amazing little blue pill, Pre-Exposure Prophylaxis, aka PrEP.
If the term 'PrEP' looks foreign to you, don't worry, we've got you covered.
PrEP is a daily pill for people who do not have HIV, to prevent HIV. It is a publicly-funded medicine in NZ, which means that for those who meet certain criteria, it is available on prescription at local pharmacies for $5 for each three-month supply.
Not only does it reduce the risk of HIV transmission by up to 99%, it also allows you to enjoy sex with your partners knowing that you are protected from HIV.
1. You can't contract HIV if you're taking PrEP
With up to 99% effectiveness at preventing HIV when taken daily, PrEP is your own personal bodyguard. What makes PrEP so powerful? It works by maintaining a certain level of the drug in your body which prevents the HIV virus from establishing an infection.
2. If you fuck or get fucked without condoms, take PrEP
Some people struggle with condom use, and others just forget to bring them. If that sounds like you, then PrEP is your best wingman. A good wingman never leaves you out in the cold!
3. PrEP is not a 'get out of jail free' card for other STIs
PrEP is like a bulletproof vest; it protects some of your vitals but not all of them. You can still contract syphilis, gonorrhoea, chlamydia, and many more. Guess what? Our trusty friend the condom is still the most effective tool to protect you against all STIs, including HIV. You can be on PrEP and still use a condom! Who doesn't like double protection? Find FREE condoms.
4. Like every other pill, PrEP has potential 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. Common side effects include diarrhea, low energy, nausea etc. Here's the other potential side effects if you want to know more!
5. Testing is PrEP's best friend (and yours too)
There are two major testing milestones that you should aim for when you decided to go on PrEP:
1) Before you go on PrEP, get yourself tested to make sure that you are HIV negative. This is because if you use PrEP when you are already living with HIV, it can cause the virus to develop resistance and reduce your options for HIV treatment.
2) Once you're on PrEP, don't forget to test for HIV every three months - this is to ensure that PrEP's magical power is still protecting you in case of an unforeseeable slip-up, such as forgetting to take the pill consistently. It also checks in on your kidneys, which are the organ most likely to be affected by PrEP
PrEP is a good option for some people, but not for everyone.
Take the quiz below to see if PrEP could be right for you:
If you are considering PrEP, you should discuss this with your GP/family doctor, or a specialist with experience in HIV and sexual health, to help decide if it is right for you. To help out, we've put together a map of doctors across the country who know about PrEP.
If your GP/family doctor agrees that PrEP is right for you, they will need to consult with a sexual health or HIV specialist before prescribing PrEP to you for the first time. If you are eligible for subsidised medicines in New Zealand, and you meet the PHARMAC criteria for PrEP, you could then take your prescription to a local pharmacy to be filled at a cost of $5 for three months' supply. To help you understand PHARMAC funded PrEP, we've put together a quick fact sheet.
If you don't qualify for subsidised medicines in New Zealand (for example, if you're an international student) or you don't meet the PHARMAC criteria, 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 $50-80 per month. We have also compiled some information of where to buy PrEP and the cost of the prescription across different suppliers.
You can legally import most medicines into New Zealand for personal use. This involves arranging for the medicine to be sent to you from an overseas supplier from with New Zealand.
Mylan's generic Emtricitabine 200mg + Tenofovir 300mg (Ricovir-EM) has been approved by Medsafe for use as PrEP. This document gives information about three online suppliers of Ricovir-EM.
We have partnered with Green Cross Pharmacy to provide free generic PrEP for those who cannot afford to import it. Find out more about free generic PrEP for people on low incomes.
It is important to note that other generic medicines ordered from outside New Zealand may not be approved for supply in New Zealand by Medsafe. You should be careful about the supplier 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. The safety and quality of medicines ordered from outside New Zealand cannot be guaranteed, however tests at a London clinic of PrEP purchased from overseas websites found no fakes, and adequate drug levels. To 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. You are able to import a maximum of 3 months supply. 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), rather than the brand name Truvada. It must cover a maximum of 90 days, without repeats.
Note that some websites may say that you do not need a prescription to buy PrEP, but this information is not correct for New Zealand importers. In New Zealand, Medsafe requires that all medicines imported to New Zealand are accompanied by a prescription that is not more than 6-months old. Whenever you are buying PrEP online from New Zealand, you need to upload your prescription.
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.
If you're 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.
Check out the map to find a doctor near you who knows about PrEP.
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].