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 prevention method in which people who do not have HIV take a pill every day to reduce their risk of becoming infected with HIV.
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 up to 99%.
- 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.
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 GPs across the country who prescribe PrEP.
If your GP or 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. This consultation can be a simple email or phone call.
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. As of March 1st 2018, it will be available at your local pharmacy for $5 for three months' supply.
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.
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.