08 September 25

ACON Westie

Keeping it Real with PrEP

What is PrEP?

PrEP, or pre-exposure prophylaxis, is a pill you can take to protect yourself from HIV. When taken correctly, PrEP is highly effective at preventing HIV infection.

PrEP is only effective for people who are HIV-negative, so you’ll need to get a HIV test before starting.

While PrEP protects you from HIV, it doesn’t prevent other STIs like chlamydia, gonorrhoea, or syphilis. To protect against these, you can use condoms or get tested regularly so infections can be treated early.

How do I take PrEP?

Because it’s pre-exposure, PrEP needs to be taken before a possible HIV exposure.

There are two options, depending on who you are:

• Daily PrEP – for everyone (including cisgender men, women, and trans people).
• On-demand PrEP – for cisgender men and some trans people.

Daily PrEP – Open to all

Pros	Cons
Reliable protection: Highly effective HIV protection when taken consistently. Simple routine: Is part of your daily routine; easier to remember. Flexible for unpredictable sex: Protects even if sex is unplanned or spontaneous. Open to all: Suitable for everyone, regardless of how you identify.	Daily commitment: Must remember to take it every day; missing doses reduces effectiveness. Cost and use: More pills are used over time, potentially increasing cost. Might be ‘wasted’ if not having sex often.

 

Daily PrEP is a good option if you want consistent protection. As the name suggests, you take 1 pill every day.

How you start and stop daily PrEP depends on how you identify.

	Starting daily PrEP	Stopping daily PrEP
For cis men	Take 2 pills (double dose) between 2-24 hours before sex, then Take 1 pill every 24 hours after the double dose	After your last hook-up, take 1 pill daily for 2 more days. If you have sex during this time, the 2-day countdown resets.
For everyone else (including trans people)	Take 1 pill daily for 7 days before sex.	After your last hook-up, take 1 pill daily for 28 more days. If you have sex during this time, the 28-day countdown resets.

On-demand PrEP – For cisgender men and some trans people

Pros	Cons
Reliable protection: Highly effective protection against HIV when taken correctly. Fewer pills: Only taken around sexual activity = less medication overall. Cost-effective: Saves money if sexual activity is infrequent, or can be planned for. Flexibility: Can keep taking 1 pill daily until two days after your last hook-up for continued protection.	Requires planning: Needs to be taken at least 2 hours in advance = needs some planning before sex. Risk if used wrong: Reduce protection if not taken using the 2-1-1 method. Limited suitability: Not suitable for cis women and some trans people.

 

On-demand PrEP is currently only recommended for cis men and some trans people*, as there current evidence suggests limitations in its effectiveness for other groups.

*On-demand PrEP can also be used by trans and gender-diverse people who were assigned male at birth and aren’t taking oestradiol-based hormones, as well as by trans men who don’t have a uterus or who don’t have receptive front hole sex.

With on-demand PrEP, the timing for taking your doses is extremely important.

To take PrEP on-demand, use the 2-1-1 dosing schedule:

• 2: Take 2 pills (double dose) between 2-24 hours before sex, then
• 1: Take 1 pill 24 hours afterthe double dose, then
• 1: Take 1 pill another 24 hours afterthat

If you keep having sex, continue taking 1 pill daily until 2 days after your last hook-up.

Summary

	Daily PrEP	On-Demand PrEP
Suitability	Everyone	Cis men and some trans people only
Pills needed	1 per day	4+ per ‘on-demand’ period
Protection	Continuous	Only around ‘on-demand’ period
Best for	Frequent and/or unpredictable sex	Infrequent and/or planned sex
Dosing	Simple routine, but daily	Requires the right timing
Cost	Higher (more pills)	Lower

 

How do I get PrEP?

With Medicare

If you currently have a Medicare card, you can access PrEP at a subsidised (reduced) cost.

This means you can go to any doctor or general practitioner and ask them to prescribe you PrEP. You can then take your prescription to any pharmacy for dispensing (collection). Keep in mind that you may have to pay for your doctor’s visit if they don’t bulk bill.

You can also bulk buy from online suppliers (see more info below).

Steps for getting PrEP with Medicare

1. Book a doctor’s visit
2. Ask for a STI/HIV screening + PrEP script
3. Go to a pharmacy and purchase using your script

Without Medicare

If you don’t have Medicare, a cheaper option is to buy PrEP online from overseas suppliers (Visit the PrEP Access Now website for more information).

You will still need a script from a doctor before ordering online. Doctors from a sexual health clinic will be able to prescribe a PrEP script for free. Alternatively, you can get a PrEP script from a GP, however this will cost money.

Ordering a few months at a time can save money. Always check that the medicine matches what’s written on your prescription.

Steps for getting PrEP without Medicare

1. Book a doctor’s visit at a sexual health clinic or GP
2. Ask for a STI/HIV screening + PrEP script
3. Find an online PrEP supplier
4. Order, pay and upload script
5. Wait for PrEP to arrive

 

For all the latest info on how to keep it real in the area, follow ACON Westie on Instagram, TikTok, and Facebook.