Why everyone needs to know about PrEP

This article is also available in Simplified Chinese.

I first discovered PrEP after making a silly mistake.

It was my second year in Australia. My new-found sexual freedom saw me consent too easily to a high-risk encounter. I hardly knew the other guy but he assured me he was “safe”. They don’t call it unsafe sex for nothing.

The morning after, I panicked while thinking I may have contracted HIV.  On the advice of a friend, I went to the local sexual health clinic where I was given a dose of post-exposure prophylaxis, or PEP, right away.

I was told that PEP could significantly reduce the risk of HIV infection if taken within 72 hours. Basically, PEP works by stopping the virus from replicating, reducing the chances of it being able to take hold in your body.

During the month I was on PEP, I kept going over the encounter in my mind and the impact a positive test result would have on my life. I hadn’t even told my family I was gay, I kept thinking. I was angry at myself and the other guy involved. It actually turned me off even meeting other guys for a while.

In the end, I was given the all-clear, but during a follow-up consultation, my doctor recommended a medication called PrEP, which had just been approved in Australia.

Unlike PEP, which is taken after a potential exposure to HIV, PrEP is taken before and can be used over a prolonged period.

As an international student at the time, I was worried about the price. But having lived through a month of anxiety, I decided the price of not being on PrEP was much higher. (By the way, the drug itself is now much cheaper. More on that below.)

What we need to know about PrEP

 PrEP is talked about a lot in my circle of gay Chinese friends.

Some say they take it because they prefer sex without condoms. It’s worth remembering that PrEP doesn’t prevent other STIs such as syphilis, gonorrhoea and chlamydia, so if you are concerned about STIs, condoms are still a great option. Others discovered PrEP in a similar way to me.

There are also some myths.

I’ve heard some suggest that people taking PrEP ‘play too much’.  That kind of talk is not only plain wrong, it can lead to stigma. Let’s stop judging others and just stick with the facts.

Others believe they don’t need PrEP because they don’t think they’re at risk. But anyone not using a condom is at risk. It only takes one encounter to be exposed to any STI, including HIV. Minimising the risk is just responsible behaviour, nothing else. Why not take advantage of modern medicine?

The fact is, you often can’t be sure of the HIV status of people you hook up with. Not even they can always be sure. There is a window period between being infected with the virus and being able to detect it.

PrEP is like an extra layer of protection that is safe and effective.

If you are able to plan your sexual activity, you can chat to your doctor about options such as PrEP-on-demand which is basically specific doses timed around your encounters.

Then there’s periodic PrEP which is daily dosing for short periods of time. These relatively new dosing options are great for those who have concerns about taking medication every day.

I get regular check-ups and it seems PrEP has had no negative impacts on my overall health. I have a pretty awesome doctor who keeps an eye on these things for me. He also recommended me taking on-demand PrEP now.

For me, the biggest benefit from PrEP has been peace of mind. I don’t wake up the morning after an encounter with a tonne of regrets.

The thought of not having this little jar of pills beside my bed seems pretty scary to me now. I view taking PrEP in the same way as wearing a mask during the COVID pandemic. Why on Earth wouldn’t I?

How to get PrEP in Australia?

Some Chinese students think they don’t have access to PrEP. That’s not the case. It’s actually pretty easy to get here, compared to many other countries.

Anyone can get a prescription from a doctor, regardless of your visa status. They’ll take some blood tests to assess your kidney and liver function, and give you an HIV screening. It’s actually very simple.

If you have a Medicare card, you can purchase PrEP for a very reasonable price, because it’s subsidised by the government under the Pharmaceutical Benefits Scheme. If you don’t have Medicare, you may pay a higher price, but it’s still affordable. If you’re shopping online, make sure the source is legit, such as PAN.

At the very least, if you haven’t been on PrEP before and you have sex with other guys, have a chat to your doctor or read more by clicking on the links below.

If you would like more information about PrEP in Chinese, please visit the PrEP web page here. You can also call the NSW Sexual Health InfoLine on 1800 451 624. For Chinese interpretation services you can call 131 450.

Garrison Cheng came from mainland China and now calls Sydney home. He works in media as a journalist and producer with a focus on Chinese communities in Australia. He also helps manage ANTRA, an NGO for Chinese LGBTIQ+ communities. He has a passion for food and is a strong advocate of the Chinese saying: ‘Most problems can be solved over a good meal. For things that can’t, make it two meals.’