08 February 22

Ending HIV

Back to hooking-up? Get back on PrEP

In this article:

• Taken a break from PrEP but want to get back on it? Here’s what you should do!
• Get tested before restarting PrEP
• Check your PrEP tablets for ‘used by’ date and quantity
• Get a prescription from your GP as needed (and how to find a new GP)
• How you identify determines how you can take PrEP

It’s not a stretch to say that lots of guys have taken breaks from hooking-up over the course of the pandemic. This has also meant that lots of us have also taken a break from PrEP.

Now, as restrictions have eased from a state-wide lockdown, it’s no wonder why we’re back to getting it on. So, if you’ve taken a break from PrEP, then now could be the time to get reacquainted!

Here’s what you need to know about getting back on PrEP.

Get tested

If you haven’t had sex for a while then you might be thinking ‘I’m still HIV negative so I can just start taking PrEP again’ – and you may be right. But regardless of if you did or didn’t have sex while in lockdown, if you restart PrEP, you should get tested first.

PrEP works as a preventative method. If you happen to be HIV positive already and then use PrEP, it could limit your HIV treatment options later, and that’s not ideal.

For those of us who have moved homes and may be in more regional areas, you might not be familiar with what testing options are available in the new neighbourhood. Check out the where to get tested tool to see what your options are.

Check your PrEP expiry date and stock levels

It’s also a good idea to check the expiry date of your PrEP pills too. Yes, just like your credit card that you nearly maxed out while online shopping, your PrEP pills have an expiry date too.

Open that PrEP bottle to check your stock. If you’re running low, get a script from your doctor and stock up at your local pharmacy.

If you’re one of the many who made the sea change, finding and connecting with a new doctor or GP to prescribe PrEP may take a little time, notwithstanding any service changes due to COVID-19. With many GPs providing booster vaccinations, their capacity to accept new clients might be stretched, so be patient and plan ahead. If, for example, you think you’re going to run out of PrEP and can’t travel back to your usual GP for a script, you can ask if they can provide a script through a telehealth consultation.

If you aren’t sure if a local GP is up to speed on PrEP, you can print off this handy letter explaining what PrEP is and how they can help you with prescribing it and performing the required tests.

How do you identify?

Depending on how you identify, restarting PrEP and your options for how you continue to take PrEP will differ.

For cisgender guys who have sex with guys

To start or restart PrEP:

• Take 2 pills (double dose) between 2-24 hours before sex.

Yes, that time period is specific, but very important. You need this time for your body to absorb the medication and take effect before being potentially exposed to HIV.

Then, depending on your preferences and circumstances, how you continue to take your PrEP will vary, with doses and intervals that are also very important.

Daily PrEP

If you want ongoing protection, regardless of if you have sex or not in that 2-24-hour period:

• Continue taking 1 pill every 24 hours after the double dose.

You can have peace of mind, knowing you’re always protected for whenever sex might happen.

Eventually, if you think you won’t have sex for a while or want to stop taking PrEP:

• After the last time you have sex, take 1 pill daily for 2 days (keeping to the same 24-hour intervals as your initial doses).

On-demand PrEP

If you don’t want to take PrEP daily, there’s an alternative that’s just as effective. Known as ‘on-demand PrEP’, it can work for a lot of different situations. It’s a great for guys who can plan exactly when sex will happen, who may not have sex as frequently, or who simply do not want to take PrEP daily. Even if you think you might have sex but then don’t, it can be a good choice for you.

The basic protocol for on-demand PrEP revolves around having sex within the 2-24-hour period after taking the double dose.

If you have sex within that 2-24-hour period, your start-to-end schedule looks like:

• Take 2 pills (double dose) between 2-24 hours before sex, then after sex
• Take 1 pill daily for 2 days (keeping to the same 24-hour intervals as the initial double dose).

If you don’t have sex until after that 2-24-hour period – and let’s be real, sex isn’t always the easiest to schedule – whether it remains as just a one-time session or if you end up having more sex, you can stay protected by continuing to take one pill every 24 hours for at least two days after your last sexual encounter. Simply put, you can safely stop using PrEP once you’ve had two sex-free days.

If you have sex after that 2-24-hour period, your start-to-end schedule looks like:

• Take 2 pills (double dose) between 2-24 hours before sex, then
• Take 1 pill every 24 hours after the double dose, then after the last time you have sex
• Take 1 pill daily for 2 days (keeping to the same 24-hour intervals as the initial double dose).

For trans guys who have sex with guys

Starting or restarting PrEP for trans and gender diverse people is a bit different. Currently, daily PrEP is the only recommended method, and depending on the type of sex you’re having, your dosing schedule will vary.

If you only have anal sex with cis guys, to start and continue daily PrEP:

• Take 2 pills (double dose) between 2-24 hours before sex, then
• Take 1 pill every 24 hours after the double dose.

If you have all types of sex (such as frontal-sex) with cis guys, to start and continue daily PrEP:

• Take 1 pill 7 days before you have sex, and
• Continue taking 1 pill every 24 hours after that.

Eventually, if you think you won’t have sex for a while or want to stop taking PrEP:

• Keep taking 1 pill daily for 28 days after the last time you have sex (keeping to the same 24-hour intervals as your doses).

For everyone else

For everyone else, such as cisgender women and heterosexual men, it’s recommended to take PrEP daily.

To start and continue daily PrEP:

• Take 1 pill 7 days before you have sex, and
• Continue taking 1 pill every 24 hours after that.

Eventually, if you think you won’t have sex for a while or want to stop taking PrEP:

• Keep taking 1 pill daily for 28 days after your last hook-up (keeping to the same 24-hour intervals as your doses).