Us queers are a creative bunch… and though some of us may be tempted to start mixing up our PrEP dosing to meet our ever-changing calendars, it’s very important to use PrEP as advised.
You may have heard that PrEP can now be taken in different ways; daily, on-demand and periodically. It’s really awesome news! And so, you may have also heard of guys taking their PrEP in a bunch of different ways where they think they were doing it safely.
But as with all medication, not taking it correctly can have serious consequences, and in the case of PrEP, it could mean you may not be properly protected from HIV.
Let’s dispel some myths about PrEP that you may have heard or thought of.
PrEP myths you may have heard about
1. With PrEP on-demand, if I forget to take my double dose 2 hours before sex, I can just take it immediately after the hook-up
After the hook-up, it’s unfortunately too late to start your PrEP on-demand schedule. You will only be protected by PrEP on-demand if you take the starting double dose between 2 and 24 hours before sex, as your body needs time to absorb the medication. Think of it like sunscreen – it’s most effective if applied before you go out in the sun, and it’s not effective at all if applied after being out in the sun.
If this were to happen to you and you’re in NSW, then you should call the PrEP Info Service (Monday to Friday 9am-5:30pm) to discuss if you may need PEP, which is a course of medication. PEP stands for ‘post-exposure prophylaxis’ and if taken within 72 hours after a potential exposure to HIV, it can prevent infection. If outside of operating hours, call the PEP hotline on 1800 737 669 (24 hours a day).
2. I’ve always taken PrEP daily, and even though I’m not having that much sex I need to take it daily forever
There is good news and then there is better news! The good news is that you don’t have to keep taking pills daily if you don’t want to – you can swap between the different methods or even stop altogether. The better news is that both on-demand and periodic PrEP, if done right, can give you the same protection as daily PrEP, while not having to commit to daily dosing!
If you are only hooking-up occasionally, say less than twice a week, and are a cisgender guy who has sex with guys, then on-demand PrEP could be for you. With periodic PrEP, you only need to take PrEP on a daily basis over the duration of a period when you’ll be having sex and want protection, be that a couple weeks to a month or so long.
3. I stopped PrEP while in a relationship which has now ended. I still have some PrEP leftover, so I’ll just start taking it again and go back to my doctor when I run out
First up, it’s great that you want to get started back on PrEP! However, before you jump straight back into it, there are a couple of things to consider. It’s best to have a check-up with your doctor to get tested for HIV, other STIs and check your kidney health. While you are there you can ask your doctor about the new ways you can take PrEP and any other questions you might have about restarting.
Another thing to consider is the expiration date of your remaining PrEP pills. While medications can last for some time, if you use pills that are expired, they may not do their job. Make sure you are protected and double check the expiry date on the packaging.
4. I’ve been using daily dosing but want to save money, so I’ll only take 4 or 5 pills each week
PrEP can be expensive for some, so it’s understandable to want to minimise cost by reducing the amount of medication you take. While there is some research to suggest that taking PrEP between 4 to 5 times a week can still offer a level of protection, it is currently not an endorsed method for taking PrEP and there is a greater risk for those who take their medication in this way. In the event you miss one of the doses, your risk of infection increases, and you would not benefit from the buffer that taking PrEP 7 days a week would have.
Instead, if you are money conscious, you can consider checking out the PrEPAccessNow website for cost-effective options. Or if you’re wanting to reduce the amount of medication you are taking, discuss swapping to either on-demand or periodic dosing with your doctor.
5. I took the on-demand double dose correctly, but missed the follow-up dose. If I just do another double dose that will make up for it
While you usually get points for creativity, when it comes to on-demand dosing it’s crucial you stick to the specific dosing guidelines. While you do get some protection from the initial double dose, by missing the follow-up dose you may be at risk of infection. In an instance like this, you should seek medical guidance as soon as possible.
If you are in NSW, you can call the PrEP Info Service (Monday to Friday 9am-5:30pm) to discuss if you may need PEP, which is a course of medication. PEP stands for ‘post-exposure prophylaxis’ and if taken within 72 hours after a potential exposure to HIV, it can prevent infection. If outside of operating hours, call the PEP hotline on 1800 737 669 (24 hours a day).
If you are finding it difficult to stick to the on-demand schedule, consider if taking it daily or on a periodic basis would work better for you.
6. Now that I’m taking PrEP on-demand, I can skip the 3-monthly check-ups with my doctor and just go back when I need a new script
You can’t deny that a benefit of using either on-demand or periodic PrEP is that you will use less medication over time and save money. It also means less visits to the doctor, right? Well, not exactly. While it seems easier to alter your doctor visits to only when you need a PrEP script, keeping up your 3-monthly check-ups is still super important. These visits mean you are getting tested regularly for HIV and STIs, and is a good opportunity to catch up with your doctor to chat about your PrEP use.
Have a question about PrEP?
Always speak with your prescribing doctor if you have any questions about taking PrEP correctly. Otherwise you can ask us a question about PrEP here.