Let's talk about PrEP and PEP, baby

HUD App is thrilled to partner with Stigma Health, Australia’s largest online sexual health clinic group, to educate and empower dating app users to take control of their sexual health and wellbeing.

What are PrEP and PEP, and how can they help prevent the spread of HIV? PrEP and PEP are actually the same treatment used in two different ways (we'll explain this shortly). They use a combination of the same drugs used to treat HIV, which act to fight the virus as it tries to infect immune cells. For adults, the CDC recommends tenofovir and emtricitabine (available in one pill), along with a third drug (either raltegravir or dolutegravir). In some countries, the usual treatment includes only the first two drugs.

What's the difference between PrEP and PEP?

Whether you're taking it as PrEP - pre-exposure prophylaxis - or PEP - post-exposure prophylaxis - depends on when you're taking it and the reason you're taking it for. Broadly, PrEP/PEP is designed to prevent people from contracting HIV.

Pre-exposure prophylaxis - PrEP - means you take it as a preventative measure. This means you don't already have HIV but may be at risk of getting it. It comes in pill form, which you take every day, or in some countries you may be able to get PrEP as an injection that you receive every two months. If you're on PrEP, and you are exposed to HIV, the medication can stop HIV from taking hold.

Post-exposure prophylaxis - PEP - means you take it as an emergency measure, after you have potentially been exposed to HIV. PEP needs to be started within 72 hours of HIV exposure and taken for 28 days.

How effective are PrEP/PEP?

When it's taken properly, PrEP/PEP reduces the risk of getting HIV via sex by up to 99%, and reduces the risk of getting HIV from injection drug use by at least 74%. PrEP/PEP only protects against HIV, though, so you still need to use a condom or other barrier methods to protect yourself against other STIs.

Like all prescription medication, you need to take PrEP/PEP exactly as your doctor tells you to. That's how you get the best possible outcome. If you aren't able to take PrEP/PEP correctly, you might be increasing your risk of contracting HIV.

<subhead> So who should get on PrEP?

PrEP is designed for people who are at high risk of exposure and therefore, high risk of infection with HIV. PrEP is for all who are high risk, and if you feel you are at risk of HIV you should seriously consider PrEP. To identify whether you are at high risk of contracting HIV, consider these questions:

• Are you a man who has sex with men? (MSM)
• Are you engaged in sex work?
• Do you engage the services of sex workers?
• Do you engage in group sex?
• Do you have an HIV positive partner?
• Are you / your partner an injectable drug user?

If you answer yes to any of these, then you’re at risk of acquiring HIV and PrEP is for you. PrEP works so well that it is recommended all at-risk people should be on treatment.

So when would I take PEP?

You should consider getting PEP if there’s a high probability you have been exposed to HIV and:

• You’ve had unprotected vaginal or anal sex – for example, where you deliberately haven’t used a male or female condom, or where you’ve used a condom, but it has broken or slipped off during sex.
• You’ve had high-risk unprotected oral sex (giving or receiving) – i.e., where you and/or your partner haven’t used a dental dam or male condom, and you or your partner have poor oral health (i.e., cuts or sores in the mouth or on your lips, gum disease or bleeding gums); though it’s rare for HIV to be spread through oral sex.
• You’ve shared injecting or tattooing equipment with someone who has or may have HIV.

Can't I just take PEP on an as-needed basis?

PEP is not a substitute for unprotected sex. If you're regularly having sex with a partner who has HIV, or you're in situations where you're being exposed to HIV often, taking PrEP is likely to be a safer, more responsible option. You should talk to your healthcare provider about this and get some comprehensive advice about safe sexual practices which include PrEP. And remember, if you aren't able to have safe sex every time you have sex, you really shouldn't be having sex at all.

If I'm on PrEP, can I just go wild?

We're going to be honest here: We're aware of a concept within the LGBTQIA+ community called "risk compensation", which means people using PrEP may be prone to taking more risks with their sexual activities, such as not using condoms, relying on PrEP alone to confer a sense of safety and protection. Feeling safe from HIV is an incredible feeling (and well-deserved by our gay community, who have been unfairly scaremongered for a long time), but HIV is not the only STI out there. PrEP only prevents the spread of HIV - you still need to use a barrier method (condoms and dental dams) to help protect against other STIs like gonorrhea, chlamydia, and syphilis.

How do I get PrEP or PEP?

PrEP and PEP are available via prescription from your doctor or sexual wellness practitioner. Search for "PrEP near me" in your internet browser and you'll get a list of places near you where you can obtain PrEP and PEP. You will need to undergo HIV screening and STI testing and there is a level of monitoring which you will need to engage in - regular blood tests and doctor appointments, for example. There are some risks to taking PrEP/PEP if you have medical conditions or take other medications, so you will need to talk to your doctor about these so you are both certain PrEP/PEP are the right option.

Online testing options like PrEP Health in Australia allows you to order PrEP online, get your initial pathology referral, and then ongoing service including HIV testing and medication is delivered anywhere in Australia contact-free with ongoing care.

So go forth and spread love and pleasure, not HIV - and have PrEP and PEP as effective tools in your arsenal of protection and prevention.