Pre-Exposure Prophylaxis (PrEP)

What is PrEP?

PrEP or pre-exposure prophylaxis is medicine people at risk for HIV take to prevent getting HIV from high-risk behavior like unprotected sex or injection drug use.

What is the medication being used as PrEP?

There are many options for generic medications for PrEP in Malaysia. Commonly, TENOF-EM/ TENVIR-EM is prescribed for this. Both these medications are approved medications that can be used as PrEP. They consist of Emtricitabine 200mg and Tenofovir Disopraxil Fumerate 300mg. It is safe to use for all people at risk for HIV through sex or injection of drugs.

Is PrEP suitable for me?

Before you take this medication, your doctor will do a HIV screening test to make sure you are HIV negative.

For those who are at risk as below to get HIV and are currently HIV negative should take PrEP:

  • Have a sexual partner who is HIV positive especially when the partner has a detachable viral load.
  • Have not always use condom
  • Have been diagnosed with STD during past 6 months
  • Have an injection partner
  • Share needle or syringes with other for drug injection

How can I start PrEP?

It’s always best to start by talking to your doctor. Usually before doctors prescribe you PrEP, HIV screening test will be done to confirm that you are HIV negative. While taking PrEP, you need to visit your clinic 3-6 monthly for follow-up visits, HIV tests and prescription refills.

How do I take PrEP?

Usually, you will be prescribed at least one month’s dose of PrEP. You will be instructed to take one tablet per day daily. Some people don’t like to take it on a daily basis as they are not at ongoing risk of getting HIV. For these circumstances, you can take PrEP on-demand basis. For on-demand PrEP, you need to take based on “2-1-1” schedule. This means taking 2 pills 2 to 24 hours before sex, followed by 1 pill 24 hours after the first dose and 1 pill 24 hours after the second dose.

How effective is PrEP?

Studies show that PrEP is highly effective for preventing HIV. PrEP reduces the risk of getting HIV from sex by about 99% if taken according to doctor instruction. However, protection for getting HIV from drug injection is not as effective, it only protects up to 74%. The most important regarding taking PrEP is that you must take as doctor’s prescription. If not, the protection rate will not be as effective as it should be.

Hong long do I have to take PrEP before it is highly effective?

PrEP reaches maximum protection from HIV for receptive anal sex at about 7 days of daily use. For receptive vaginal sex and injection drug use, PrEP reaches maximum protection at about 21 days of daily use.

Do I still need to use condom if I take PrEP?

PrEP only provides protection from HIV. So, you will advise continuing to use condoms in order to prevent other sexually transmitted diseases (STD) that can be transmitted through genital fluids.

Is PrEP safe to take and are there any side effect?

PrEP generally is safe to use. No significant health effects have been seen/ reported in people who are HIV negative and have been taken PrEP for up to 5 years. However, in some people PrEP can cause minor side effects like nausea, diarrhea, headache, fatigue and dizziness. But all these side effects are usually not serious and will go away over time.
In some rare cases, PrEP can affect kidney functions.

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