Pre-Exposure Prophylaxis (PrEP)

What you need to know

PrEP can be taken as a daily tablet or on-demand (sometimes called 2-1-1) PrEP which means a person doesn’t have to commit to taking it daily. On-demand PrEP can be used for specific events or periods of higher risk.
Both daily and on-demand PrEP, when used correctly, are some of the most effective tools we have against HIV.
While taking PrEP can prevent HIV, it does not protect you against other STI, BBV or pregnancy. It is something you can add alongside condoms and your other existing safer sex practices, not instead of them.

Is PrEP for you?

PrEP is recommended for anyone at higher risk of acquiring HIV. This includes:

cis and trans men, and trans women, who have anal sex with men without consistently using condoms
people who’ve had gonorrhoea or chlamydia in the anus or rectum
people who inject drugs, or who have unprotected sex with people who inject drugs
sex workers offering services with a higher risk of HIV transmission
people whose partner is living with HIV and hasn’t reached an undetectable viral load, (see below) where condoms aren’t consistently used
partners of people living with HIV who are trying to conceive

These criteria come from the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM), and they’re written as a guideline for clinicians. If any of the above are relevant to you, or you just aren’t sure, it’s best to speak to your health practitioner.

How well does it work?

Taken as prescribed, PrEP cuts the risk of HIV infection by around 99 per cent. It needs to be in your system before you’re exposed, which is why starting it ahead of higher-risk periods is essential.

Already living with HIV?

PrEP isn’t the right medication for you, and taking it won’t lower the risk of passing the virus on. However, daily antiretroviral treatment (ART) controls the amount of virus in the blood (the “viral load”) and protects the immune system from damage. Most HIV positive people in Australia manage this with a single tablet a day.

What is U=U?

When ART brings someone’s viral load down to undetectable levels, they cannot transmit HIV to sexual partners.
This is known as Undetectable Equals Untransmittable (U=U), and is backed by large clinical trials with zero transmissions recorded between couples where the HIV-positive partner had an undetectable viral load.
It’s one of the most important breakthroughs in modern HIV care, and it means that you can adequately assess risk with clients or partners.