What Is HIV PrEP?

Pre-exposure prophylaxis or PrEP is a type of medication that, when taken as prescribed, can prevent HIV infection. This medication is only suitable for those who do not have HIV but are at higher risk for HIV infection.

PrEP helps to reduce the risk of contracting HIV.

At the moment, two medications have been approved for PrEP. When taken regularly, they are both effective at reducing the risk of transmission of HIV.

How Does PrEP Work in HIV Prevention?

The two medications used for PrEP belong to a group of antiviral drugs called nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs). These drugs work by preventing the process of multiplication by the HIV virus.

Before you start PrEP, it is advised that you see a doctor and get tested for HIV. It is important that you are negative for HIV before starting PrEP. On top of that, the doctor will also advise you to do a blood test to check your liver and kidney function to make sure they are normal.

For subsequent follow-ups, You are advised to see the doctor every three months for HIV and also check for common STDs like syphilis, chlamydia, and gonorrhoea.

If you did not test for HIV before starting PrEP and were later found to be HIV positive while taking PrEP, you may develop drug resistance, and this may affect the treatment of your HIV infection.

Why It is Also Important to See a Doctor Before Starting Prep is so that you can also receive proper counselling and advice on the proper use of PrEP.

PrEP counselling includes but is not limited to:

1. Type of drugs to take
2. How to take PrEP
3. Importance of compliance
4. Side effects to look out for
5. Importance of regular monitoring
6. Risk of contracting STDs

What are The Different Types of PrEP Available in Singapore?

The two approved PrEP medications are Descovy and Truvada.

Truvada

Truvada consists of emtricitabine and tenofovir disoproxil fumarate. It is approved for use both as daily PrEP and also on-demand PrEP.

Descovy

Descovy is the latest medication approved for PrEP. It contains the components emtricitabine and tenofovir alafenamide.

Currently, Descovy is only approved as daily PrEP and is not yet approved for use as on-demand PrEP. It is also not approved for use in women.

Who is Suitable to Take PrEP?

Those who are good candidates for PrEP are listed as but not limited to the following:

• Have a sexual partner who is HIV positive
• Inconsistent use of a condom
• Have contracted a sexually transmitted infection (STI) in the past six months
• Drug users who share needles (syringes)
• Have an injection partner who has tested positive for HIV
• Have been prescribed postexposure prophylaxis multiple times
• Risks vs. benefits of taking PrEP

Pros

• Very effective in HIV prevention
• Convenient daily pill dosing
• A good option for sero-discordant couples (only one partner is HIV positive) when trying to conceive
• Compliance is important

There are potential side effects.

• Possible side effects
• Some common side effects of both medications include:
• Diarrhoea
• Fatigue
• Headache
• Nausea

If you feel you may be at risk for contracting HIV, do speak to our doctor to find out if PrEP is suitable for you and how you can get started on PrEP.