It’s PrEP Awareness Week: the annual campaign to spread the message that Pre-Exposure Prophylaxis (PrEP) prevents HIV transmission. Dr Alan McOwan, consultant at sexual health clinic 56 Dean Street, discusses why PrEP is the best weapon we have against HIV and asks Boyz readers to take action.
While new HIV transmissions are falling, the recent focus on monkeypox in the LGBTQ community is threatening this progress by diverting attention and resources away from PrEP: in a recent survey of UK sexual health clinics conducted by the British Association of Sexual Health and HIV, over 42% reported that monkeypox had reduced access to PrEP at their service.
The impact of monkeypox on those accessing PrEP is a worrying development. The purpose of PrEP Awareness Week is to keep HIV transmissions on the decline – especially amongst those who are 18-25 years old and may be less aware of HIV prevention initiatives and treatments such as PrEP.
‘Diagnoses of HIV in young gay men have actually risen outside London’
PrEP has been a game changer in the last few years, says Dr Alan. New diagnoses of HIV have fallen by over 90% at Dean Street. However things have levelled off recently. Diagnoses of HIV in young gay men have actually risen outside London. Figures show that this group are also least likely to be taking PrEP. That’s one of the reasons we’re running PrEP Awareness Week. It’s vital we get the PrEP message out to everyone. I’m asking every Boyz reader to find someone who doesn’t know about PrEP and tell them about it.
PrEP has been a game changer in the last few years, says Dr Alan from 56 Dean Street
56 Dean Street prescribed almost half of England’s PrEP in 2021 and it really is the best weapon we have against HIV, so here are the most important things you need to know.
PrEP, which is free from all NHS sexual health clinics, involves taking pills containing the drugs tenofovir and emtricitabine to protect you from catching HIV. To do this, it must be started before sex. Studies show that if you take two pills, you’ll protected for anal sex in as little as two hours. Then continue one pill a day until you’ve taken at least 2 doses after your last risk. People often ask me what to do if they don’t have two hours before sex. I advise people to start the PrEP anyway. There will be some protection. If in doubt it’s definitely better to start the PrEP and then call your sexual health clinic for advice the next day.
PrEP is brilliant for prevention during periods of risk, but not powerful enough to treat HIV by itself. If you take PrEP while you have HIV without knowing, the HIV virus may become resistant to the medicines in PrEP. This can make the HIV more difficult to treat. For this reason it’s essential to do an HIV test just before you start PrEP, and to keep testing regularly when you’re on PrEP. An HIV test every three to six months is recommended.
Most people don’t get any side effects at all. The most common are mild bloating and nausea which generally settle within ten days of starting. It’s also important to check your kidney function when you first start PrEP as, in a very small number of cases, PrEP can affect your kidney function. We will also do a Hepatitis B test as you cannot stop/start PrEP if you have an active Hepatitis B infection.
‘I’m asking every Boyz reader to find someone who doesn’t know about PrEP and tell them about it’
People sometimes think that they can’t take creatine and PrEP together. However, it’s generally fine. However, it’s a good idea to stop taking creatine and other gym supplements a few days before you come in for tests, because this can sometimes confuse the kidney blood results. Most people just need their kidney blood test checked once a year while on PrEP.
If your sexual partner is HIV positive with an undetectable viral load, they cannot pass HIV to you. So if they’re your only sexual partner, you don’t need to take PrEP. Your partner’s meds are doing the job.
There are sexual health clinics all over England, Scotland, Wales and Northern Ireland where you can get free PrEP. Find them here.
While monkeypox has understandably dominated news headlines of late, it’s impact on those who should be accessing PrEP is all too real as we’ve also seen HIV diagnoses rise in several groups. We want to encourage all those at risk to find their nearest sexual health clinic and get on PrEP by visiting our website at getonprep.co.uk. It’s really that simple.
Dr Alan McOwan is a consultant at 56 Dean Street, part of Chelsea and Westminster Hospital NHS Foundation Trust.
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