Essential things to know before you start PrEP
On the day of or just before starting PrEP you’ll need to have a few tests.
Ideally, we’d like you to have:
- A full sexually transmitted infections (STI) screen. We recommend a full STI screen every 3 months – even if you don’t have any symptoms.
- What is called a ‘fourth generation HIV antibody antigen test’. These tests have a much shorter ‘window period’ of 4 weeks than other tests. They can give an accurate result 4 weeks after potential exposure to HIV. It’s a good idea to repeat the fourth generation HIV test after 4 weeks to make sure an acute or recent infection was not missed by the first test.
- A hepatitis B test, to rule out an active hep B infection. The the drugs in PrEP can also supress the hep B virus and we’d take this into consideration when helping you start or more importantly stop taking PrEP.
- A blood test to check your kidney function. In a very small number of people PrEP can damage renal (kidney) function. This is rare and usual only in people with existing kidney problems or taking other medication that may affect their kidneys.
Managing PrEP yourself
We understand that you might manage your PrEP routine on your own. You may have bought generic PrEP online because you can’t access a trial or other proper NHS provision.
We want to help you do this the best we can.
If you are in this situation, the only thing you really need before starting PrEP is the fourth generation HIV antibody antigen test, again repeated in 4 weeks. Most people should be able to access this at the very least.
And again a full STI screen every 3 months is recommended – even if you don’t have any symptoms.
Ask about your vaccinations for hepatitis A, hepatitis B and HPV.
Getting sexual health clinic support
Remember that some frontline staff in the NHS – such as reception staff – might not be fully aware of PrEP, especially if their clinic currently does not offer PrEP support.
Many other NHS staff will know about PrEP, and support it, but might be unaware of what support they are able to offer.
Facts about drug resistance
If you are HIV negative and taking PrEP, as long as you stay negative you don’t have to worry about drug resistance.
Your body does not ‘get used to the PrEP’ and stop protecting you from HIV. (Don’t worry, we know it is common for people to get confused about this.)
You can only develop drug resistance if you actually have HIV in your system – if you’re HIV positive. That’s why it’s so important to make sure you’re definitely HIV negative before you take PrEP.
Drug resistance can happen to people living with HIV, where the virus in your body develops a resistance to drugs. It is not your body developing a resistance to the PrEP medication.
Take PrEP – stay negative.