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PrEP

Roger Pebody

This briefing paper provides an overview of pre-exposure prophylaxis (PrEP) for people planning, commissioning or providing HIV prevention activities in the UK. It does this by reviewing thirty key questions about PrEP and how it might be implemented in the UK.

Thanks to Yusef Azad (NAT), Mitzy Gafos (Medical Research Council), George Valiotis (HIV Scotland) and Ingrid Young (University of Glasgow) for advice and feedback.

  • What is PrEP?

    Pre-exposure prophylaxis (PrEP) is an HIV prevention strategy that uses antiretroviral drugs to protect HIV-negative people from HIV infection. People take antiretrovirals (ARVs) when they are at...

  • Why is PrEP needed when effective prevention methods are already available?

    Male and female condoms, when used consistently and correctly, are highly effective against HIV. Moreover, a diverse range of behavioural interventions have been implemented since the 1980s....

  • PROUD study graphic

    Over 500 men who have sex with men were enrolled into the PROUD study in England. Click on the graphic to see a larger version....

  • How effective is PrEP?

    When considering PrEP for men who have sex with men in the UK, the most relevant data come from the PROUD study, which was conducted in England...

  • Key PrEP studies

    A wide range of results have been reported in other PrEP studies, with some finding high effectiveness and some none at all. Click on the table...

  • How adherent do people need to be for PrEP to be effective?

    By testing participants’ blood for the presence of PrEP drugs, researchers have attempted to estimate the number of PrEP doses they have actually taken. They have then...

  • What are the side-effects of Truvada?

    As with other ARVs, Truvada can cause short-term side-effects including nausea, tiredness, gastrointestinal symptoms and headache. These are typically experienced by up to one-in-ten people during the first...

  • What’s the risk of drug resistance developing?

    When someone has drug-resistant HIV, this means that the HIV in their body has some mutations. Because of the mutations, some anti-HIV drugs may not work well....

  • How might PrEP users change their sexual behaviour?

    Does the protection given by PrEP encourage people to use condoms less than before, or to have more sexual partners? Some people have been very concerned by...

  • What do PrEP users say about the experience of taking PrEP?

    Interviews with gay men taking PrEP show that they see themselves as being at risk of acquiring HIV and very much want to stay HIV negative. PrEP...

  • How many people are taking PrEP in the UK?

    The 544 participants of the PROUD study will continue to receive PrEP until April 2016. Outside of this, current policy is that the NHS should not provide...

  • Is Truvada licensed for use as PrEP?

    The drugs used in PrEP are already licensed for use as part of treatment for HIV-positive people. Although the European Medicines Agency has not yet licensed the...

  • How long will people take PrEP for?

    People are not expected to stay on PrEP forever. Experience from the United States shows that people stop taking it when they no longer feel at risk,...

  • Is PrEP cost-effective?

    Although PrEP is much more expensive than most other HIV prevention methods, studies suggest that it may be cost-effective in some circumstances. Moreover, it may sometimes be...

  • How should provision of PrEP be targeted in the UK?

    PrEP policies should be based on the specifics of local epidemiology so that PrEP reaches individuals who are most likely to benefit from it – those who...

  • What do international guidelines say about PrEP?

    The World Health Organization recommends that in all countries, PrEP should be available to men who have sex with men, alongside other HIV prevention interventions. It may also...

  • What other services need to be provided alongside the drugs?

    People thinking about using PrEP need to be given enough information about PrEP and other prevention options to help them decide whether PrEP is appropriate for them. The...

  • Who will pay for NHS provision of PrEP and how will decisions be made?

    In England, the cost of the drugs used as PrEP would be borne by NHS England, whose specialised services team is responsible for all commissioning of antiretroviral...

  • Could other drugs and delivery methods be used as PrEP?

    So far most studies have examined the use of Truvada (tenofovir and emtricitabine) pills as PrEP. But PrEP using a single-drug regime of tenofovir could be possible...

  • Key points

    Pre-exposure prophylaxis (PrEP) involves HIV-negative people taking antiretroviral drugs to lower their risk of HIV infection. Several studies have shown it to be effective as long as...

PrEP

Published July 2015

Last reviewed July 2015

Next review July 2018

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.