PrEP

PrEP can work for loads of people. You can decide for yourself if PrEP is the right tool for you to protect yourself from HIV.

Some of the reasons guys like us might choose to use PrEP might be that you…

• Don’t always use condoms when fucking people whos HIV status you don’t know – or HIV-positive partners with a detectable viral load.
• Had condoms break, fall off, or not get used the whole time you’re fucking
• Woken up after a fuckfest, and not sure if you used a condom with everyone you intended to
• Are often the bottom (receptive partner) and want to have full control over your STI prevention
• Have had an STI in the arse
• Use chems like meth when hooking up occasionally
• Have accessed PEP (post-exposure prophylaxis) before after a potential exposure to HIV

~OR~

None of the above right now, but your situation may change soon. Headed over for a fuckfest in Berlin or off to Mardi Gras for a down an’ dirty weekend?

Even if you said no to all of the above, and you still feel PrEP might be the right tool for you – have a chat with your doctor.

To start PrEP head along to your doctor. If you already have a good sexual health doctor, chances are they’re already prescribing PrEP to other guys they see.

Any GP can prescribe PrEP, but some are more familiar with PrEP than others. You can find a doctor who prescribes PrEP in your area. If your current doctor doesn’t know about PrEP – there are tools to get them up to speed.

When you start PrEP you’ll talk about some of the stuff we mentioned above. Try to be as open an honest with your doctor as you feel comfortable doing so they can help you decide if PrEP might be right for you.

The doctor will do an HIV test, and screen for other STIs as well. They will also check your kidney function, and talk about other vaccinations for your sexual health – like for HEP A.

With PrEP now listed on the PBS you can fill your PrEP script at the local pharmacy. You can also buy PrEP online to have it shipped discreetly to your door. Buying online takes a bit longer, so plan ahead and make your next appointment well ahead of time.

No medicare? No problem. You don’t need a Medicare card to buy PrEP online. For those under financial hardship, students, or part-time workers you can access a PrEP coupon to get free PrEP. Simply apply online by using your ID and prescription.

You can start PrEP right away – you don’t need to wait for your tests to come back. Your doctor will tell you once your tests come back if PrEP isn’t right for you – taking a week or so of PrEP won’t matter.

Daily PrEP is the way most guys would be familiar with PrEP. You may have seen information around talking about PrEP being a pill you take every day. That’s one way to take PrEP and it’s incredibly effective.

Why do it Daily?

Daily PrEP offers round the clock protection. So long as you keep up taking your PrEP daily – no matter what happens in the bedroom (or club, or alley, or dark room) you’re protected. Daily PrEP also works for everyone and the ways they like to fuck. Daily PrEP works great for trans guys and folk having vaginal/front-hole sex.

How to start: 7 to get going

Take a single PrEP pill every day for a week. Once you’ve got 7 days of PrEP in your body – you’re protected from HIV when fucking without condoms.

Keep going: 1 per day

Take a single pill each day. the time of day doesn’t matter if your routine changes. However, if you forget to take it and it’s closer to the time you would take your next pill than the one you missed – simply skip that dose. There’s no need to ‘double-down’

Time to stop: 28 days to cool off

PrEP doesn’t have to be forever. Maybe you and your partner just decide to only fuck each other, or you bring condoms back into the mix full time. You can stop PrEP when it suits you. Simply take PrEP for another 28 days after your last sex without condoms where HIV could be present. If you fuck without condoms during that ‘buffer’ period, and you’re concerned about HIV – just keep taking PrEP until you’ve got 28 days of HIV risk-free sex.

It’s a good idea to have a chat with your doctor about stopping PrEP.

Wanna start PrEP again?

Fucking fantastic! you can start and stop PrEP during the times you need it.

Just pop back to your doctor for some more tests. If you’ve got PrEP left over from last time, you can keep using it so long as the PrEP is in date – just check the bottle package.

On-Demand PrEP is another way you can use the power of PrEP to remain HIV-negative. It involves taking the same anti-HIV medications as Daily PrEP – just round the times you need it’s protection rather than each day.

Why do it On-Demand?

Whether you take your PrEP daily or On-Demand you should talk to your doctor about which is the right choice for you. On-Demand PrEP has not been proven to provide good protection for vaginal/front-hole sex. Trans guys can still benefit from amazing protection by using Daily PrEP.

Some of the reasons guys might take their PrEP on-demand might be that they are:

• In a mostly monogamous relationship with an agreement about protection within the relationship. PrEP might only be needed here and there when fucking new partners.
• Not having sex that often! If sex doesn’t happen that often, you may prefer to take less medication.
• Experiencing ongoing side effects from PrEP. Most people don’t experience side effects on PrEP, but taking less of the medication may suit some guys who do.
• Needing some flexibility. If you use condoms most of the time but want the option with certain partners to mix it up, you want that choice.
• Having a sex holiday! you’ve got your protection strategy sorted here at home, but if you’re traveling and want a bit of freedom to fuck and stay protected you can opt-in to PrEP for a short while.

How to start: 2 to start up

Ok, so you’ve got a hot fuck coming round? Great! Take two PrEP pills together between 2-24 hours before you’re planning to fuck. 2 hours is the latest you can take it – so that your PrEP has enough time to absorb into your system.

Keep going: 1 pill 

Take a single PrEP pill 24 hours after your first double dose. It’s important to time this dose 24 hours after your 2 ‘starter’ PrEP pills, not based on when you actually fucked.

Time to stop: 1 more pill

Take another single PrEP pill 24 hours after your last  dose. You’re done! So long as you have had two sex free days where you took PrEP you’re protected!

What happens if…

Now that’s all well and good for a single fuck – or maybe one session, what happens if your sex isn’t as simple as that? Well, if:

They cancel: That hot guy off the apps you’re planning to fuck tonight went cold – or plans changed? If you’ve already taken your two ‘starter’ pills – no stress. Simply don’t take the two single ‘after’ pills.

Get lucky again: Say you have a great fuck, and then a few hours later you have another great fuck. Awesome! So long as you haven’t taken your either of the single PrEP pills – just follow the golden rule as above, like this: [2 + SEX+ 1 + 1]

Another day, another fuck: If you’re doing it On-Demand, and you’ve taken your single PrEP pill after sex, but then get another fuck… great! all you have to do is add an extra day of single PrEP, like this:

[2 + SEX+ 1 + SEX + 1 + 1] You’ve had two days of PrEP after your last sex. You’re covered.

Fucking later on: If you have a fuck, and finish up your On-Demand PrEP, then you have another fuck planned within a week – you don’t need to double dose! So long as your next fuck is 7 days or less since your last PrEP pill, your ‘starter’ PrEP becomes a single PrEP pill, like this: [2 + SEX+ 1 + 1 … + 1 + SEX+ 1 + 1] You still finish up the same way, with two sex free days of PrEP.

Fuck in a week: If you finish up your fuck and On-Demand PrEP and have a sex session planned more than a week after your last PrEP, just start the PrEP cycle all over again, like this: [2 + SEX+ 1 + 1 ……..  2 + SEX+ 1 + 1] Basically you’re just doing On-Demand PrEP twice.

Confused?

Is the way you’re doing On-Demand PrEP is starting to feel a bit like being back at school and you’re concerned about the timing and doses? Have a think about if Daily PrEP might just be an easier solution.

Stopped and wanna start PrEP again?

Fucking fantastic! You can start and stop PrEP during the times you need it. You don’t need to go for a checkup after each time you use On-Demand PrEP. you do need to return for a check up every 3 months with your doctor, even if you’ve still got PrEP pills left.

So long as your PrEP pills are in date you don’t need to refill your prescription, just check the package or bottle for the date. Your prescription will be written for 30 pills with two repeats. If you’re doing On-Demand you can always pick up one bottle, and save your prescription with the repeats for later – rather than get all 90 pills at once.

PrEP offers powerful protection from HIV – with very minimal side effects. In fact, the vast majority of guys who start PrEP don’t notice much of a change other than the feeling of protection that PrEP offers.

A small group of folks who take PrEP may experience some side effects when they start PrEP that go away within a few days to a week or so. For that small number of people, these commonly show up as:

• An upset stomach; diarrhoea and stomach pains
• Headahces
• Vivid dreams
• Mild insomnia

If you experience these side effects most of the time it’s perfectly ok to just wait for them to subside. You can always pop back to your doctor for a chat if you have concerns, or your side effects don’t go away. some PrEP users have told us that they stopped PrEP because of side effects but started PrEP again later – and experienced those side effects again. For some guys, it may be easier to stick with it.

What about long term?

Truvada, or generic Truvada, is the only licensed medication in Australia to use as PrEP. This medication was chosen over others because we already knew that side effects on it were mild if non-existant. After all, it has been used to treat people living with HIV for years. Truvada – and generic versions – can impact renal (kidney) function in som people. Your doctor will monitor your kidney function every month. Even if you have had kidney issues in the past, or only have one, this doesn’t necessarily stop you from starting PrEP. Talk to your PrEP prescribing doctor.

PrEP users can also experience mild bone density loss. The good news is that this all goes back to how it was before you started PrEP if you decide to stop.