PrEP is a drug taken by HIV-negative people before sex that reduces the risk of getting HIV.
PrEP, short for Pre-Exposure Prophylaxis, is one of the most significant advances in HIV prevention in modern medicine.
When taken correctly, PrEP reduces the risk of acquiring HIV through sexual contact by well over 99%, making it one of the most effective preventative interventions available in any area of healthcare.
At The Wright Practice, we provide comprehensive PrEP assessment, prescribing and ongoing monitoring tailored to individual circumstances.
PrEP is a medication taken before potential HIV exposure in order to prevent infection becoming established within the body.
Unlike PEP (Post-Exposure Prophylaxis), which is taken after a potential exposure, PrEP is designed to provide protection before exposure occurs.
The medication works by preventing HIV from replicating within the body should exposure occur. If HIV is unable to establish infection, transmission is effectively prevented.
In the UK, PrEP most commonly consists of a medication containing two antiretroviral drugs: tenofovir disoproxil and emtricitabine.
Many patients know this medication by the original brand name Truvada®, although several equivalent generic formulations are now available and are equally effective.
These medications have been extensively studied and have formed the foundation of modern HIV prevention programmes worldwide for many years.
PrEP may be appropriate for a wide range of individuals.
Examples include:
The decision to start PrEP should always be individualised and based on a discussion of personal circumstances, sexual practices and risk profile.
Many patients are surprised to learn that PrEP is no longer reserved for traditionally high-risk groups and may be appropriate for anyone who wishes to reduce their risk of HIV acquisition.
When taken correctly, PrEP is extraordinarily effective.
Large international studies have demonstrated reductions in HIV acquisition of greater than 99% for sexual transmission when medication is taken as prescribed.
In practical terms, HIV acquisition whilst taking PrEP correctly is exceptionally rare.
The vast majority of documented cases occur in situations involving:
For this reason, assessment before commencing treatment remains important.
Daily PrEP involves taking medication every day regardless of sexual activity. This is the simplest regimen and is suitable for most patients.
Advantages include:
For many individuals, daily dosing becomes part of a normal daily routine and offers the greatest peace of mind.
Some individuals may be suitable for event-based PrEP, sometimes referred to as “on-demand” or “2-1-1” PrEP.
This involves taking:
Event-based dosing is supported by strong evidence in certain populations, particularly men who have sex with men. However, it is not suitable for everyone and requires a clear understanding of the dosing schedule. For this reason, it is important that patients receive appropriate advice before using event-based PrEP.
Before prescribing PrEP, it is important to ensure that HIV infection is not already present.
Assessment may include:
PrEP should not be viewed as a prescription that is issued indefinitely without review.
Ongoing monitoring typically includes:
No.
PrEP is highly effective at preventing HIV infection but does not protect against:
For this reason, regular sexual health screening remains important even when taking PrEP. Increasingly, discussions may also include vaccination and other preventative strategies such as Doxy-PEP where appropriate.
Most individuals tolerate PrEP extremely well. Side effects are generally mild and, when they occur, often improve after the first few weeks of treatment.
Potential side effects may include:
Long-term monitoring of kidney function forms part of routine follow-up. For the vast majority of patients, PrEP is safe, well tolerated and straightforward to use.
PrEP is used by people in a wide variety of relationship situations. Some individuals use PrEP whilst single. Others use PrEP within long-term relationships.
Some patients choose PrEP because they value the additional reassurance it provides, even when their overall level of risk is relatively low. The decision to use PrEP should be viewed as a positive and proactive healthcare choice rather than a reflection of lifestyle or behaviour.
We believe that PrEP should be accessible, evidence-based and tailored to the individual.
At The Wright Practice, we provide:
Our aim is to help patients make informed decisions about HIV prevention and ensure that PrEP is used safely, effectively and with confidence.
Wow! Dr. Dan was extremely knowledgeable and attentive to my health and well being. I’m so glad to have found him!
I have been going to Dr Wright for a number of years now. He is highly knowledgeable, compassionate, open minded and efficient, I couldn’t recommend him highly enough
I have been a patient of Doctor Dan for some time and continue to consult with him despite having left the UK. Dan has the enthusiasm and energy of a young man, whilst taking the holistic “physician” approach of an old school family doctor, equipped with the most modern insights and technology.
Dr Jain was great. Expert knowledge with practical advice
Schedule a consultation | Call: +44 (0)207 139 1833 | Email: info@thewrightpractice.com
101 Harley Street, London, W1G 6AH
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