In our ongoing series focusing on men who have sex with men, The Steam Room, experts frequently refer to PrEP, and the precautionary benefits associated with taking it.

If you are at risk of being exposed to HIV, taking PrEP can be invaluable to your health on the long term, and is a preventative measure that must not be overlooked.

PrEP is the acronym for Pre-exposure Prophylaxis. PrEP is an HIV prevention strategy that entails the use of antiretroviral medication for people who are HIV-negative. A combination of two ARVs (emtricitabine and tenofovir) prevents infection with HIV when it is taken daily.

According to research done in clinical trials, PrEP lowers the risk of sexually contracting HIV by as much as 90%. It is, however, important to note that PrEP does not protect a person against other sexually transmitted infections like gonorrhoea, syphilis, HPV or chlamydia, which is why it is important to take PrEP in combination with the use of condoms and a water-based lubricant when engaging in sexual activity.

Who can take PrEP?

Anyone who is at risk of contracting HIV can take PrEP. This includes people who inject substances, in which the risk of contracting HIV is reduced by more than 70%. The only condition for beginning treatment with PrEP is that a person should test negatively for HIV. Because the ARVs used in PrEP are combined with an additional ARV for the treatment of HIV, a person who is on PrEP and is also HIV-positive can build resistance to the drugs, which may complicate their treatment regimen later.

While on PrEP, one should also go for regular RNA HIV tests. RNA tests can show a positive result based on the presence of the virus as soon as 10 to 14 days after infection with HIV, which makes them the more reliable option. Should a person be infected with HIV, treatment with ARVs for people who are HIV-positive can commence more quickly, limiting the risk of building up resistance to the drugs that are being taken as a part of PrEP.

Men who have sex with men are at a higher risk of HIV infection, due to the riskier nature of anal sex, and should consider treatment with PrEP.

Where can PrEP be obtained?

PrEP is available at all retail pharmacies in the country, and can be obtained after getting a script from a GP and after undergoing a kidney function and HIV test. PrEP costs roughly R600 per month for treatment with the original drug, and R250 for the generic version. Some medical aids do contribute to the cost of treatment with PrEP, but it can also be obtained from selected state facilities.

Sex workers and men who have sex with men can get access to PrEP at no charge at the following facilities:

Cape Town: Ivan Toms Centre for Men’s Health – 021 447 2844

Johannesburg: Health4Men at Yeoville clinic – 011 648 7979 or 072 654 0816

Pretoria: TEN81 – 012 430 3272

Sex workers can access PrEP from the Wits Reproductive Health & HIV Institute (WRHI) clinic in Hillbrow.