PrEP involves the daily use of a single tablet containing two anti-retroviral medications to reduce the risk of infection in people who are HIV-negative and are exposed to the virus. PrEP has been shown to significantly reduce the risk of HIV infection in sexually active adolescents, adults and in people who use drugs. The effectiveness of PrEP depends on correct use (daily pill taking) of the intervention and can provide up to 99% protection. Unfortunately, PrEP is ineffective in preventing STIs other than HIV. The best level of sexual protection is thus obtained from the use of condoms (for STI prevention) together with PrEP (for HIV prevention).
PrEP does not provide immediate protection from HIV as it takes time to build up sufficient levels in the body. It takes seven days of dosing to prevent the anal acquisition of HIV and up to 20 days to prevent the vaginal acquisition of the virus. It does not need to be taken lifelong but is designed to be used during risky life periods when there is potential for HIV exposure to occur.
PrEP is available at any retail pharmacy in the country. It requires a script from a GP and you will need an HIV test and kidney function test first. HIV-negative people who believe they are at risk for acquiring HIV and access healthcare in the private sector can access PrEP from an educated GP. The retail cost of PrEP is approximately R600pm for the original drug (Truvada) or R250pm for a generic version. Some medical aids will contribute to this.
PrEP is currently available for men who have sex with men and sex workers at no user cost in the public sector at selected state facilities. PrEP is available for MSM at the Ivan Toms Centre for Men’s Health in Cape Town (021 447 2844) and Health4Men at Yeoville clinic in Gauteng (011 648 7979 or 072 654 0816). If you reside in Pretoria you can access free PrEP at TEN81 (012 430 3272) to make an appointment. Sex workers can access PrEP from the Wits Reproductive Health & HIV Institute (WRHI) clinic in Hillbrow. PrEP will be available at the Health4Men serviced clinics in Soweto and Chiawelo as of February 2018.