Safely buying PrEP online

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30 Jun 2015

Can I buy the meds for PrEP online? My doctor says he can give me a private prescription for PrEP but I can’t afford that.

A doctor can prescribe an approved medicine privately if they believe it is medically appropriate for the patient. In Australia, some doctors recommend patients buy generic drugs until the government decides whether PrEP will be made available in the health system. These doctors ensure their patients have the appropriate HIV and safety monitoring.

Because some people might find other ways to access PrEP, the information below highlights issues for anyone doing this. Anyone using PrEP in these ways should do so with the knowledge of a doctor. 

The following main points are:

  • PrEP should only be used if you know you are HIV-negative

Everyone in the UK PROUD study had an HIV test before they could join the study. Ideally, you should have had no risks during the four weeks before starting PrEP. A few people in PrEP studies test negative when they start PrEP, but turned out to have been in early HIV infection. This was too recent to be picked up by the HIV test. If you take PrEP when you are HIV-positive, especially in early infection, it is likely you will develop drug resistance. PROUD included routine HIV testing when on PrEP – every three to six months.

  • Time to reach protective drug levels

Many medicines need to be taken for a few days in order to reach effective levels in the body. The two meds in current PrEP are tenofovir and FTC. In the PROUD study, people were advised to take daily PrEP for two weeks before assuming that drug levels were protective.

  • Adherence

Lots of different studies have reported that PrEP is effective if you take it but not effective if you don’t. For gay men, this requires taking a single pill of tenofovir/FTC on at least four days every week. Several research groups have suggested that women would need to take PrEP on six-seven days every week to get the same protection. This is because drug levels are much higher in rectal tissue compared to vaginal tissue.

  • Side effects and safety monitoring

Although the risk of side effects from PrEP are generally very low, safety monitoring is important. When HIV-positive people use the same meds, it is important to check kidney function before starting PrEP and then routinely while taking PrEP. These concerns are just as important for PrEP.

  • Support, advice and other STIs

The PROUD study included the chance to talk to health advisors and a doctor about sexual health and other things related to HIV risks. Many people in the study found that this interaction helped them feel more in control of any risks. Having a doctor or health advisor knowing that you are taking PrEP might be very important. Sexual health clinics often provide excellent services and support. Continuing to see your local clinic for support and to check for other STIs that PrEP doesn’t protect against is important.

  • Legality and reliability

Buying any medicines online includes a risk that you might not be buying the same active drug. Find a trusted online pharmacy and ensure that the generic manufacturer is likely to be trusted. However, many online pharmacies – such as AIDS Drugs – are widely used to buy more affordable prescription medicines.

Originally published on UK HIV site i-base