How to access PrEP:
The simplest method is to visit your regular doctor/GP, they can prescribe it for you - checkout our provider section if you want information to give your GP, or find someone that is already prescribing if you don't currently have a GP.
If virtual appointments are more convenient for you, our Online section has details of several different providers that can prescribe PrEP via a video call.
If virtual appointments are more convenient for you, our Online section has details of several different providers that can prescribe PrEP via a video call.
What is PrEP?
Pre-exposure prophylaxis (PrEP) is an internationally recommended HIV prevention method, in which people who do not have HIV take an HIV medication to prevent getting HIV. When taken as prescribed PrEP is 99% effective at preventing HIV. In New Zealand we use the generic form of emtricitabine and tenofovir disoproxil fumarate which is a single pill version of PrEP taken once daily.
Other forms of PrEP including the dapivirine vaginal ring (DVR), TAF based Descovy and the long-acting injectable cabotegravir (CAB-LA) are not currently available in New Zealand.
You can read about other ways to reduce your risk here.
Other forms of PrEP including the dapivirine vaginal ring (DVR), TAF based Descovy and the long-acting injectable cabotegravir (CAB-LA) are not currently available in New Zealand.
You can read about other ways to reduce your risk here.
Starting, using and stopping oral PrEP?
Daily PrEP
A daily PrEP regimen is effective for everyone to reduce the risk of HIV acquisition and involves taking a single daily tablet at approximately the same time (a couple of hour either side is okay).
Start by taking one dose daily for 7 days prior to potential exposure, then continue daily and you are able to stop 7 days after the last potential exposure.
PrEP211
The PrEP211 regimen can be used to prevent sexual acquisition of HIV by cisgender men and trans and gender diverse people assigned male at birth who are not taking exogenous estradiol-based hormones. PrEP211 is effective for all positioning (insertive and/or receptive).
PrEP211 involves taking a loading dose of PrEP where two tablets of PrEP are taken together as early as 24 hours before sex (preferably), or as late as 2 hours before sex. Continue to take one dose per day until two days after the day of the last potential sexual exposure.
Hepatitis B virus (HBV) infection is not a contraindication for PrEP211.
For more details on how PrEP211 works as well as examples, click here.
A daily PrEP regimen is effective for everyone to reduce the risk of HIV acquisition and involves taking a single daily tablet at approximately the same time (a couple of hour either side is okay).
Start by taking one dose daily for 7 days prior to potential exposure, then continue daily and you are able to stop 7 days after the last potential exposure.
PrEP211
The PrEP211 regimen can be used to prevent sexual acquisition of HIV by cisgender men and trans and gender diverse people assigned male at birth who are not taking exogenous estradiol-based hormones. PrEP211 is effective for all positioning (insertive and/or receptive).
PrEP211 involves taking a loading dose of PrEP where two tablets of PrEP are taken together as early as 24 hours before sex (preferably), or as late as 2 hours before sex. Continue to take one dose per day until two days after the day of the last potential sexual exposure.
Hepatitis B virus (HBV) infection is not a contraindication for PrEP211.
For more details on how PrEP211 works as well as examples, click here.
Do I need PrEP if my partner is living with HIV?
No, studies have shown that there is zero risk of HIV transmission when your HIV-positive partner is on treatment and has maintained an undetectable viral load for more than 6 months. PrEP can help bridge the period where the HIV-positive partner has a detectable viral load.
More information on what it means to be Undetectable can be found here.
More information on what it means to be Undetectable can be found here.
What are the side effects?
Many people who take PrEP, say they haven’t had any side effects, but as with any drug, there are some reported side effects to consider.
Short Term: Approximately 10% of people taking PrEP initially experience mild side effects, such as nausea, diarrhoea and headaches. These tend to go away quickly. It's recommended to take PrEP with food to minimise any tummy issues.
Long Term: A small number of people taking PrEP may experience changes in their kidney function and in their bone density. These side effects tend to be mild, non-progressive, and reversible after PrEP discontinuation. Severe kidney-related adverse events are very rare. .
Emtricitabine and tenofovir disoproxil fumarate have been used for a long time for the treatment of HIV, so it’s a very well-known drug and is highly tolerable. You can check for potential drug interactions here.
Short Term: Approximately 10% of people taking PrEP initially experience mild side effects, such as nausea, diarrhoea and headaches. These tend to go away quickly. It's recommended to take PrEP with food to minimise any tummy issues.
Long Term: A small number of people taking PrEP may experience changes in their kidney function and in their bone density. These side effects tend to be mild, non-progressive, and reversible after PrEP discontinuation. Severe kidney-related adverse events are very rare. .
Emtricitabine and tenofovir disoproxil fumarate have been used for a long time for the treatment of HIV, so it’s a very well-known drug and is highly tolerable. You can check for potential drug interactions here.
How do I get it?
Currently emtricitabine and tenofovir disoproxil fumarate are approved for use as PrEP by Medsafe in New Zealand, so your GP can prescribe it for you - checkout the provider section, if you want information to give your GP, or to find someone that is already prescribing.
What tests are involved?
An HIV test is required as you should not initiate PrEP if you are HIV Positive – additional medication is required for treating HIV.
PrEP services are an opportunity to provide comprehensive sexual and reproductive health services, including STI testing and treatment. PrEP services also offer an opportunity to integrate human papillomavirus (HPV) screening, which would contribute to preventing cervical and anal cancer. Testing for STIs among PrEP users, with or without symptoms, is suggested at initiation and regularly thereafter (such as every three to six months).
If you are at risk of HIV you may also be at risk of Hepatitis B and Hepatitis C as they have similar routes of transmission. It is highly recommended to be tested for Hepatitis Surface Antigen (HBsAg) and Hepatitis C antibodies once, at or within three months of PrEP initiation.
Impaired kidney function is a contraindication for TDF-based oral PrEP. Given the low risk of kidney impairment measuring kidney function for people without known kidney related comorbidities is: optional when aged under 30; optional/conduct once within 3 months of initiation for under 50, every 6 to 12 months for over 50 and for people with comorbidities. Waiting for kidney function tests should not delay initiation of PrEP.
PrEP services are an opportunity to provide comprehensive sexual and reproductive health services, including STI testing and treatment. PrEP services also offer an opportunity to integrate human papillomavirus (HPV) screening, which would contribute to preventing cervical and anal cancer. Testing for STIs among PrEP users, with or without symptoms, is suggested at initiation and regularly thereafter (such as every three to six months).
If you are at risk of HIV you may also be at risk of Hepatitis B and Hepatitis C as they have similar routes of transmission. It is highly recommended to be tested for Hepatitis Surface Antigen (HBsAg) and Hepatitis C antibodies once, at or within three months of PrEP initiation.
Impaired kidney function is a contraindication for TDF-based oral PrEP. Given the low risk of kidney impairment measuring kidney function for people without known kidney related comorbidities is: optional when aged under 30; optional/conduct once within 3 months of initiation for under 50, every 6 to 12 months for over 50 and for people with comorbidities. Waiting for kidney function tests should not delay initiation of PrEP.
How do I know if I’m eligible to be prescribed funded PrEP?
To be eligible for funded PrEP your GP will simply need to confirm you are HIV negative and that your doctor considers you at elevated risk of HIV exposure making PrEP clinically appropriate.
Funded PrEP is available to anyone, regardless of gender or sexual orientation.
Funded PrEP is available to anyone, regardless of gender or sexual orientation.
How much does it cost?
PrEP can be obtained at your local pharmacist. If you are eligible for subsidised PrEP, you will only pay the co-pay amount ranging from $5 for 3 months to free if you go to a discount pharmacy (e.g. at the supermarket). To purchase it unsubsidised the cost is around $25 for 30 pills (as of 1 July 2022).
What About PEP?
PEP (Post exposure Prophylaxis) is where you take an HIV medication after an incident to prevent getting HIV. It's an effective solution if you are using condoms, but have an instance where you had a slip-up for whatever reason (maybe the condom broke), and are concerned about your vulnerability.
You take PEP for 28 days following the exposure to prevent getting HIV. You access PEP through the Emergency Department and it must be started within 72 hours to be effective.
You take PEP for 28 days following the exposure to prevent getting HIV. You access PEP through the Emergency Department and it must be started within 72 hours to be effective.
Can I stop and start the pills?
Yes, if you want to take a break, you can.
Discontinuing PrEP
WHO recommends that cisgender men and trans and gender diverse people assigned male at birth who are not taking exogenous estradiol-based hormones can safely cease PrEP by taking a dose of PrEP 24 and 48 hours after their last at-risk sexual exposure.
Discontinuing daily PrEP for other populations
PrEP should be continued for 7 days after the last at-risk sexual exposure
Discontinuing PrEP
WHO recommends that cisgender men and trans and gender diverse people assigned male at birth who are not taking exogenous estradiol-based hormones can safely cease PrEP by taking a dose of PrEP 24 and 48 hours after their last at-risk sexual exposure.
Discontinuing daily PrEP for other populations
PrEP should be continued for 7 days after the last at-risk sexual exposure
Updated 2022 per WHO guidelines
