What is PrEP211?

PrEP211 is recommended ONLY for Gay/Bi guys because its efficacy has yet to be determined in all other populations at risk of HIV infection such as transsexual or heterosexuals. If you do not want to take a daily pill this is an option to just use PrEP when you need it.

This is called PrEP211 (or on-demand or event-based dosing).

Just taking PrEP before and after a risk is very effective. This option works well if:
  • If you infrequently have anal sex without condoms.
  • If you usually know when you will have sex.
  • If you are not eligible for government subsidised PrEP and are buying PrEP online, PrEP211 dosing will be less expensive because you need fewer pills
  • Taking fewer pill might also reduce side effects
  • If you have kidney issues fewer pills minimises this burden.
PrEP211 dosing cannot be used if you have hepatitis B.

PrEP211 dosing involves:

  1. Taking a double dose of PrEP (two pills) before you have sex. Ideally this should be between 2 and 24 hours before sex.
  2. Taking a single pill 24 hours after the double dose.
  3. Taking another single pill the following day, 24 hours later.
You should aim to take a single pill 24 hours and 48 hours after the first double-dose.

Examples of PrEP211

PrEP211 Dosing: If you have sex once a week

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If you think you might have sex on Friday or over the weekend, you could take two pills on Friday, i.e at 5 pm.

If you have sex on Friday at 8 pm, then you would take a single pill on Saturday and Sunday at around 5 pm (2 hours before or after 5pm is ok), taking a total of 4 pills overall.

The initial double dose can be anytime 2 to 24 hours before sex. You still get good protection if you took the Friday dose at 5 pm but didn’t have sex till Saturday at 11 pm as you would take a single dose at 5pm Saturday. And then finish off with a pill Sunday and Monday (your two sex free days).

If you start PrEP on Friday but then your plans change or you get ghosted and don’t end up having sex, and you have no other plans to have sex, there is no need to continue taking PrEP as there was no potential exposure.

Even if the pre-dose is only two hours before sex it will provide protection.

PrEP211 Dosing: Sex several times over a few days

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Take your double dose on Friday as usual 2 to 24 hours before sex.

If you have sex on Saturday, and a few times until Sunday evening at 7pm, continue to take a single pill every day at around the same time until the last sex act then you take the final two doses on your two sex free days. Using the example above, your last dose would be on Tuesday.

PrEP211 Dosing: Sex several times, then more sex less than 7 days after the last PrEP dose

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If there are less than seven days between the end of one on-demand dosing period and the beginning of another, you only need to take one single PrEP tablet when you restart.

If it is more than seven days since your last PrEP dose, start again with a double dose of two pills.
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