There are two PrEP variants. Some gay men want to take PrEP permanently over a long period of time. Others only want to take it for a short time, for a sex party or a holiday. In both cases, correct intake is necessary for PrEP to work. Regular check-ups are also part of PrEP.
Daily PrEP
For long-term PrEP over several months or longer, you take one tablet a day.
You start taking one tablet a day two days before you have sex for the first time. After this time, you are protected against HIV. Even after this "top-up phase", you continue to take one tablet a day. Important: If you want to stop taking PrEP, you must continue to take one tablet for two days after the last time you had sex. However, your doctor may also recommend a longer tapering phase.
Hint
The Oral sex is shown here not addressed, because the risk of HIV during oral sex is negligible - Therefore, after oral intercourse with a person suspected of being infected with HIV, no Post-exposure prophylaxis (PEP) offered.
Intake schedule: daily intake
PrEP and trans*
Important for trans* men who have anal sex as well as fronthole sex and take PrEP:
- The top-up phase lasts 7 days, 1 tablet per day.
- Then continue with 1 tablet daily.
- After the last fronthole sex, take 1 tablet daily for at least 7 to a maximum of 28 days.
Discuss the exact duration with your doctor.
According to the European and German-Austrian guidelines of the medical associations, occasion-based PrEP is also possible for anal sex, but not for fronthole sex.
Occasion-related PrEP
In the case of event-related PrEP - for example at sex parties or during a holiday - you take TWO PrEP tablets according to the IPERGAY scheme 2 hours to 24 hours before sex. However, taking them just two hours beforehand is considered very short, as the medication has to pass from the stomach via the blood into the mucous membranes. It is therefore safer to start a few hours earlier or rather 24 hours beforehand.
Then you take ONE tablet every day.
If you want to stop taking PrEP, you must take one tablet a day for two days after the last time you had sex. However, your doctor may also recommend a longer tapering phase.
PrEP checks
- HIV test: You must be HIV-negative in order to take PrEP. This is because if you have an HIV infection, the PrEP tablets are not sufficient for treatment and resistance can develop. Before starting PrEP, four weeks after starting and then every three months, a HIV test required.
- Hepatitis B: Here, too, you must have it checked that you are not infected. Because if you do have hep B and you stop taking the PrEP tablets at some point, the hep B infection may worsen. By the way: You can be vaccinated against hepatitis B have it. For gay men, the health insurance company pays for the vaccination.
- Kidney valuesThe PrEP pill can reduce the performance of the kidneys. If you are taking PrEP, you should therefore have your kidney values checked regularly before and during PrEP. It is best to discuss with your doctor how often you should have your kidneys checked. If the kidney values are questionable, PrEP must be discontinued. The kidneys will then recover. If you already have kidney disease, PrEP is not for you.
- Get checked for sexually transmitted diseases: Regular tests for sexually transmitted diseases, in particular syphilis, gonorrhoea and chlamydia as well as hepatitis C, are also recommended. PrEP provides reliable protection against HIV infection, but not against other sexually transmitted diseases. Venereal diseases. In addition to PrEP, you can also use a condom to reduce your risk of contracting a sexually transmitted disease.
Since 1 September 2019, statutory health insurance companies have covered the costs of PrEP tablets and associated tests. Trained doctors can prescribe PrEP for you.
