PrEP & PEP
A New Way to Reduce Infection
Think you might have put yourself at risk? Are you thinking about the possibility that you might have been exposed to HIV? PrEP/PEP may be your answer.
Fast Facts
- PrEP, is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day. The pill (brand name Truvada) contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV.
- PEP means taking antiretroviral medicines (ART) after being potentially exposed to HIV to prevent becoming infected. PEP should be used only in emergency situations and must be consumed within 72 hours after a recent possible exposure to HIV.
What is PrEP?
PrEP stands for pre-exposure prophylaxis. The word “prophylaxis” means to prevent infection or disease. PrEP is a new way for people who do not have HIV to prevent themselves from becoming infected by taking a protective pill every day.
This pill, called Truvada, contains two medicines that are also used to treat HIV. If someone takes PrEP and if they are exposed to HIV via unsafe sex (or unsafe needle use), these medicines can work to keep the virus from establishing itself inside their body. PrEP is an effective HIV prevention strategy in populations in which HIV testing is common. This is important to remember when making recommendations for or against using PrEP: testing regularly is essential for its success.
How effective is PrEP?
Recent studies have indicated that PrEP, if taken consistently, can prevent 92% of HIV infections.
Other studies have shown that under ideal circumstances (if users absolutely never forget to take it), protection can be as high as 99%.
Note that this is an even higher protective effect than using condoms (80%). Combining PrEP with condom use leads to a 99.2% level of protection, according to the US Centers for Disease Control and Prevention.
If taken correctly, PrEP works.
However, PrEP only works for HIV and not other sexually transmitted infections. Therefore, preventions for other STIs must always be taken into account
Is PrEP a vaccine against HIV?
No, it is not:
PrEP medicine is not injected into the body and does not work the same way as a vaccine
A vaccine teaches the body to fight off infection for several years. PrEP is taken in pill form every day by mouth, and it must be maintained on a daily basis for the protective effect to continue.
Can I also take PrEP now and then rather than every day?
Some studies have found that PrEP is, under certain specific circumstances, also effective if taken intermittently, such as only during periods of exposure. This is sometimes called “intermittent PrEP” or iPrEP.
A 2014 study in France instructed MSM to take a double dose of Truvada (two pills) 2 to 24 hours before they anticipated having sex and then one pill the day after and another pill two days after having unprotected sex.
For men who followed this regimen strictly, this reduced the incidence of HIV by 86% (with a 95% confidence interval of 40%–99%). Although this is a smaller protective effect than taking PrEP every day, the result of the study is still impressive.
The US Centers for Disease Control and Prevention, however, continues to recommend that people who take PrEP should do so continually (every day).
Who should take PrEP?
The US Centers for Disease Control and Prevention recommends PrEP for
- People who are HIV-negative and at substantial risk for HIV infection. This includes HIV-negative people who are in an ongoing sexual relationship with someone who is living with HIV.
- MSM and other key population who have had sex without a condom or have been diagnosed with an STI within the past six months.
- People on PrEP remain under medical supervision and test for HIV every three months. PrEP can affect the kidney function, so kidney function tests should be conducted for those on PrEP
If I start taking PrEP, must I take it for the rest of my life?
No.
People go in and out of periods in which they are at high risk for HIV infection—not everybody is equally at risk or equally sexually active all the time. You can advise friends or clients that if their risk declines or even disappears, they can stop taking PrEP; for example, if they get into a relationship and enter into a monogamous relationship.
However, if after a few years the relationship ends and they enter into a party mode once again, they can easily go back on PrEP.
How soon after starting PrEP does the protective effect begin?
According to the manufacturer of PrEP, it takes at least seven days for the medicine to reach a sufficiently high protective level in the body.
However, recent French and British studies on intermittent use of PrEP showed that taking a double dose of PrEP 2 to 24 hours before sex, followed by one pill the day after and another two days after having sex had a protective effect of up to 86%. This would suggest that the protective effect of PrEP starts quicker if a double dose is taken.
Do PrEP medicines have side effects?
For the first few weeks of starting PrEP medication, a minority of users complain about nausea, vomiting, fatigue and dizziness. For most people, these symptoms eventually disappear once the body gets used to it.
One potential danger when using the drug is developing kidney problems.
Another study found that some people taking Truvada had a minor decrease in bone mineral density within the first month of taking it.
Once Truvada was stopped, the bone density appeared to return to normal measures.
These are two reasons why it is recommended to be under medical supervision, with quarterly check-ups to ensure the kidneys and bones remain healthy.
Does PrEP medication change the way the body or face looks?
No.
There is no scientific evidence for this.
If someone starts using PrEP, can they stop using condoms?
Like condoms, PrEP is highly effective at preventing HIV when used consistently and correctly. PrEP only protects against HIV and not other STIs, thus regular testing is crucial.
Some people will keep using condoms while on PrEP and others will decide to stop using them. If you are already using condoms consistently and doing so makes you feel comfortable and protected, then keep doing what feels right to you. Many people struggle with using condoms consistently, which is one reason why PrEP was developed.
But you must decide for yourself what level of protection feels right and gives you the peace of mind to lead a sexually fulfilling life.
Where does someone get PrEP?
To commence on PrEP medication, eligible patients must be issued a prescription by a doctor. PrEP can be obtained from certain pharmacies, clinics, and some government hospitals in Malaysia. Regular consultation and STI testing are part of the regimen for getting a prescription for PrEP.
Where you can get free PrEP?
SABAH
GOVERNMENT CLINICS
KLINIK KESIHATAN TAWAU
Jalan Chong Thien Vun, 91000 Tawau, Sabah
Contact : 089-775 710
KLINIK KESIHATAN SANDAKAN
Km 3.2 Jalan Utara, Jalan Utara, 90000 Sandakan
Contact : 089-225 800
KLINIK KESIHATAN PUTATAN
D/A Penampang Lot 13A-2, Pusat Dagangan Donggongan Penampang, Jln Pasir Putih, 88200 Putatan, Sabah
Contact : 088-765 704
NGO PARTNERSHIP
Sabah AIDS Support Services Association (KASIH)
Association (KASIH)Unit 1.81 Tingkat 1, Kompleks Asia City, Jalan Asia City, Sabah, 88000 Kota Kinabalu, Sabah
Contact : 088-211002
SARAWAK
GOVERNMENT CLINICS
Klinik Kesihatan Jalan Masjid
Jalan Masjid,
93000 Kuching, Sarawak
Contact : 082-427 110
NGO PARTNERSHIP
Sarawak AIDS Concern Society (SACS)
2nd Floor, Lot 1609, Block 10 KTLD,
Jalan Batu Lintang
93200 Kuching, Sarawak
Contact: 018-9817327
PERLIS
NOT AVAILABLE YET
NGO PARTNERSHIP
Persatuan Cahaya Harapan Negeri Kedah/Perlis
No 211,Tingkat 1,Bangunan Thendayuthapani, Jalan Putra
05100 Alor Setar, Kedah Darul Aman
Contact : 04 – 7336979
Email:[email protected]
KEDAH
GOVERNMENT CLINICS
KLINIK KESIHATAN KUAH
Jalan Air Hangat, 907000 Langkawi, Kedah
Contact : 04-966 8030
KLINIK KESIHATAN KOTA KUALA MUDA
Kampung Sematang, 06600 Kuala Kedah, Kedah
Contact : 04-762 1526
NGO PARTNERSHIP
Persatuan Cahaya Harapan Negeri Kedah/Perlis
No 211,Tingkat 1,Bangunan Thendayuthapani,
Jalan Putra
05100 Alor Setar,Kedah Darul Aman
Contact : 04- 7307 158
Email:[email protected]
PULAU PINANG
GOVERNMENT CLINICS
Klinik Kesihatan Butterworth
Lot 1699, Seksyen 4 Jalan Bagan Luar,
12000 Butterworth, Pulau Pinang
Contact : 04-323 3828
NGO PARTNERSHIP
Family Health Development Association (FHDA)
333, Jalan Perak,
11600 Penang, Malaysia.
Contact : 016-4144978
Email : [email protected]
Website : www.penangfhda.org
AIDS Action and Research Group [AARG]
Bangunan C05,
Pusat Pengajian Sains Kemasyarakatan,
Universiti Sains Malaysia
11800 Penang.
Contact : 013-4222261
Email : [email protected]
PERAK
GOVERNMENT CLINICS
KLINIK KESIHATAN GREENTOWN
Jalan Raja Musa Aziz,
304050 Ipoh, Perak
Contact: 05-253 0801
NGO PARTNERSHIP
Pertubuhan Perlindungan Teluk Intan (PEKASIH)
No.72 Lorong Melati, Kampung Bahagia,
36000 Teluk Intan, Perak
Contact: 014-3059440
KLINIK KESIHATAN SUNGAI
Klinik Kesihatan Sungkai Jalan Pekan Lama,
Sungkai Batang Padang, 35600 Sungkai Perak
Contact: 017 - 526 2298
SELANGOR
GOVERNMENT CLINICS
KLINIK KESIHATAN AMPANG
No.6 3, Jalan Ampang Mewah,
Pekan Ampang, 68000 Ampang, Selangor
Contact: 03-4292 3332
NGO PARTNERSHIP
PT Foundation
No. 7C-1, 1st Floor, Jalan Ipoh Kecil,
Off Jalan Raja Laut, Wilayah Persekutuan, 50350
Contact: Tel: 03-4044 4611
KUALA LUMPUR
GOVERNMENT CLINICS
Klinik Kesihatan Cheras
Jalan Yaacob Latif, Cheras,
56000 Kuala Lumpur,
Wilayah Persekutuan Kuala Lumpur
No. Tel : 03-9133 3322
Klinik Kesihatan Kuala Lumpur
Jalan Temerloh, Titiwangsa,
53200 Kuala Lumpur,
Wilayah Persekutuan Kuala Lumpur
No. Tel : 03-2618 3200
NGO PARTNERSHIP
Kuala Lumpur AIDS Support Services (KLASS)
No 16-4, Jalan 13/48A,
The Boulevard Shop Office Off Jalan Sentul
51000 Kuala Lumpur
Contact: 03-40456681
PT Foundation
7C-1, Jln. Ipoh Kecil,
Off Jln. Raja Laut,
50350 Kuala Lumpur.
Contact: 03-40444611
Pertubuhan Pembangunan Kebajikan Dan
Persekitaran Positif Malaysia (SEED)
No. 69,Jalan Tiong Nam,
50350 Kuala Lumpur.
Contact: 018-371 2563
NEGERI SEMBILAN
GOVERNMENT CLINICS
KLINIK KESIHATAN SEREMBAN
Jalan Rasah, Seremban Seremban,
Bukit Rasah, 70300 Seremban, Negeri Sembilan Contact : 06-767 9267
NGO PARTNERSHIP
Kelab Sahabat Meta
No 1, Gerai Arkib Majlis,
Pekan Pasir Besar
73400 Gemas, Negeri Sembilan
Contact: 06-4576132
MELAKA
GOVERNMENT CLINICS
Klinik Kesihatan Jalan Gereja
Jalan Gereja, Bandar Hilir,
75000 Melaka
Contact: 06-2824452
NGO PARTNERSHIP
JKN Melaka
KK Kuala Sungai Baru, Kuala Sungai Baru, 78200 Alor Gajah, Melaka
Contact No.: 017-6158397
JOHOR BAHRU
GOVERNMENT CLINICS
KLINIK KESIHATAN MAHMOODIAH
12, Jalan Mahmoodiah, Kampung Bahru,
80100 Johor Bahru, Johor
Contact: 07-226 6166
KLINIK KESIHATAN BATU PAHAT
Jln Kluang, Taman Limpoon,
83000 Batu Pahat, Johor
Contact: 07-433 2544
NGO PARTNERSHIP
Intan Life Zone
No.47-01, Jalan Tun Abdul Razak, Susur 1/1,
80000, Johor Bahru, Johor.
Contact No.: 07-2281886
KELANTAN
NOT AVAILABE YET
NGO PARTNERSHIP
Persatuan Perantaraan Pesakit Kelantan (SAHABAT)
15586, Jalan Hospital,
Bandar Kota Bharu, 15200 Kota Bharu, Kelantan
Services: Hepatitis C Screening and Treatment
TERENGGANU
NOT AVAILABE YET
NGO PARTNERSHIP
Pertubuhan Komuniti CAKNA Terengganu (KCT)
Lot 7084, Tingkat 1 Taman Merak, Kampung Bukit
Perpat, Jalan Kuala Berang, 21800 Ajil, Hulu Terengganu.
Fax: 09-680 1014
Email: [email protected]
Persatuan Kabajikan KARISMA Malaysia
Lot 765 – C,
Wisma Haji Abdul Wahab,
Batu 49, Jalan Paka,
23000 Dungun, Terengganu
Contact: [email protected]
PAHANG
GOVERNMENT CLINICS
KLINIK KESIHATAN JAYA GADING
Lorong Jaya Gading 14, Kampung Batu Sepuluh,
25150 Kuantan, Pahang
Contact: 09-538 4252
KLINIK KESIHATAN TEMERLOH
Jalan Triang,
28000 Temerloh, Pahang
Contact: 09-296 1275
KLINIK KESIHATAN BESERAH
Kampung Pelindung,
26100 Kuantan, Pahang
Contact: 09-544 5633
NGO PARTNERSHIP
Drugs Intervention Community Malaysia @ KOMITED Malaysia
Kompleks Belia dan Sukan Pahang, Jalan Tun Ismail,
25000 Kuantan, Pahang
Contact : +609-514 5575
Website : KOMITED Malaysia
PERSATUAN KEBAJIKAN KARISMA MALAYSIA
No 2, Lorong Seri Damai Perdana 21, Batu 6 Jalan Gambang,
25150 Kuantan. Pahang
Contact : 011-25444712
You can locate all the clinics that provide free PrEP in Malaysia.
Is there something you need to ask about your health or looking for information
about the services we offer?
Find the right clinic for you, or locate a NGO in your area.
What is PEP?
someone has (or may have) been exposed to HIV to reduce the chance of becoming infected. Anyone who goes on PEP should continue to take themedicine for 28 days.
Who should take PEP?
example, if you have recently been exposed to HIV during sexual intercourse.
What is important to consider is also the HIV prevalence in the general men who have sex with men and the transgender population. For example, in a country with few HIV cases, the chance of encountering someone with HIV is much smaller than in a city like Bangkok, where in some saunas, up to 50% of patrons might have HIV.
There is no golden yardstick according to which someone can decide whether to take PEP or not. It depends partly on how worried they are!
How soon after possibly having been exposed to HIV should someone take PEP?
The sooner, the better—but it should be within 72 hours after possible exposure to HIV. The virus may have started to replicate beyond that, and PEP would not be able to work.
Does the availability of PEP encourage risky behaviours?
Where does someone get PEP?
PEP is available in selected MOH hospitals with infectious disease physicians, university hospitals and private clinics. In cases of officially reported sexual assault of women, PEP may be made available for free to them.
