PrEP protects against HIV

For our American visitors : please note that injectable PrEP is not available in France

PrEP (Pre-Exposure Prophylaxis) is an HIV prevention strategy. It involves taking an antiretroviral drug on a continuous or discontinuous basis to prevent HIV infection.

PrEP is aimed at people who are not infected with HIV, who do not systematically use condoms during sex and who are at high risk of contracting HIV. These include, in particular:

- Men who have sex with men (MSM),
- Transgender people,
- Intravenous drug users (IDUs),
- Sex workers exposed to unprotected sex,
- People from high-prevalence regions (sub-Saharan Africa, Guyana, etc.),
- People with multiple sexual partners.

These indications are not the only selection criteria. Prescription can be given to all populations at high risk of HIV.

Studies conducted in France and abroad to assess the efficacy of PrEP show that there have been no cases of HIV transmission in people who took their PrEP correctly.

How do I take PrEP?

PrEP involves taking 2 molecules active against HIV: emtricitabine and tenofovir disoproxil. They are combined in a single tablet (Truvada®). Generic versions are available from pharmacies.
Depending on the frequency of sexual relations, there are two dosing schedules:
- Daily: take a tablet at the same hour.
- By demand:
- 2 tablets before intercourse, maximum 24 hours and minimum 2 hours before intercourse,
- 1 tablet a day at the same hour until two days after the last intercourse,

Daily PrEP allows some flexibility and you may occasionally miss up to 4 doses. In the on-demand regimen, it's best to strictly follow the schedule.
These patterns differ from person to person (with a vagina, with a penis, MSM, etc.). Don't hesitate to contact us to find out what's best for you.

PrEP, side effects and interactions

Emtricitabine and tenofovir disoproxil are generally well tolerated. However, like most drugs, they can cause side effects in the first few weeks: nausea, diarrhea, abdominal pain and headaches. These side effects quickly disappear.
More serious side effects, such as kidney failure or osteoporosis, are very rare. These side effects disappear when the drug is stopped.
Emtricitabine and tenofovir disoproxil do not adversely interact with alcohol, poppers or recreational drugs, nor with most antidepressants, contraceptives or other hormonal treatments.
Emtricitabine and tenofovir disoproxil have no known effect on libido or sexual performance. On the other hand, other drugs toxic to the kidneys should not be used, and non-steroidal anti-inflammatory drugs (Ibuprofen, Profenid, Voltaren, etc.) should not be used for prolonged periods.

PrEP and condoms

PrEP is not incompatible with condoms - quite the contrary. While PrEP protects against HIV, only condoms can protect against STIs. The two are complementary.
If you don't use a condom all the time, you'll need to have regular STI check-ups.

What about serodifferent couples?

If the HIV-positive partner has an undetectable viral load for at least six months, PrEP is of no use to the other HIV-negative partner, as HIV transmission is impossible.
This is known as TaSP (Treatment as Prevention): effective antiviral treatment leading to an undetectable viral load is in itself a highly effective means of prevention in a couple. If there are no STIs neither condoms nor PrEP are necessary.

Where to go for PrEP treatment?

Initially, the 1st prescription of PrEP could only be made by a doctor practicing in a hospital department that cares for people living with HIV (PLHIV) or in a hospital CeGIDD (testing center). Since April 15, 2021, and in order to facilitate access to PrEP, any doctor can make the first prescription and renewal of PrEP: in town, in a CeGIDD, in a health center, in a hospital, in a social or medico-social establishment. Follow-up consultations can be carried out by teleconsultation, in agreement with the patient and within the framework of regulations.

Sida Info Service has created a map listing PrEP consultation centers. On the map, click on the icon at top left to find out about PrEP consultations in hospitals and CeGIDDs :

PrEP : Interactive Map
(external service provided by Google - by displaying it, you accept its terms of use and potential data exchanges)

La PrEP en français