PrEP (Pre-Exposure Prophylaxis) is an internationally recommended HIV prevention method, in which people who do not have HIV take the HIV medication emtricitabine and tenofovir disoproxil fumarate every day, to prevent getting HIV. When taken daily PrEP is 99% effective at preventing HIV.
In New Zealand the generic form of PrEP is a single pill taken once daily, and in most cases is fully funded if you are eligible for subsidised NZ healthcare (essentially any citizen, permanent resident, those here on visas for 2 years or more, and few special cases).
Your doctor will have to qualify you for the funding - we will apply for this if you are a HIV-negative male or transgender person who has sex with males and have multiple risk factors for HIV infection, OR for HIV-negative people with partners who have a detectable HIV viral load.
There are actually 2 ways of taking PrEP - daily vs PrEP211.
Daily PrEP is (obviously) when you take a PrEP tablet every day. PrEP211 is when you take PrEP tablets only when you are going to have sex.
Daily PrEP is suitable for all people who are at risk of HIV. Daily PrEP is the only PrEP regimen that is recommended for cis-gender and transgender women, for transgender men who have vaginal sex, for men who have anal or vaginal sex with women, people who inject drugs and for people with chronic hepatitis B.
Cis-gender gay/bi guys do have a choice of daily PrEP and PrEP211. Daily PrEP is preferential and safer for those gay/bi guys who cannot predict when sex will occur, who cannot delay sex for more than 2 hours and for those whose potential exposure to HIV occurs more than twice a week. Daily PrEP is the only suitable regimen for anyone with chronic hepatitis B infection to maintain virological suppression, prevent drug resistance and hepatitis flares.
PrEP211 dosing involves taking two PrEP pills before you have sex (ideally between 2 and 24 hours before sex), and a further 1 pill 24 hours and then 48 hours later. Ideally there is no further sex on those 2nd and 3rd days. If further sex does occur, you should contine with the daily pill under you have had 2 sex-free days. The WHO have published the PrEP211 schedule as acceptable - however the daily regime is likely to be more reliable.
You will need to have a consultation with your online doctor where they will get you sorted with the initial blood tests, and apply for the subsidised prescriptions. By the time the blood test results are back, we should be ready to get your prescripion sent straight to a NZ pharmacy of your choice (there are free pharmacies in NZ, and online delivery pharmacies which might be a more discrete option).
PrEP can have short-term side effects, including nausea, abdominal cramping, vomiting, dizziness, headache, and fatigue. These problems typically arise in the first week or 2 of starting PrEP and often disappear in the next few weeks. Long term there are concerns that this may affect kidneys or bone density if taken for 2 years or more. The subsidy reguime in New Zealand requires that some ongoing blood tests are conducted to allow continued use of PrEP. (Your doctor will explain these).
Book an appointment for a video consultation with a qualified New Zealand GP, who can discuss all this with you. If appropriate, we can arrange for the medications to be precsribed and delivered to you.