PrEP & PEP

Aqra bil-Malti

You probably heard of PrEP, but we want to make sure that you get all the facts right. Pre-Exposure Prophylaxis (PrEP) is a pill consisting of a combination of two drugs, which when taken correctly by people who are not living with HIV, is very effective in the prevention of HIV.

This is not a new or experimental drug. While it was previously only available for purchase in local pharmacies, PrEP is now available free of charge in Malta for local residents who are legally employed.

A study by The Kirby Institute in 2019 has shown how Australia saw drop in rate to a five-year low (a decline of 23%) as a result of commitment by government, healthcare, the community and research sector, in amongst others, promoting PrEP among gay and bisexual men.  This is why we believe that PrEP is one of the most powerful weapons we have got against HIV.

Reminder: If someone living with HIV is on effective treatment and has an undetectable viral load, they do not transmit HIV through sex. This is known as U=U, undetectable equals untransmittable.

This is a major public health fact and a major relief for many couples. It also helps reduce stigma.

  • Since January 2026, PrEP is provided for free, but you still need a specialist's prescription.

    1. Start by calling the GU Clinic for an appointment.  .

    2. Screening: They will test for HIV and Hepatitis B and carry out a kidney function test to ensure it is 100% safe for you to start. Never skip this step or use someone else's pills.

    3. Collection: Once prescribed by a GU specialist, you can collect your free PrEP from:

      • Mater Dei Hospital Pharmacy

      • Gozo General Hospital Pharmacy

      • Paola Health Centre Pharmacy (Ċensu Moran)

      • Floriana Health Centre Pharmacy

    4. Follow-up: The GU Clinic will ask you to visit once every three months for routine screening and to monitor your kidney health

  • If you are not eligible for free PrEP, it can be found online (via sites like I Want PrEP Now or Dynamix).

    A prescription from Mater Dei’s GU Clinic is still needed.

  • Follow these instructions to the letter to ensure you are protected:

    Daily

    • Start PrEP 7 days before having sex.

    • Take one pill daily with or without food, at the same time each day.

    • Do not stop PrEP until at least 2 days after the last sexual encounter.

    • Ideal for individuals whose partner is living with HIV or those with frequent sexual activity.

    Event Driven (On-Demand)

    • Dose 1: Take 2 pills between 2 and 24 hours (ideally closer to 24) before sex.

    • Dose 2: Take 1 pill 24 hours after the first dose.

    • Dose 3: Take 1 pill 24 hours after the second dose.

    • Keep taking 1 pill daily if sexual activity continues, and only stop 2 days after the last encounter.

    Note: Event Driven PrEP is recommended for cisgender men and trans/gender-diverse people assigned male at birth who are not taking estradiol-based hormones.

    • Zero Effect if taken "just before": Taking a pill right before sex provides no protection. It takes time for the drug to reach protective levels in your tissues.

    • HIV Only: PrEP does not protect against other STIs like Gonorrhea or Syphilis. Use condoms for full peace of mind.

    • Test First: If you take PrEP while already having HIV, the virus can become resistant to treatment. Always get tested at the GU Clinic before starting.

  • PEP (Post-Exposure Prophylaxis) is emergency medication taken after a possible HIV exposure.

    • Now Free: As of January 2026, PEP is free for everyone in Malta regardless of the type of exposure (consensual, occupational, or accidental).

    • Timing is Critical: It must be started within 72 hours, but every hour counts. Sooner is always better.

    • Where to go:‍ ‍During Clinic Hours: Go to the GU Clinic.

      • Outside Hours: Go straight to the Accident & Emergency (A&E) department at Mater Dei or Gozo General Hospital.

  • If someone living with HIV is on effective treatment and has an undetectable viral load, they cannot transmit HIV through sex. Undetectable = Untransmittable. This fact helps us fight stigma and live healthier, more open lives.