PrEP & PEP

What is PrEP?

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, and although it has only been made available in local pharmacies lately, the drug has been credited for a drop in the rate of new HIV cases elsewhere in the world. 

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.

What is PEP?

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

Key facts:

  • Start within 72 hours, sooner is better

  • Taken daily for 28 days

  • Used for emergencies, not regular prevention

If you think you need PEP (Post-Exposure Prophylaxis) you should try to get it as soon as possible and within 72 hours of a possible HIV exposure. In Malta you can ask for it at the GU Clinic at Mater Dei Hospital during clinic hours, or at Accident & Emergency (A&E) outside those hours, and it will be made available to you. PEP medication is currently not free and can cost around €450 to €600 or more depending on the drugs prescribed and where you buy it from one of the pharmacies that stock it locally

Remember… U=U

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

How do I go with buying PrEP?

Start by calling the GU Clinic for an appointment. They will carry out a test for HIV, Hepatitis B and carry out a kidney function test to ensure that it is 100% safe for you to start taking PrEP.  Ignore advice by friends who may suggest skipping this step.  Take it from us. What they’re saying is complete nonsense.

Once you start taking PrEP, the GU Clinic will ask you to visit them once every three months, to assess kidney status and to screen for both HIV and other STIs. Like any other drug, PrEP needs regular monitoring, but in this case, it is fairly easy and straightforward.

Getting PrEP Online

PrEP is cheaper when bought online, but do not just look up PrEP on the internet and buy it from anywhere.  Make sure that you know what the source is.  People in the community suggest I Want PrEP Now, an accredited seller that provides generic PrEP in Malta at a very competitive price.

What are generics?

The pills sold both in local pharmacies and on Dynamix International are known as generics. These pills contain the same active ingredients of other more expensive pills such as Truvada (Emtricitabine and Tenofovir). This makes the pills cheaper than the branded drug, but still have the same effect and are approved by the FDA. If you use another website that is not Dynamix, make sure that you look for FDA approval. It is suggested that you consult with the GU Clinic before choosing your medicine, to make sure that you’re taking the right treatment.

Find PrEP in Malta

Since May 2019, generic PrEP is available from local pharmacies.
Find the closest pharmacy in the map at the bottom of the page.

How do I take PrEP?

There are various ways to take PrEP.  Follow the instructions below to the letter in order to ensure that 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, give or take a few hours

  • Do not stop PrEP until at least 2 days, but ideally after taking 28 pills (once daily)  after the last sexual encounter

  • This method is ideal for individuals whose partner is living with HIV


Event Driven (also known as On-Demand)

Start by taking 2 pills between 2 and 24 hours (ideally closer to 24 hours) before having sex, with or without food

  • Take 1 pill per day at the same time you took your first dose

  • Take 1 pill per day until 2 days after the day of the last potential sexual exposure (2 full days without sexual exposure)

  • If your sex activity last for more than one day, keep taking 1 pill daily, always at the same time as previous doses.  Keep taking pills 1 daily and stop only 2 days after the last encounter

Who can take PrEP on Demand?

  • Cisgender men, trans gender diverse people assigned male at birth who:

    • have sexual exposure AND

    • are not taking exogenous estradiol- based hormones

Important to know

Taking PrEP JUST before sex has got zero, nil, zilch effect.  Let us repeat that. If you take a single, double, or triple dose, even an entire box of pills, just before sex, it will have absolutely NO EFFECT in preventing HIV transmission and it will only put pressure on your organs without working at all.

  • There are other methods for taking PrEP but they are not recommended by the GU Clinic, so neither do we.

  • PrEP will only protect you against HIV.  Do not rely simply on PreP if you want to prevent other STIs such as Gonorrhea and Syphillis. Combine PrEP with other forms of protection for better peace of mind.

  • Do not take PrEP before getting tested.  If someone who has already got HIV starts taking PrEP, they run the risk of HIV developing resistance against treatment drugs.  This could lead to several difficulties when it comes to treating HIV and reducing viral load.