13 January 21

Ending HIV

PrEP on-demand dosing guide

PrEP on-demand is a new way to take PrEP without having to commit to taking medication daily – and the best part is it’s just as effective. Well, that’s one of the best parts.

You may have heard of PrEP on-demand – some guys are already starting to use their PrEP in this way. It’s the same PrEP pill that prevents HIV, just a different way of taking it.

What is PrEP on-demand?

PrEP on-demand is just as its name suggests; you take it ‘on-demand’, or when you know you’re going to have sex. PrEP on-demand requires less pills over a shorter period (before and after sex) which means less drug in your body. Over time, it could be cost saving too.

It’s easy to start and stop as you need, but before you can start, you must know how to take it safely. Because, while there are less pills involved, the timing of when to take those pills is very important. Deviating from the dosage schedule means you may not be as protected from HIV, and you don’t want that!

Who is PrEP on-demand good for?

PrEP on-demand is currently only recommended for cis guys who have sex with guys. For other folk, such as trans and gender diverse people, speak to your doctor about what might work for you, but otherwise, daily PrEP is recommended.

For PrEP on-demand to be effective, you must be able to plan when you have sex, or able to delay it by at least 2 hours.

If you’re having sex less frequently, say, less than twice a week or a just couple of times a month or year, on-demand can suit you.

Before you start taking PrEP on-demand

If you’ve never taken PrEP before or took PrEP in the past but have stopped, you’ll want to book an appointment with your doctor to get a test for HIV and STIs, assess your kidney health and if you’re needing a script, receive one.

After that, you’ll need to have 3-monthly check-ups with your doctor. With your script, you can get PrEP either in person at a pharmacy or online through the personal importation scheme (check out PrEP Access Now for more information).

What is the dosing regimen for PrEP on-demand?

To take PrEP on-demand, use the following schedule:

• Take 2 pills (a double dose) between 2 to 24 hours before sex, then
• Take 1 pill 24 hours after the double dose, then
• Take 1 pill another 24 hours after that

Think; 2-1-1. 

Say for example the hook-up turns into a much longggger session and you keep having sex, or a big night out turns into a long weekend. Hot! In this case: 

• Continue taking 1 pill every 24 hours after your first dose for as long as you are having sex, then after the last time you have sex,
• Take 1 pill daily for 2 days, keeping the same 24-hour intervals

What’s great about PrEP is that for most of us, there are little to no side effects – it’s a pretty safe drug. So, even if you think you might hook-up later but then don’t, there’s no harm in taking the pre-sex double dose just in case. 

If sex doesn’t happen at all, and you don’t anticipate having sex in the near future, then you can safely stop taking PrEP immediately without having to take any further doses (unlike antibiotics, for example, which require completing all doses).

Pro-tip: set reminders for your dosing and keep PrEP handy

Life gets busy, so sometimes keeping track of things can be a bit tricky. So why not give yourself a hand and set automatic reminders for when to take your PrEP pills.

Most smartphones will have an inbuilt reminder app or calendar function which you can set to give you daily reminders.

On top of this, you’ll need to remember to keep your PrEP with you, in case you might be travelling or not at home over the duration you’ll be taking it.

Adherence is key to taking PrEP on-demand

PrEP on-demand can only work if it’s used as advised. Stick to the dosing guidelines and you can be confident you’re protected from HIV. If keeping to such a specific schedule seems a bit challenging, you can always take PrEP daily to benefit from the ease of taking your pills at the same time every day. Check out our PrEP dosing frequency tool and see if taking PrEP on-demand could be the option for you.

If you think you’ve missed a dose or put yourself at risk of HIV, you should call the PrEP Info Service on 1800 451 624 (Monday to Friday 9am-5:30pm) to discuss if you may need PEP, which is a course of medication. PEP stands for ‘post-exposure prophylaxis’ and if taken within 72 hours after a potential exposure to HIV, it can prevent infection. If outside of operating hours, call the PEP hotline on 1800 737 669 (24 hours a day).