Lets Get PrEP’ed

Pre-Exposure Prophylaxis or PrEP suitability criteria in Scotland have changed.

PrEP involves HIV negative people taking antiretroviral medication on a regular basis to prevent HIV infection. It is different to PEP (Post-Exposure Prophylaxis) which is taken after a potential exposure to HIV.

PrEP is available free of charge to people at the highest risk of HIV in Scotland. If you are a Scottish resident and you meet the suitability criteria for PrEP, you can be provided with the tablets and the monitoring and advice you need at the Chalmers Centre or the Sexual Health Clinic at Howden. PrEP can also be accessed via specialist sexual health services in other parts of Scotland. There are currently no plans to make PrEP available through your GP or non-sexual health clinics.

PrEP is now considered suitable for most people who request it and in almost all situations offering and initiating PrEP to those who request it is appropriate. PrEP may not be considered suitable if individual risk is not higher than the UK baseline or where clinical risk of PrEP outweighs benefit.

Which indicators or factors are associated with suitability for PrEP?**

Population level indicators

Men who have sex with men
Black African men and women
Transgender women – PrEP for trans and non-binary people | Guides | HIV i-Base
Recent migrants
People who inject drugs
People who report sex work or transactional sex

Behavioural and personal indicators

Condomless anal or vaginal/frontal sex with one of the groups listed above
Condomless anal or vaginal/frontal sex where a sexual partner may have undiagnosed or untreated HIV infection
Chemsex or group sex
Injecting drug use using shared equipment
Travel to countries with high HIV prevalence where sex with people from those countries is likely**

Other clinical markers.

Other sexually transmitted infection
HCV infection
PEPSE use

Injecting Drug use:

Injecting in an unsafe setting, sharing injecting equipment or limited access to needle and syringe programmes (NSP) or opiate substitution treatment (OST)
Sexual risk in people who use drugs

Reduced sexual health autonomy**

drug and alcohol use
abusive relationships
safeguarding, consent and vulnerability issues

** Factors known to be associated with HIV risk should prompt a consideration of PrEP and the presence of these factors alone, does not represent an indication for PrEP, however.
(Medland N, Estcourt C, Clutterbuck DJ, 2022)

If you are taking or thinking about taking PrEP, the Chalmers PREP videos and the PrEP-guide-UK-Feb-2024-FIN.pdf (i-base.info) contain useful information. The Chalmers PrEP videos were produced with money from a grant kindly funded by the Edinburgh & Lothians Health Foundation. NOTE: PrEP suitability criteria is not up to date in these resources.

The most commonly used tablet license for PrEP in the UK is a combination pill containing two different drugs called Tenofovir and Emtricitabine. The first branded (and most commonly used) tablet of Tenofovir/Emtricitabine is “Truvada” – though other generic versions can be used when required.

Just a reminder…. while taking PrEP is effective in preventing you from HIV, PrEP does not protect you from other STIs including Chlamydia, Gonorrhoea and Syphilis. Anyone taking PrEP daily or event based should try and test every three months as well as having a routine PrEP review, especially if you’re having more sex without condoms.

If you think PrEP might be suitable for you and would like an appointment to discuss further give us a call or drop us a message, we’re happy to talk about anything PrEP.

We don’t prescribe PrEP at ROAM, but we can give you information, do the tests you need before starting PrEP and organise an appointment for you to get a PrEP prescription if it is suitable for you.

For a quick reference, check out the these useful links