PrEP
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PrEP?

Prevents HIV and is available to everyone!

 

What Is PrEP?

PrEP (pre-exposure prophylaxis) is a medication that prevents you from getting HIV. It stops the virus from replicating if you encounter it. When taken as directed, PrEP is 99% effective at preventing HIV.

PrEP is for everybody; it is easy to access through your GP or Sexual Health Services and is dispensed by your local pharmacy. It rarely causes any side effects – and when it does, they are minor and go away fast.

 
Oh, also… PrEP is FREE!

How to Access PrEP

The simplest way is to visit your regular doctor, they can prescribe PrEP for you and it becomes part of your overall healthcare.

You can also access PrEP through your local Sexual Health Clinic.

If online appointments are more convenient for you or you simply want an alternative to your GP, we suggest you sign up and book a video call with one of the providers below:

Pocket Lab
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A team of like-minded doctors dedicated to providing quality, accessible, & affordable healthcare to New Zealanders.

Cost

Online appointments available nationwide 7 days a week, 8:30am - 8pm. Call Centre Hours are Monday to Friday, 8am - 5pm.

PrEP Appointment $69 - Click for details

What's included?

  • Doctor video consultation
  • PrEP prescription - 3 months
  • DoxyPEP prescription
  • Condom prescription
  • STI and other lab tests
  • Positive STI test management, if appropriate for telehealth
If you are not eligible for New Zealand government funded public health services, you may incur additional charges when accessing lab tests or prescriptions in the community.

Tend
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Book via the Tend app for same day care. Open 7 days a week till 9pm even on public holidays. Alternatively, in person appointments can also be booked for Tend Clinics located in Auckland, Tauranga, Christchurch and soon Ashburton.

Cost

Online appointments available nationwide 7 days a week, 7am - 9pm

In-person appointments available in Auckland, Tauranga, Christchurch, check tend.nz for different clinic hours.

Enrolled clients located in Auckland, Tauranga, Christchurch - between $55.95 to $63 for 15min appointment (Tend is your regular GP)

Casual clients inc non-NZ residents, or those NOT located in Auckland, Tauranga, Christchurch
- $79.95 for 15min appointment (Tend is not your regular GP)

In all cases (GP, Sexual Health or Online Clinic):

  • You will need to test HIV negative before starting PrEP.
  • Your prescription will be sent to your pharmacy of choice.
  • If you have a positive HIV result, you will be connected with local providers for treatment and support.

Take advantage of your appointment to ask about DoxyPEP. DoxyPEP is the use of the antibiotic doxycycline after oral, anal or vaginal sex to help prevent getting chlamydia and syphilis.

 
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Starting PrEP

Start with a double dose of PrEP (2 pills) at least 2 hours before sex

This is the most important dose to guarantee the full efficacy of PrEP

Start with a double dose of PrEP (2 pills) at least 2 hours before sex

This is the most important dose to guarantee the full efficacy of PrEP

 
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Continuing Daily

Continue taking one pill daily – at approximately 24 hours

Timing is flexible, do not stress about taking it at a precise hour

Don’t panic if you miss the occasional dose, residual drug should keep you protected but try your best to be adherent

Continue taking one pill daily – at approximately 24 hours

Timing is flexible, do not stress about taking it at a precise hour

Don’t panic if you miss the occasional dose, residual drug should keep you protected but try your best to be adherent

 
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Stopping PrEP

It is all good to stop taking PrEP whenever you want

If you were having ANAL SEX (penetrating a butt or taking it up the butt) or INSERTIVE VAGINAL SEX (penetrating a vagina*)
Continue taking your single pill daily until two days after the last time you had sex

If you were having RECEPTIVE VAGINAL SEX (having your vagina* penetrated by a penis) or if you were INJECTING DRUGS & SHARING NEEDLES
Continue taking your single pill daily until seven days after the last time you had sex or shared needles

*This includes surgically created vaginal canals, typically as part of gender-affirming surgery

It is all good to stop taking PrEP whenever you want

If you were having ANAL SEX (penetrating a butt or taking it up the butt) or INSERTIVE VAGINAL SEX (penetrating a vagina*)
Continue taking your single pill daily until two days after the last time you had sex

If you were having RECEPTIVE VAGINAL SEX (having your vagina* penetrated by a penis) or if you were INJECTING DRUGS & SHARING NEEDLES
Continue taking your single pill daily until seven days after the last time you had sex or shared needles

 

*This includes surgically created vaginal canals, typically as part of gender-affirming surgery

Forgot My Starter PrEP (and had sex)

 

If you missed the initial double dose (2 pills), resume your PrEP use as soon as possible with a double dose. This should be within 24 hours of sex and no later than 72 - then continue with daily dosing.

If you didn’t take any PrEP pills in the 7 days before sex (3 days for receptive vaginal and sharing needles) continue daily dosing for 28 days (aka PEP) . After 28 days, seek lab testing and medical advice to ensure there was no transmission.

If it’s been more than 72 hours since your potential exposure, PEP is no longer an option. Seek medical advice or talk to us. We advise testing at 28 days.

Frequently Asked Questions (FAQ)

Do I need PrEP if my partner is living with HIV?

There is zero risk of HIV transmission when your HIV-positive partner is on treatment and has maintained an undetectable viral load for more than 6 months.

PrEP can help bridge the period where the HIV-positive partner has a detectable viral load.

Click here for more information on what it means to be Undetectable.

What are the side effects?

Most people experience no side effects from PrEP.

Approximately 10% of people starting PrEP experience mild side effects, such as nausea, diarrhoea and headaches in the first month. These tend to go away quickly and are minimised if PrEP is taken with food.

A very small number of people taking PrEP may experience changes in their kidney function or bone density. These side effects tend to be mild, non-progressive, and reversible after PrEP discontinuation. Severe kidney-related issues are very rare.

The drugs contained in PrEP pills have been used for HIV treatment for a long time, and are very well-known and highly tolerable. It’s very safe to use PrEP with hormonal contraception and during hormone therapy, pregnancy and breastfeeding. You can check for potential drug interactions here.

What tests are involved?

HIV testing is required to start PrEP and will be ongoing while on PrEP. PrEP is not effective if you have acquired HIV and can lead to drug resistance.

Being on PrEP is all about staying engaged with your sexual health. Since PrEP only covers HIV, it’s a good idea to test for STIs regularly - and receive treatment as required. Condoms and DoxyPEP can help prevent STIs.

It is also an opportunity to catch up with your vaccinations. Tests can be undertaken to detect your immunisation history and vaccines for MPOX, HPV, Hepatitis A and B may be offered to you if needed.

Because PrEP might put some pressure on kidney function, this may be monitored to ensure your kidneys are healthy while you’re on PrEP.

How do I know if I’m suitable to be prescribed PrEP?

HIV is transmitted by anal and vaginal sex or sharing needles. If any of this is a possibility in your future, you’re suitable for PrEP. You also need to confirm that you are HIV-negative.

PrEP is available to anyone, regardless of gender identity or sexual orientation.

Can I get PrEP if I have poor kidney function?

In New Zealand we use the generic version of TDF/FTC (Truvada) for PrEP. TDF is processed in the kidney so if you have kidney issues, the generic TAF/FTC (Descovy) is a better option and it’s taken in the same way. This drug is not approved as PrEP in New Zealand, but doctors can prescribe it off-label for self-importation. It is legal to buy PrEP online for personal use (up to 3 months).

If you have questions or need assistance to bring it up to your GP, talk to us.

How much does PrEP cost?

PrEP is fully funded and provided for FREE. GP and pharmacist fees will apply.

To be eligible for funded healthcare, you need to be a New Zealand citizen or resident or hold a 2+ year work visa. Other work visa holders, refugees, protected persons, and Australian citizens and residents may also be eligible. See the full list here.

If you’re not eligible for funded healthcare, the cost of PrEP is around $30 for 30 pills with a prescription. You may also have to pay for GP fees and lab tests which are likely to be quite expensive. Your insurance may cover these costs, check the fine print. If you need assistance or if cost is a barrier for you, talk to us.

What are the other types of PrEP?

TAF/FTC is a widely used alternative as it has lower impact on kidney function. It's taken the same way as the TDF/FTC PrEP we use in NZ.

Injectable PrEP, is a regular injection of HIV medication to prevent you from getting HIV. The options are CAB-LA every 2 months, and Lenacapavir every 6 months. A recent study showed Lenacapavir to be more effective than oral PrEP at preventing HIV, likely because it takes away the need to take daily pills.

The Dapivirine Vaginal Ring (DVR) provides a modest, but significant reduction in HIV incidence for people with vaginas.

Unfortunately, New Zealand does not have any of these options available yet. If one of these is your prevention method of choice, you may want to consider importing it or talk to us.

What about PEP?

PEP (post-exposure prophylaxis) is where you take an HIV medication after sex to prevent getting HIV.

PEP must be started ideally within 24 hours after sex and no longer than 72, and you take it daily for 28 days. You can access PEP through the Emergency Department.

In New Zealand, PEP and PrEP are the same drugs. If you have PrEP to hand, read the Forgot My Starter PrEP (and Had Sex) section.

Any other helpful tips?

  • A pill box makes it easy to see if you missed a dose
  • Aim for the same time each day. Link it to a routine task like brushing your teeth

 

Guide for General Practitioners

Australasian Society of HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) PrEP Guidelines. Prevent HIV by Prescribing PrEP. Sydney, 2023.

ASHM has created an online training module specifically for New Zealand GPs in the management of PrEP.

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