PrEP

What it is, and how to get it in Singapore.

💊 What is PrEP?

Pre-exposure Prophylaxis (PrEP) is an HIV preventive drug usually taken before sex. It can stop HIV from taking hold and spreading in your body.

It is a single combination tablet of 2 drugs (Tenofovir & Emtricitabine) taken as an oral pill before sex.

When taken correctly, PrEP can reduce HIV transmission by 99%.

Please note that PrEP does not stop you from contracting other Sexually Transmitted Infections (STIs), only using a condom reduces the transmission of other STIs.

🤔 Who is PrEP for?

PrEP is taken if you are not living with HIV.

Consider taking PrEP if you:

Had multiple partners and did not always use condoms during vaginal/anal sex in the last 6 months
Had sexually transmitted infections in the last 6 months
Have a partner living with HIV who is not on suppressive antiretroviral therapy
Are a drug user who shares equipment and needles with others to inject drugs

🤔 Which PrEP should I take?

There are two kinds. Find the one that fits you best.

💊 Daily PrEP

Can be taken by anyone, regardless of your gender identity and sexual orientation.

However, you should take an HIV test first and approach a medical professional for advice regarding starting, taking and stopping PrEP.

💊 On-demand PrEP

Can only be used during anal sex among cisgender gay men, bisexual men, and men who have sex with men.

Note: It is not yet known if on-demand PrEP works for cisgender men and women engaging in heterosexual sex, people who inject drugs, and transgender persons.

💊 Taking Daily PrEP

Daily PrEP means consistently taking one pill every day.

Peak protection comes after 20+ days

The exact number of days that daily PrEP takes to work is currently unknown. However, it has been observed that if you take PrEP every day, protection in the rectal tissue is achieved after 7 days and maximum protection in the blood is achieved after 20 days.

Check your liver and kidney every 6 months

If you take daily PrEP, it is recommended that you take liver and kidney function tests every 6 months. This is to make sure that the PrEP is not having any adverse effects on your body.

💊 Taking On-demand PrEP

On-demand PrEP means:

Take two pills 2-24 hours before sex
Take one pill 24 hours after the first dose
Take one pill 24 hours after the second dose

👉 Getting PrEP

Before starting PrEP, you must take an HIV test to ensure that you do not have HIV.

Note: Be mindful of the window period for HIV testing. For a conclusive result, you should get tested for HIV 3 months after possible exposure to HIV transmission.

Step 1: Get a referral to do HIV testing

Go to a polyclinic or a General Practitioner (GP) who accepts CHAS cards and ask for a referral letter. If they give you dirty looks, tell them it’s none of their business.

Step 2: Head to a clinic

Choose a clinic to do HIV testing:

Non-Anonymous HIV testing

BePreP Clinic at National University Hospital (NUH)
HIV PrEP Clinic at National Centre for Infectious Diseases (NCID)
Dr Tan & Partners (any clinic, walk-ins or by appointment)

Note: BePreP Clinic and HIV Clinic offer prescriptions for branded and generic PrEP as well as HIV testing, liver and kidney tests, and a Hepatitis B test. They also offer sexual health counselling and can advise you about starting PrEP.

Anonymous HIV testing

Dr Tan & Partners@Robertson (walk-ins or by appointment)

💵 Costs of testing

Singapore citizens and permanent residents have access to subsidised rates for these tests.

Singaporean Citizen (SC) or Permanent Resident (PR)

First visit: ~$70
Second visit: approx: ~$50

Foreigners

First visit: ~$200
Second visit: approx: ~$120 to $140

Step 3: Sit there shake leg

Be patient. Test results can take a few days to a couple of weeks to return.

Step 4: Collect prescription and decide what kind of PrEP to buy

If your results are HIV negative, you will be given a prescription.

You can now decide if you want to buy branded PrEP (often GILEAD, appx SGD $400/mth), or generic PrEP.

Generic PrEP has the same ingredients but is cheaper than branded PrEP. It is, however, more inconvenient to get it.

Buying generic PrEP

You can buy generic PrEP online from PrEP Singapore. To do this, you will need to upload certain blood test results (e.g. HIV test, liver and kidney tests, Hepatitis B test) and a prescription. If you follow the steps above, you will have all this information ready.

With a prescription, you can buy a 3-month supply from PrEP Singapore for around SGD$150 (approx SGD$50/mth).

Do not order more than a 3-month supply as it can be confiscated by customs.

Once you finish your 3-month supply, you have to produce another negative HIV result and prescription.