Is PrEP on-demand right for you?


Dr Cris Quitral who explains how you can do online testing and find out about PrEP FAQs on-demand is smiling in a photograph taken on a neutral background.

Dr Cris Quitral from Hey Fella explains how PrEP on-demand works and if it’s right for you. 

In the field of sexual health, I get asked a lot of questions. 

This can be from patients I see, from people I meet out in the community and even from some of my closest friends. 

One topic that comes up regularly is Pre-exposure prophylaxis or PrEP as most of us know it by. 

Many folks are across regular daily PrEP use but in the last few years, the use and interest in PrEP on-demand has risen. 

There are some very big differences in how on-demand works in comparison to regular daily PrEP usage.  

Let’s look at some of the common questions about PrEP on-demand to see if it could be right for you. 

What is PrEP on-demand?

PrEP on-demand is what it says on the box: it’s about taking PrEP for planned events & during a specific time period rather than usage every day. 

This tailored approach is particularly relevant for those who engage in more planned sexual activity and have a lower frequency of potential exposure. So it’s more event-driven rather than consistent daily usage. 

How does it work? 

The usage follows the 2-1-1 rule:

  • 2 tablets at least 2 hours before having sex
  • 1 tablet 24 hours after the first dose
  • 1 tablet 24 hours after the second dose

Remember, your second and third doses are timed from when you started PrEP on-demand, not when you had sex.

If you’re having a great ol’ time and the sexual activity goes on for a very long time, well, firstly, good for you! But remember:

  • Continue to take 1 tablet every 24 hours after the last dose for as long as you are hooking up/having sex
  • PrEP is to be continued 24 hourly until you have had 2 tablets (24hrs apart) after the last dose event/hook-up

If you don’t end up having sex you can safely stop taking PrEP on-demand without needing to finish the full course of PrEP on-demand

It is super important to follow this approach otherwise the use of on-demand PrEP risks not working. Setting your alarm for 24-hour periods is something I tell my patients to do. It’s an important reminder while your mind may be on other things…

Who should use it?

As mentioned those who don’t have a lot of regular sex but may have a special event or scenario where they know they are more likely to get a bit of action. 

This means you can avoid using PrEP all the time and only use it for those special occasions. 

This can also be useful for those who have experienced kidney or liver issues with regular PrEP use. Reducing the usage to on-demand can give your organs a much-needed break. 

Many couples who only open up their relationship for specific events or situations may find this a useful approach as well. 

Additionally, at this stage, on-demand PrEP is only recommended for cisgendered men. 

Considerations

The risks are similar to PrEP daily use. You may experience nausea or stomach upsets and it can impact kidney and liver function. Regular three-monthly screening to check on your liver and kidneys is very much recommended. 

And, as mentioned earlier, the proper use must be adhered to or you will put yourself at risk, and will require a course of PrEP if the medication is not taken as directed and on time

If you do think the on-demand PrEP might be right for you (or if you think daily may be the way to go), you can request a PrEP consultation online at Hey Fella. 

You visit our website to register and go through our quick three-step process to sort everything out.

Myself and other LGBTA doctors are also on hand if you have any questions or want to check if this is the right approach for you. 

So, have fun, be safe and check out the Hey Fella website for any advice or services related to PrEP.

Read next: How online STI testing works

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Dr Cris Quitral

QNews, Brisbane Gay, App, Gay App, LGBTI, LGBTI News, Gay Australia

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