Pre-exposure prophylaxis for HIV (PrEP)
What is PrEP?
PrEP (pre-exposure prophylaxis) is a medicine that can be taken as HIV prevention prior to exposure to the virus. PrEP is used by HIV negative people to prevent infection. When used correctly, PrEP effectively prevents HIV infection through sexual contact between men, heterosexual sex and injection drug use. The World Health Organization (WHO), and other global health entities, recommend the use of PrEP as a prevention method for people with the highest HIV risk.
Who is PrEP for?
PrEP is recommended for people who do not have HIV but have a high risk of getting HIV. For men having sex with men, this includes HIV-negative men who are sexually active with multiple sexual partners. Additionally they have anal sex and do not use a condom during every intercourse. Recent sexually transmitted infections such as gonorrhea, chlamydia and syphilis are also indications for PrEP use. Read more about when to use PrEP on the miestenkesken.fi website.
You do not need to use PrEP if your partner is HIV positive on HIV medication and their viral load is undetectable. A person living with HIV does not transmit the virus even during unprotected sex, when they are on HIV medication and their viral load is undetectable.
How is PrEP used?
The WHO recommends taking one pill every day at the same time. The medication is generally quite well tolerated and it does not have many serious side effects. Men having sex with men can also use PrEP on an on demand basis. Read more specific instructions about this method on the Hivpoint miestenkesken.fi website.
How can I get PrEP in Finland?
The National Institute for Health and Welfare release national guidelines for PrEP on 17 April 2019. You can find the guidelines (in Finnish) here. The health care professional involved in organizing the PrEP treatment should have knowledge of HIV, STIs and sexual behavior. They do not have to be HIV specialists. Just in case, you can print and bring the basics of PrEP leaflet (in Finnish) to your appointment as background information. In the public healthcare system, for example infectious disease and STI policlinics can prescribe PrEP. As far as we know, generic PrEP medicines are going to enter the Finnish market in May. The prices for the medicines are still unknown but doctor’s visits and laboratory check ups related to PrEP are free in the public healthcare system. The medicines are paid fully by the user and not covered by Finnish social security.
It is important to test kidney function (creatine test), do an HIV test and test for other STIs before starting the medication. Before starting PrEP, it is very important to be sure that you do not have HIV. A recent HIV infection shows up in the tests 4-12 weeks from transmission, so you should avoid high risk situations during that time. After starting PrEP, regular laboratory tests including HIV and other STI testing every three months is essential. PrEP should always be used under medical supervision.
At the moment the only available medicine used for PrEP in Finland is Truvada, but generic options will be available in May 2019. As of now the only way to get affordable PrEP is by asking your doctor here in Finland for an EU prescription and buying the medicine from abroad (within the EU) with that prescription.
More up-to-date information about PrEP, buying it from abroad and the generic medications on the Hivpoint miestenkesken.fi website.