PrEP vs PEP: Which HIV Prevention Method is Right for You?

March 2, 2023
Jordan R.
Julius Care Team 🏳️‍🌈 🏳️‍⚧️

HIV is a serious and potentially life-threatening disease that affects millions of people worldwide. While there is currently no cure for HIV, there are very effective treatments, and several effective prevention methods available to reduce the risk of infection. Two of the most well-known and widely-used prevention methods are Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP, also called nPEP).

PrEP and PEP are both medication regimens that can be taken to help prevent HIV infection, but are used in different situations and have different levels of effectiveness. Understanding the differences between these two prevention methods is crucial if you are at risk of HIV infection.

What is PrEP?

PreP (Pre-Exposure Prophylaxis) is a daily medication that reduces the risk of HIV infection in people who are at high risk.

PrEP contains two antiretroviral drugs that block the virus from multiplying in the body. When taken as directed, PrEP can reduce the risk of HIV infection by up to 99%, but it does not protect against other sexually transmitted infections. Side effects may include nausea, headache, and diarrhea, but these are usually mild and temporary.

PrEP is recommended for people at high risk of HIV, such as men or transgender people who have sex with men, sex workers, and people who inject drugs. Learn more about PrEP in our full guide to PrEP.

What is PEP?

Post-Exposure Prophylaxis (PEP) is a medication regimen that is taken after a possible exposure to HIV to reduce the risk of infection. PEP consists of a combination of three antiretroviral drugs that are taken for 28 days. The drugs work by blocking the virus from multiplying in the body.

PEP is most effective when started within 72 hours of exposure, but it may still be effective up to 72 hours after exposure. It is important to start PEP as soon as possible after exposure to maximize its effectiveness.

Comparing PrEP and PEP

PEP is generally considered a less effective HIV prevention method than PrEP, but it can still significantly reduce the risk of infection if taken correctly. According to the Centers for Disease Control and Prevention (CDC), taking a course of PEP can reduce the risk of HIV infection by up to 81%. Daily PrEP has been shown to be up to 99% effective at reducing HIV infection when taken as directed.

PEP is not intended to be used as a long-term prevention method and is typically used only in emergency situations, such as after a condom breaks during sex or after sharing needles with someone who is known to have HIV.

Both PrEP and PEP may cause side effects in some people, including nausea, diarrhea, and headache. However, these side effects are usually mild and go away on their own within a few weeks of starting the medication.

Which One is Right for You?

If you’re looking to prevent HIV, the biggest question is whether you’ve recently had a high risk exposure.

If you have had a high risk exposure to HIV in the past 72 hours, you should get PEP as soon as possible. You can check out our articles on getting PEP in Quebec and how to get PEP in Ontario.

If you have not had a recent high risk exposure, and would like to protect yourself in the future, PrEP might be a better option.

You can also look into PEP in Pocket, which is a new Canadian initiative that aims to increase access to PEP for people who may have been exposed to HIV. The program allows individuals to carry a starter kit of PEP with them at all times, so they can begin taking the medication immediately after a potential exposure, rather than waiting to access a healthcare provider or pharmacy. The starter kit includes a three-day supply of PEP, along with information on how to access additional medication and support.

When deciding between PrEP and PEP in pocket, it is important to consider several factors, including:

  • Timing: PEP must be started within 72 hours of exposure to be effective, while PrEP must be taken daily to be effective.
  • Frequency: If you engage in occasional or frequent risky behaviour, then PrEP might be better for you. If you very rarely engage in risky behaviour, then PEP in pocket could suit you better.
  • Effectiveness: PrEP is generally more effective than PEP, but PEP can still significantly reduce the risk of infection if taken correctly.
  • Cost: PEP can be more expensive than PrEP, especially if it is not covered by insurance. However, if used infrequently, it can come out to be less expensive than PrEP

It's also important to note that regardless of which option you choose, it's still important to practice other prevention methods, such as using condoms and getting tested for HIV and other sexually transmitted infections regularly.

How to Get PEP and PrEP in Canada

In Canada, both PrEP and PEP are available with a prescription from a healthcare provider.

There are a few ways to access PrEP in Canada. You can look into using an online service such as Julius MD. You can also ask your family doctor or visit an online clinic in person to ask if PrEP is right for you. For more information, check out our guide on getting PrEP in Canada.

To access PEP, you will need to seek medical attention as soon as possible after a potential exposure to HIV. PEP is most effective when started within 72 hours of exposure, so it is important to act quickly. You may be able to access PEP through a hospital emergency department, a walk-in clinic, or a pharmacy. Read up on our guide to getting PEP in Quebec and our guide to getting PEP in Ontario.

In Canada, there are also several resources available for people who have questions about PrEP and PEP or who need assistance accessing these medications. For example, CATIE (the Canadian AIDS Treatment Information Exchange) provides information and resources on HIV prevention and treatment, including PrEP and PEP. Additionally, some provinces offer support programs for people who are taking PrEP or PEP, such as free medication and laboratory testing.

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