How to take PrEP: The options gay and bisexual men need to know

Whether you're new to PrEP or looking to brush up on how it works, finding out how to take it the right way is key to making sure you stay protected against HIV.

PrEP has been a game-changer for HIV prevention and has led to fewer new cases of HIV amongst gay and bisexual men over the last few years. When used correctly, it is over 99% effective at protecting you against HIV.

Over 83,000 gay and bisexual men in England used PrEP in 2023, but how clued up are you on the different ways to take it?

Let’s break it down.

Starting PrEP

You need to know you are HIV negative before you start taking PrEP so that means getting an HIV test.  

Once you are ready, you can start with a double dose (two pills) of the medication, two to 24 hours before sex. After two hours you are protected from HIV and then you can start one of the following routines.

Daily PrEP

One pill taken every day.

This is the way most people take PrEP as they find it easier and protection is always “on.”

It is best if taken around the same time every day.  

If you take PrEP every day and miss a dose you’ll still be protected as long as you are taking 4 doses a week. Just take a dose the next day as usual. Talk with someone at the clinic or PrEP provider to get help if you are regularly missing doses.

Four times over the week

Another way is to take four pills over the week, sometimes called the T's and S's as you take the pills on days the start with T and S – so, Tuesday, Thursday, Saturday and Sunday. This is to make it easy and simple to remember when to take it, and it would still provide protection on Monday, Wednesday and Friday.

Some people prefer this method for the fewer pills they have to take per week.

Event-based PrEP

If the idea of taking PrEP daily or four times a week doesn’t appeal, or you just want to have PrEP only around the time you have sex, this might be your option.

You start as you would normally do with two pills 2 to 24 hours before sex. You follow that with another pill 24 hours after you’ve had sex and the last pill 24 hours after that.

Tips to stick to your PrEP routine

It can be easy to miss taking your dose of any medication, PrEP included. There are ways that can support you to remember to take your doses.
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• Stick to a routine - it helps to take the pills around the same time every day.

• Pill boxes - many people use pill boxes that are sectioned into days to put their pills in. You can find a range of options at your local pharmacy.

• Apps - there are a couple of apps with alerts to remind you to take your PrEP.

These include:

PrEP Emerge  

PrEPtime
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• Plan ahead - if you are likely to stay away from home, carry a dose with you.

PrEP and STIs - how to stay on top of your game.

PrEP offers protection against HIV but doesn’t cover you against other STIs. You have options to stay protected from STIs that include:
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• Condoms are effective for protection against STIs. Remember, use them correctly, consistently and with water-based lube.

• Get vaccinated for hepatitis A and B  

• Get vaccinated for gonorrhoea - a new vaccine for gonorrhoea that gay and bisexual men will be eligible for will be available from August 2025. Talk to your sexual health clinic for further details.

• DoxyPEP - this involves taking 200mg of doxycycline up to 72 hours after you have had sex to protect you against syphilis and chlamydia.

• Get vaccinated for HPV - gay and bisexual men can get a vaccine for HPV up to the age of 45 from a sexual health clinic.

• Get vaccinated for Mpox - Find an mpox vaccination site

PrEP is about taking control. Remember to choose the dosing option that works for you and take your PrEP as prescribed.

For further information on PrEP you can visit your sexual health clinic.

Read more about PrEP

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