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PrEP is only available for free in England through clinical trials.
Thousands of people who are not on those trials buy their PrEP from online pharmacies.
If you’re thinking of buying PrEP online, here’s how to do it safely.
Can I get NHS support if I buy PrEP online?
Many NHS sexual health clinics now provide free support to people who are using PrEP that’s been bought online. This includes advice, support and monitoring. Apart from an HIV test and a standard STI screen, the only additional tests that you need from a clinic are kidney function tests (see below) and a test for Hepatitis B. This is needed because PrEP drugs are also active against Hep B. If you have Hep B you can still use PrEP but will need advice on the safest way to do it.
What are kidney function tests?
A very small number of people develop issues with their kidneys when they use PrEP. Kidney function tests spot any problems with your kidneys and will help you work out, with a health professional, if you should not use PrEP, or should stop using it. It is advisable to have both a blood test (that tests for creatinine and eGFR in the blood) and a dipstick urine test (that tests for protein in the urine) before starting PrEP, or as soon after starting as possible.
Should I test for HIV before starting PrEP?
Before starting PrEP it’s important to know for sure that you don’t have HIV. Make sure you use a ‘4th generation’ HIV test – these tests are better at picking up recent HIV infection than older generation tests. ‘4th generation’ HIV tests are usually only available in sexual health clinics: finger-prick HIV tests, including those available to test yourself, are not as good at picking up recent HIV infection.
How soon after testing negative can I start PrEP?
If your 4th generation HIV test comes back negative, you can start to take PrEP straight away. If you’ve taken any HIV risks in the four weeks before that HIV test, it’s a good idea to take another test four weeks later, in case the first HIV test did not detect recent HIV infection. If that test comes back as HIV positive, stop taking PrEP, and seek immediate advice and support from a sexual health or HIV clinic.
Should I start PrEP if I’ve had recent flu?
If you’ve experienced recent flu-like symptoms, after an HIV risk, then it is important not to start PrEP. The symptoms could be of recent HIV infection and you should seek support and advice from a sexual health clinic.
What other tests should I have once I’ve started using PrEP?
If you’re sexually active then the same guidelines on HIV and STIs screening applies, regardless of whether you use PrEP or not. Full HIV and STI screens are a great idea for all people with an active sex life! In addition, to check your kidney health, it’s advisable to have a dipstick urine test at every clinic visit, and a blood test to check your kidneys every year (see above). When you’re at the clinic it’s also a good plan to check your vaccination status for Hepatitis B and, if you’re under 45, to ask about the new HPV (warts virus) vaccination pilot programme.
Where can I get PrEP in the UK?
The website iwantprepnow.co.uk lists a number of online pharmacies that have been checked and verified. Checks have been made to ensure that the sites are reliable and that the PrEP they are selling is genuine (see below). Many of these sites do not accept credit/debit cards but instead use bank or wire transfers, and sometimes Pay Pal for payments. We have received no reports of people being ‘ripped off’ from the pharmacies reviewed on iwantprepnow.co.uk.
How do I know the PrEP sold online is genuine?
PrEPster and iwantprepnow.co.uk have worked with sexual health doctors to undertake Therapeutic Drug Monitoring (TDM) tests on people who have bought and used PrEP from the websites featured on iwantprepnow. Recent research reported the results of over 200 of those tests – and found no evidence that the drugs are not genuine. In summer 2018 PrEPster undertook tests on PrEP bought from six major suppliers and found no evidence of fake PrEP.
Is it legal to buy PrEP online?
If you live in the UK it is legal to buy and import PrEP as long as it is for personal use. It is strongly recommended that no more than three months’ worth (usually up to 3 bottles of 30 pills) is bought at once.
What if I don’t live in the UK?
Most online pharmacies won’t deliver to countries where it is illegal to buy and import PrEP. However, some people are buying PrEP online using a UK delivery address and then shipping PrEP to their country via a courier service. We strongly advice checking local country advise when doing this.
Other ways of getting PrEP
Some people are getting PrEP through a private prescription from their doctor. This costs around £400 a month. Dean Street in London have also started to offer PrEP for £55 a bottle. There are reports of people using ‘PEP for PrEP’ or ‘clinic hopping’, and of people buying PrEP informally such as through friends, contacts, or from other informal sources. We strongly urge caution in obtaining PrEP from sources that cannot be traced or verified.