What is PrEP?

PrEP means Pre-Exposure Prophylaxis, and it’s the use of HIV medication in purpose of preventing HIV negative people from becoming infected. Usually PrEP treatment is a single pill taken daily.  PrEP is a combination of two HIV medicines (tenofovir and emtricitabine), sold under the brandname Truvada. Generic versions of Truvada also exist but due to Truvada patent the generics are not available in all European countries. Studies have shown that PrEP is highly effective for preventing HIV if it is used as prescribed.

Why take PrEP?

PrEP is for HIV negative people who are at high risk for getting HIV.  This includes men who have sex with men who have anal sex without condom with multiple partners.  Also men who have sex with men diagnosed with a sexually transmitted disease (especially Syphilis or rectal Gonorrhea/Chlamydia infection)  in the last last year. PrEP is also recommended for men who take drugs in a sexual context (Chemsex) or take part in sex parties.

People who have an HIV positive partner who is on HIV treatment (and has undetectable viral load) don’t need PrEP. HIV is not transmitted from an HIV positive person who is on treatment – not even through unprotected sex.

How to use PrEP?

The most common and recommended way by World Health Organisation (WHO) is to take PrEP is to take it daily. If taking daily PrEP, it is best to take it at the same time each day so that it becomes part of a routine but a few hours late or early is fine. For some people it’s better to take the medication with food to prevent stomach symptoms. PrEP has relatively few long-term side effects.

One possibility is to take PrEP event or demand based . If you know that you might have condomless sex 24 hours in advance:

Take 2 pills 2 – 24 hours before sex
Take 1 pill 24 hours later
Take 1 more pill 24 hours after

There will be both option available in Finnish guidelines for PrEP use. (Guidelines will be publish at spring 2019)

How to get PrEP?

There are no published official guidelines yet concerning PrEP in Finland. Guidelines should be available during Spring 2019. At the moment the only available medicine used for PrEP in Finland is Truvada. The cost for one month’s supply of Truvada is about 800 Euros. Generics versions of PrEP should be available soon (situation February 2019). Patent issue of generic PrEP is now at suprime court and there is also other negotiations going with medical companies to have cheaper PrEP to Finland. Generic versions are available in many European countries and outside of European Union but according to Finnish custom rules and regulations you are not allowed to import them to Finland outside of EU. Medicine orders (3 month supply for personal use) with prescription from another EU country is possible.

One possible way to get PrEP is to order it from an online pharmacy to England. The lowest cost for one month’s supply of Truvada generic is 30 Euros / month.  It is also allowed to import 3 months supply of prescription medicine from EU/EEA country to Finland. This requires that you have a prescription written by a physician from European country. The medicine is shipped to a permanent address in England (PO Box won’t work).

The generic version of Truvada is available in many European countries (e.g., Netherland, Sweden and Germany). It is possible to purchase medicine from EU countries if you have a prescription written by a Finnish physician. In Sweden PrEP generic is available in pharmacys for example Apotek pharmacies (no shipping). Generic PrEP costs 20 – 50 e/30 pills in Sweden. One option is to order PrEP from Germany based internet pharmacy. One of these pharmacys is: Info for order: Before ordering generic PrEP from Germany you must contact the pharmacy via email and the prescription should be sent to the pharmacy by post. In Germany 30 pills of PrEP cost about 70 Euros and PrEP for 3 months use will cost around 200 Euros (shipping and handling not included).

Always when getting on PrEP it’s important to see a physician that has enough knowledge about PrEP. Before starting the medication some laboratory tests are also required. It’s very important to be sure that a person going on PrEP does not have HIV and also regular HIV and other STI testing is essential when a person is on PrEP. PrEP should be used always under medical supervision.

Here is a link for WHO’s quidelines for clinics/doctors (in finnish) – basics of PrEP. Note! This is not official quideline for Finland. It’s translation from WHO’s guidelines.

Here is new info card based on Finnish PrEP quidelines. (in finnish)

Blog about PrEP: Hey, Should we talk about PrEP?

More info about PrEP and how to get it to UK: iwantprepnow

Reliable PrEP internet pharmacys : Green Cross Pharmacy ja Dynamix International