Do I need to use a condom if I'm taking PrEP antiretroviral tablets?

Q. Who should take PrEP? Can you stop using condoms if you are taking PrEP?

A. Pre-exposure prophylaxis, commonly referred to as PrEP, consists of antiretroviral tablets to be taken by people at high risk for HIV acquisition.

PrEP is prescribed by a health professional and taken daily to lower the chances of getting infected with HIV.

In South Africa, a combination of two antiretroviral medicines has been approved for daily use as PrEP to help prevent an HIV-negative person from getting HIV from a partner who is HIV-positive.

Studies have shown that PrEP is highly effective for preventing HIV if it is used as prescribed.

Daily PrEP use can lower the risk of getting HIV from sex by more than 90%, and from injection drug use by more than 70%.

PrEP is recommended for people who are burdened with disproportionately high rates of acquiring and transmitting HIV. In South Africa some of the most vulnerable groups are young women, men who have sex with men, sex workers and people who use drugs.

PrEP can also be considered for people who are HIV-negative and in an ongoing sexual relationship with an HIV-positive partner.

It is also considered for a person or a partner who has had anal sex without using a condom or been diagnosed with a sexually transmitted infection, which could include gay men, bisexual men and women with bisexual male partners.

People who do not regularly use condoms during sex with partners of unknown HIV status are at substantial risk of HIV infection, and thus may be considered for PrEP.

Condoms are effective in preventing HIV as well as some sexually transmitted infections, like gonorrhoea, chlamydia, human papillomavirus, genital herpes and syphilis.

You must take PrEP daily for it to work, and continue to use condoms properly and correctly every single time to prevent STIs.

If your risk of getting HIV infection becomes low, you may stop taking PrEP. It is always advisable to consult your health provider before starting or stopping treatment.

In South Africa, PrEP is available at limited sites.

With the large base of evidence for the success of PrEP, it is urgent that PrEP is available for all who would be considered high risk with vulnerabilities to acquiring HIV.

• Dr Tlaleng Mofokeng (MBChB), sexual and reproductive health practice, DISA Clinic, 011-886-2286, visit safersex.co.za.

Do you have a question about sex?

E-mail your questions to lifestyle@sundaytimes.co.za with SEX TALK as the subject. Anonymity is assured.