Before you start PrEP

First, please talk to a health adviser, nurse, doctor or community worker.

These people can help you if you want to start PrEP, or are already taking it.

Then it is essential to have an HIV test before or as you start.

If you are already HIV positive and don’t realise it, you could develop drug resistance.

Ask for a 4th generation HIV blood test. This is also called an antigen/antibody test. This will tell you if you have HIV so long as you haven’t had other risks in the last six weeks.

Most finger prick tests are currently 3rd generation. This test needs 2-3 months to show a positive result. Don’t rely on a finger prick test before PrEP if you have a more recent risk.

If you are just starting PrEP and had a risk in the last six weeks, have another 4th generation HIV test six weeks after starting. This is to be sure an early infection is not missed.

Be careful about starting PrEP if you have flu-like symptoms and had a recent HIV risk. This is in case these symptoms are related to a recent HIV infection.

If you are starting PrEP after PEP, it is best to start straight away if you need to. Ideally you should have a 4th generation HIV test after you finish PEP/start PrEP. Then have another test six weeks after starting PrEP.

Check your kidneys

A kidney test just involves a blood test for creatinine. This should ideally be done just before or on the day you start. Some clinics might still test for protein in a urine sample.

Check for other sexually transmitted infections (STIs)

Testing for HIV and STIs is a great idea for anyone with an active sex life. This is whether you use PrEP or not.

Test for hepatitis B (hep B, HBV)

Testing for hep B is essential. This is because PrEP meds are active against both HIV and HBV.

This is a good time to have this vaccine, or to boost a previous vaccine. Please ask your clinic about this.

People with hep B need to take PrEP every day, with medical advice, especially if you want to stop.

Stopping PrEP can lead to rapid inflammation in the liver. 

This can be very serious. It can lead to hospitalisation and in rare cases can be fatal.

Last updated: 1 February 2024.