PrEP for trans and non-binary people

PrEP is just as safe and effective for people who are transgender or non-binary as it is for cisgender people.

Dosing choices depend on the type of sex, although daily dosing has generally been recommended. 

Anyone having receptive vaginal/frontal sex can quick-start with a double dose (two pills). This works in two hours rather than the old advice to take daily PrEP for 7 days before sex. 

After sex, take daily PrEP (one pill) for seven days. For daily PrEP, current guidelines recommend at least six daily doses a week. This might be reduced in the 2024 UK guidelines.

Anyone having insertive or receptive anal sex or insertive vaginal/frontal sex can use 2:1:1 event-based dosing. Event-based dosing using 2:7 dosing is recommended for receptive vaginal/frontal sex.

Please see these links.

• How to start and stop PrEP
• Daily PrEP dosing
• Event-based dosing
• Examples of event-based 2:1:1 and 2:7 dosing

PrEP is very safe with hormone treatment

Even though you might worry about drug interactions, neither your hormone or PrEP levels will be affected.

Liverpool University produce an excellent guide to drug interactions between hormone treatments and other HIV meds:
www.hiv-druginteractions.org/printable_charts

Ongoing studies are looking at other aspects of PrEP in trans women and men.

Useful links

CliniQ

CliniQ is a London-based specialist clinic providing sexual health and well-being services for trans people.

56T clinic

56T clinic at Dean Street has a very busy PrEP service for trans and non-binary people.

Clinic T

Clinic T is a trans and non-binary friendly sexual health service in Brighton.

Indigo Gender Service

Indigo Gender Service is an NHS trans health care service in Manchester.

Last updated: 1 February 2024.