PrEP for trans and non-binary people

PrEP is just as safe and effective whether you are transgender, non-binary or cisgender.

This is the case for both oral and injectable PrEP.

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

Everyone can start PrEP 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 if you want to use event-based dosing (called 2:7). If you want to continue on daily PrEP, you just need to take at least 4 daily doses each week.

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.

Note: Some researchers think that 2:7 dosing is more pills than are needed and that fewer doses after sex would be okay, for example, 2:1:1:1 dosing. This is based on limited data though and isn’t yet included in guidelines.

Please see these links.

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 produces an excellent guide to drug interactions between hormone treatments and other HIV meds:

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 healthcare service in Manchester.

Last updated: 1 November 2025.