Can on-demand (2:1:1) PrEP be used by straight men? or women?
Is on demand prep just for anal – or also straight men having virginal sex? Is it only for men or both genders?
Thanks for your questions.
On demand dosing depends on which part of your body will come into contact with HIV.
The main difference is that PrEP drugs reach much higher levels in anal tissue compared to vaginal tissue.
So if your only risk is from anal sex and you are being fucked, on demand dosing can be used by everyone.
Any risk from vaginal (or front hole) sex and you are being fucked, needs daily dosing.
In practice, this mean most cis gender and trans gender women use daily dosing.
Trans gender men who have front hole sex also need to use daily dosing.
Cis gender men can use on demand for any type of sex. It doesn’t matter whether you are gay or straight.
This is because the IPERGAY study reported no infections in men who risk was just from insertive sex (ie being active for anal sex).
More info on PrEP dosing
- Daily PrEP: for anal and vaginal sex
- On-demand dosing: for anal sex or straight men having vaginal sex
- Real-life examples for on-demand dosing
UK guide to PrEP