Question
Can I extend 2-1-1 PrEP dosing?
17 February 2024. Related: All topics, PrEP.
Hello,
I have a couple questions regarding on demand prep.
It says to take 2-1-1 but also to keep taking prep for 2 days after last sex encounter. What if the day of having sex is the same day I’m taking the second dose (1 pill). So my last dose (1 pill) would be closer to 24 hours after sex not 48 if one were to follow the 2-1-1. Should I take another pill so as longs as it’s 48 hrs? Which would probably be more like taking 2-1-1-1 (total of 5 pills not 4).
Second question. If I’m restarting on demand with one pill because it’s been less than 7 days since last on demand regimen, is it also required to take it at least 2 hours before having sex again or does it matter since it’s considered you have Truvada protection still in your body?
I’d appreciate any clarification .
Thanks in advance .
Answer
Hi, how are you doing?
As you have mentioned you should take another pill. 2-1-1-1 dosing is suitable.
In this event it works similar to daily dosing. The initial dose is a ‘loading’ dose and is the main reason to being different to daily dosing.
It is okay to continue with as many doses as you need to ensure you have 2 days of PrEP after the last time having sex.
For your second question, you do not need to take PrEP at least 2 hours before. You will already have a level of PrEP in your body. This time requirement is only needed for the initial double dose if having sex on that day.
Josh.
Hi Alex, as you had been on PrEP with no gaps you did not need to restart with a double dose. You can start with on-demand PrEP (a double dose) and continue daily until you have no further sexual encounters. As long as you ensure to take PrEP for the 2 days following the last sexual encounter, PrEP will remain effective.
Having this additional double dose of PrEP midway through will not have caused any problems with your health. PrEP will still remain effective.
Good afternoon from here Sir Josh,
My name is Alex. May I please raise some questions regarding my case on Prep ?
Well, i had sex on Thursday. I did take 2 pills of prep that day and one on Friday then finished another one on Saturday. As planned, I had another encounter on Sunday (just the next day after last dose 1) so i took two pills again as I thought it’s new and to restart it. I will then take one on Monday and last 1 on Tuesday. Does this correct sir? And if it’s not according to prep protocol, will it affect my health? Will prep decrease its effectiveness? Thank you!
Hi victor, no this is not an issue. As you had stared with the on-demand dose of a double loading dose, continuing with PrEP from this point works like daily PrEP.
As long as you ensure to continue PrEP for 2 days after the day of exposure, PrEP will remain effective.
Hello. I have a kind of similar question:
I have been taking 2-1-1 prep but I have always been precise with the guidelines (2 before sex, 1 and 1 after). But this is the first time that for reasons out of control I didn’t have sex on the first day, and instead on the second day (insertive anal). Being 2-1-(sex)-1.
Should that being an issue? I’ll take a 3rd pill just in case (5 in total). But I like to be really strict on this topic so I’m a bit worried.