HIV prevention has advanced greatly in recent years, and one of the most powerful tools available today is Pre-Exposure Prophylaxis (PrEP). PrEP involves taking HIV medicines before exposure to reduce the risk of becoming infected. It is especially important for people at higher risk of HIV.
If you think you might be at risk of HIV—for example, if you are in a relationship where one partner is HIV positive, have had unprotected sex, or belong to a group with higher chances of exposure—you can get personalised advice from licensed doctors through Hope Plus. This premium service helps you get timely care and avoid complications.
Let’s break down how PrEP works, who should consider it, and the different options available in Uganda.
What is PrEP?
PrEP is a preventive method where HIV-negative people take antiretroviral drugs (ARVs) daily or use long-acting alternatives to protect themselves from HIV infection. Think of it as a protective shield—it does not cure HIV, but it can stop the virus from taking hold if you are exposed.
Who Should Consider PrEP?
PrEP is recommended for HIV-negative people at substantial risk of infection. This includes:
- People in discordant relationships (where one partner is HIV positive and the other is negative).
- Anyone who has had unprotected vaginal or anal sex with multiple partners of unknown status.
- People who have sex in exchange for money, goods, or services.
- People who use or inject drugs.
- Those who have had repeated sexually transmitted infections (STIs) in the past year.
- Recurrent users of post-exposure prophylaxis (PEP).
- Members of key populations such as sex workers, fisherfolk, long-distance truck drivers, uniformed forces, and men who have sex with men (MSM).
- Adolescent girls and young women at high risk, including pregnant or breastfeeding women.
If you fall into any of these groups, PrEP can be a life-changing option for you.
Steps Before Starting PrEP
Before prescribing PrEP, health workers carry out a few important checks:
- Confirming that you are HIV negative using the national testing algorithm.
- Ensuring you do not have signs of recent (acute) HIV infection.
- Checking for hepatitis B infection. If positive, you can still use PrEP, but doctors take extra care when stopping it.
- Assessing kidney function, since PrEP medicines are filtered through the kidneys.
How PrEP is Taken
The most common form of PrEP in Uganda is a daily pill. It contains a combination of medicines such as tenofovir (TDF) with either emtricitabine (FTC) or lamivudine (3TC).
- You take one tablet daily, ideally at the same time each day.
- At first, you may be given a 1-month supply with a follow-up appointment, then 2-month and later 3-month refills.
- During follow-up visits, you will be tested for HIV, checked for side effects, and given support to stay on track.
- Women may also have pregnancy tests if there is a chance they are expecting.
Adherence—taking your pill every day—is the most important factor for PrEP to work effectively.
Other PrEP Options in Uganda
Apart from daily pills, there are newer and more flexible options for HIV prevention:
- The PrEP Ring: A soft silicone ring containing a drug called dapivirine is inserted into the vagina and left in place for one month. It releases the medicine slowly where protection is most needed. Side effects are usually mild and may include vaginal discharge, itching, or mild pelvic pain. The ring is especially useful for women who prefer not to take daily pills.
- Injectable PrEP (Cabotegravir): This is a long-acting injection given in the buttock once every 8 weeks. It has been shown to be over 95% effective in preventing HIV. Many people like it because it avoids the need for daily tablets. Side effects are rare and usually mild, such as slight pain at the injection site.
When to Stop PrEP
PrEP is not meant to be taken forever. It can be safely stopped if:
- You test HIV positive (you would then need HIV treatment instead).
- Your risk of HIV decreases, for example, if you enter a mutually faithful HIV-negative relationship.
- Your partner living with HIV has been on treatment for over 6 months and has an undetectable viral load.
- You experience intolerable side effects.
- You find it too difficult to take it consistently.
Remember, stopping PrEP should always be discussed with a healthcare professional.
Key Takeaways for Patients
- PrEP is a safe and effective way to prevent HIV if you are HIV negative and at high risk.
- It must be used consistently—either daily (pill), monthly (ring), or every 8 weeks (injection)—to provide full protection.
- Regular follow-up testing is essential to confirm HIV status and check your health.
- PrEP does not replace condoms; using both together offers the best protection against HIV and other STIs.
PrEP has the power to protect individuals, families, and communities in Uganda. If you believe you may benefit from it, don’t hesitate to seek guidance early.
