PrEP Survey Northern Ireland

Have you heard of PrEP? Are you on it? If not, why not? Either way we would love to hear about your experience and opinion about it in this short survey.https://www.surveymonkey.com/r/BNL2BLF

Who are we?

Yvonne – Advanced Nurse Practitioner in Genitourinary & HIV medicine in Belfast Trust. Provides a weekly PrEP clinic at Crumlin Road Health centre and looks after people living with HIV, particularly those on Long-ActingInjectable treatment.

Carol – Consultant in HIV/GUM, leading the PrEPservice in Belfast. I also run the QUB students Union walk-in clinic.

What is PrEP?

It’s a tablet you take before sex to prevent HIV infection. It can be taken different ways. The main ways people use it are daily (every day) or event based (relating to sexual activity), but it is best to talk to someone with clinical expertise to help work out what’s best for your activity

Background.

FastTrack Cities is a global initiative focused on eliminating new sexual HIV diagnoses by 2030. Northern Ireland became a FTC region April 2024.

There are approximately 1,350 residents in Northern Ireland accessing HIV care.  HIV is a long-term but manageable condition, and it is preventable.  In Northern Ireland, Gay & Bi men remain the group most affected by new and late HIV diagnosis, and some of them have never heard of or accessed PrEP.

The number of new HIV diagnosis has been reducing in Northern Ireland and PrEP use has been key in achieving that reduction.

What are we asking?

The survey is completely anonymous; no identifiable details are collected. There is no way to link responses to individuals. Most people take around 8 minutes to complete. It is divided into two parts, one for those taking PrEP & the other for those not taking PrEP.

We are asking questions around people’s experience with PrEP. For those who have accessed it, if you areusing it consistently and correctly, do you use it with every partner or do you self-select who to take it with? It will also provide insight into knowledge, barriers and perception of risk of those who have not accessed PrEP.

This feedback is essential in planning service delivery & development, education & policy. It is only for those living in NI and please only complete the survey once.

Should everyone be taking PrEP?

If you are HIV negative, are having sex with gay, bi or transgender individuals, using Chems or selling / exchanging sex, then you should consider PrEP.  If you are worried about your risk, have a discussion with your local clinic for advice.

There are lots of ways to prevent HIV when having sex. Firstly, it is important is to know your status by testing regularly. If you get a negative HIV result, you can then prevent it by using condoms, PrEP or Post Exposure Prophylaxis (PEP) if there is any risk. Oral Sex is not a risk for HIV. Used consistently & correctly PrEP can reduce the risk of acquiring HIV by up to 99%

How do you take PrEP?

Event based PrEP is taken according to the rule of two:2 tablets at least 2 hours before sex (can be 2-24hrs before) and then 1 tablet each day for 2 days.

Daily is taking 1 tablet every day, but can be started off with 2 tablets to ensure PrEP cover in 2 hours’ time.

A new injectable option has just been approved by NICE and is available for use in England, Wales and Scotland. Northern Ireland is exploring this as an option currently. It is an injection into the muscle every 2 months. There also is another option pending approval, which is once every 6 months. Regular injections won’t be to everyone’s taste, but providing choice increases the number of people using prevention and this benefits all.

Are there any side-effects?  Is it okay with my other tablets?  How often do I need to attend clinic?

Both PEP & PrEP are very safe to take. Some people experience slight nausea, bloating or headache with the first few doses but these usually resolve quickly.  Before you start and if continuing PrEP, you will require regular HIV, Hepatitis and kidney checks usually every 3- 6 months.   Interactions with your other tablets and medications will be assessed before starting & at each review.

What happens if I miss a few tablets?  

PrEP is extremely effective when used consistently. If you have missed 2 doses in a row, then your protective drug level has gone down & you should take 2 tablets again & wait at least 2 hours before any sexual contact.  It is important to continue taking 1 tablet daily for 2 days after your last sexual intercourse before stopping.

What if I’m taking it event based & hook up with someone unexpectedly, can I take it when I get home?  

If you have had sex and haven’t taken PrEP, we would advise getting PEP (Post Exposure Prophylaxis). This medication can be taken up to 3 days (72 hours) after sex without a condom, to prevent HIV. It is available in any Emergency Department or from GUM clinics as an emergency. The sooner you take it the more effective it is.

If you have PrEP available, take 2 as soon as possible AND access PEP.

PrEP should always be taken before sexual contact to be effective.

How do I get PrEP?

It is available in all 5 Health Trusts, in the Genito-urinary Medicine (GUM) or sexual health clinics. In the Belfast Trust it is available by making an appointment and having an assessment visit.

Details for each GUM clinic and how to access PrEP are available www.sexualhealthni.info

What if my HIV test is positive?

HIV is a treatable condition. Most people living with HIV are on 1 tablet a day and well. The treatment freezes or suppresses the virus so it is undetectable in the blood and body fluids. This means it can’t be passed on, we say undetectable is untransmittable or U=U. : www.rainbow-project.org/uu Please speak to someone if you have questions.

Is there protection for other conditions available?

There are vaccines to protect against Hepatitis A & B, HPV, Gonorrhoea and Mpox, and tablets (DoxyPEP) for Syphilis and Chlamydia. These are all available in GUM clinics free of charge. Please book in and ask.

If everyone who is sexually active knows their HIV status, assesses their risk and accesses PrEP or PEP as needed, we could prevent HIV transmission. Together we could get to zero new transmissions and everyone living well in Northern Ireland.