FAQs

The only way for you to know this is for you to take an HIV test.

There is lots of information about risk, but unless your risk is zero, which is sometimes the case, you need to test to find out.

Testing is easy and free or cheap.

If you are worried that you have been at risk, like millions of other people, just take a test.

The only way you can know your HIV status is by taking an HIV test.

If you are sexually active, then it is better for you and your partner to know your HIV status.

HIV testing should be a routine part of looking after your sexual health. As is repeating the test every 6-12 months – or as appropriate, depending on your level of sexual activity and risk. This is important in case you are exposed to HIV in the future.

In the UK and many other countries, at least one-third of people living with HIV are not yet diagnosed.

General risks are not very helpful for individual circumstances for two reasons.

1. If you have had any risk that is, for example, 1 in 1000, you still need to test to know your result. This remains true whether the risk was much higher (1 in 10) or much lower (1 in 20,000).
2. Because a general risk of 1 in 1000 (sometimes quoted for unprotected insertive sex) is meaningless without considering other factors.

You need to know the chance that your partner is HIV positive, whether they are on treatment, if so, what is their viral load? Some things you won’t be able to test for, like genetics.

Even these few factors could change the same risk of 1 in 1000 to as high as 1 in 10 or as low as 1 in 20,000.

No. If you want to know your HIV status you need to take your own test.

You cannot interpret your HIV status based on another persons’ results.

You also have no right to ask another person to take an HIV test.

This is about your sexual health. It is your responsibility to test. You cannot impose your worries about your health on another person.

If you test positive, then it makes sense to notify your partners so they can also test.

Post Exposure Prophylaxis, or PEP, is a course of HIV medication which you can take if you have been at risk of HIV infection. The course of medication lasts 28 days and, if you start taking it within 72 hours of being at risk, it may be able to prevent you from becoming infected with HIV. In other words, it is a form of protection (against HIV) that you can take after you have taken a risk or had a condom break.

How effective is PEP?
Research indicates that PEP can prevent infection with HIV, but it is not 100% effective [1]. PEP is more likely to be effective when the treatment starts as soon as possible after the risk occurred. It will not be prescribed later than 72 hours after HIV exposure.

What are the side effects?
People taking PEP are likely to experience the same kind of side effects as HIV-positive people experience when they begin to take HIV medication, which can include:

Diarrhoea
nausea
headaches
tiredness.

As a result of these side effects, some people fail to complete the full course of PEP.

What medication will they use?
PEP consists of a triple combination of anti-HIV drugs [3]. A number of different drugs may be used, but the recommended combination is Truvada (one tablet taken once daily) and Ritonavir (one tablet twice daily). Truvada is a combination pill consisting of tenofovir (TDF) and emtricitabine (FTC). The drugs should be taken as prescribed for 28 days.

Taking PEP
The drugs used for PEP are expensive and powerful so the decision to offer treatment is not taken lightly. PEP uses the same drugs that treat HIV infection so you are likely to experience the same kind of side effects as people who are beginning to take HIV medication. Common side effects include diarrhoea, nausea, headaches, and tiredness. In rare cases more serious side effects, such as liver damage, can occur. The doctor will need to explain the effects of these medications before you start PEP. Some people often stop taking PEP or miss doses due to these side effects, but this stops the treatment from working. In order to have the greatest chance of success, every dose of PEP must be taken as prescribed. If you find you have missed a dose, take it as soon as you remember it.

Where do I get PEP?

This will vary from country to country, the following applies to the UK.

At a Sexual Health Clinic
At an Accident & Emergency (A&E) department of some hospitals – A&Es are especially important at weekends because most Sexual Health Clinics will not be open
Because HIV medication is expensive, clinics will only prescribe PEP if they believe that you have had a real chance of infection
PEP will not be given to someone who is already HIV-positive so you will always be tested for HIV before you are put on the course.

PrEP stands for Pre-Exposure Prophylaxis. An HIV-negative person takes pills (developed to treat people with HIV) regularly to reduce their risk of HIV infection. Several studies show that PrEP works. PrEP is currently only available in the UK to people enrolled in the PROUD study, or by private prescription from some sexual health clinics and GPs.

How effective is PrEP?
The PROUD study, which began in 2012, announced its findings on 24 February 2015. The study found that:

PrEP reduced the risk of HIV infection by 86% for gay and other men who have sex with men when delivered in sexual health clinics in England
The researchers concluded that PrEP offers a major opportunity to curb new HIV infections in men who have sex with men in the UK
Research suggests that PrEP is as effective as condoms in preventing HIV transmission, as long as the pills are taken regularly, as directed
Evidence from another large international study suggests that gay men who maintained at least four doses a week had 96% fewer infections.

PrEP does not prevent other sexually transmitted infections or pregnancy. It allows someone to protect their own health, irrespective of whether their partner uses a condom. Because it is taken several hours before sex, it does not rely on decision-making at the time of sex.

Why take HIV treatment to avoid taking HIV treatment?
People living with HIV need to take lifelong treatment. PrEP consists of fewer drugs and people only need to take it during periods when they are at risk of HIV. Many people find that their sexual behaviour changes over time, for example when they begin or end a relationship.

Does PrEP have side-effects?
Any medicine can have side-effects, so taking PrEP is a serious decision. The drugs in PrEP have been used as part of HIV treatment for many years. This has shown that they have a low risk of serious side-effects. Most people taking PrEP don’t report side-effects. Some people have stomach problems, headaches and tiredness during the first month but these usually go away. People taking PrEP have regular check-ups at a clinic.

Does PrEP mean people take more risks?
The PROUD study did not find significant difference in risk behaviour between the control arm of the study (those not on PrEP) and the immediate arm (those prescribed PrEP at the commencement of the study). Other studies of PrEP have consistently reported that being on PrEP did not result in people adopting riskier behaviours. Instead it gives people who already find it difficult to consistently use condoms a way to protect their health.