I receive various questions from over half a million young people who follow my pages on social media every day. There is a question that I am often asked by young people who are particularly scared and anxious after having unprotected sex:
"Dr. Priya, I had unprotected sex last night. I'm very scared now that I might get HIV. What should I do immediately to save my life?"
When I met Asanga (age 24) who had sent this message, the first thing I told her was to calm down. "Asanga, it's natural to be scared after having unprotected sex. But at this time , PEP (Post-Exposure Prophylaxis), which can be taken within 72 hours, can save your life. And today, we will also talk in detail about the wonderful protection method called PrEP (Pre-Exposure Prophylaxis), which can be used to prevent such fears in the future."
๐จ Red Flags that require immediate medical attention
If you have experienced any of the following dangerous situations, you should immediately go to a government STD clinic and seek emergency treatment within 72 hours:
- Having sex without using a condom with someone who is HIV positive or unsure of their status.
- A condom breaks or comes off during sex.
- Fever, body aches, sore throat, and rashes after unprotected sex 2-4 weeks ago.
- Sharing a single-use needle or syringe.
What is the difference between PrEP and PEP?
Many people confuse PrEP and PEP, so it is important to understand the basic difference between them:
| Feature | ๐ PrEP (Pre-Exposure Prophylaxis) | ๐งช PEP (Post-Exposure Prophylaxis) |
|---|---|---|
| Meaning | Preventive treatment taken before sexual intercourse. | Emergency treatment after sexual intercourse. |
| Time to take medication | It should be taken daily starting a few days before sexual intercourse. | It should be started within 72 hours of unprotected intercourse. |
| Medicine course | Continue to take daily as long as the risk persists. | The pills must be taken continuously for 28 days. |
| Success | If used correctly, it prevents HIV by 99%. | If taken correctly, it largely prevents HIV transmission. |
How does PrEP work?
PrEP is an antiviral medication that prevents the HIV virus from multiplying in the body before the body is exposed to it. It can be taken in two forms:
1. Oral Pills: Taking one pill daily, such as Truvada or Descovy .
2. Injectable: The recently introduced Apretude vaccine is given intramuscularly monthly for the first two months, and then every two months thereafter.
Both of these methods, if used correctly and according to medical advice, prevent the risk of contracting HIV through sexual intercourse by 99% .
> [!IMPORTANT]
> PrEP only prevents HIV (human immunodeficiency virus) infection. PrEP cannot be used to prevent pregnancy or other sexually transmitted infections (STIs) such as syphilis, gonorrhea, and herpes.
Who should take PrEP?
Doctors recommend PrEP medication to people who are not currently infected with HIV (HIV negative) and who fall into the following categories:
- People who have sex with multiple partners without using condoms.
- People whose partner is infected with the HIV virus (Serodiscordant Couples).
- Men who have sex with men (MSM).
- People who use shared needles or syringes to inject drugs.
Things to consider when using PrEP
- Regular medical checkups: Before starting PrEP, you should definitely get an HIV test to make sure you are HIV negative. You should also get HIV tests and renal function tests every 3 months while taking PrEP.
- Time it takes for protection to take effect: At least 7 PrEP pills must be taken daily to be fully protected during anal sex. At least 21 pills must be taken continuously daily to be fully protected during vaginal sex.
Are there any side effects of PrEP medication?
Like any Western medicine, PrEP pills can cause minor side effects such as nausea, stomach upset, and headaches during the first few weeks of use. However, these usually go away completely within 2-3 weeks as the body adjusts to the medication. There may also be some mild soreness or swelling at the injection site. These minor side effects are nothing compared to the devastation caused by contracting HIV.
How to get free PrEP service in Sri Lanka?
Sri Lanka's National STD and AIDS Control Program (NSACP)It provides PrEP medication, HIV testing, counseling, and condoms completely free of charge through clinics located throughout the island.
You can book clinic appointments confidentially through the Know4Sure.lk website.
๐ Major Government STD Clinics:
- Colombo National Clinic: 29, The Serum Place, Colombo 10. Tel: 0706477044 / +94 112 667 163
- Kalutara Clinic: District General Hospital Kalutara. Tel: 034-2236937
- Mahamodara (Galle) Clinic: Teaching Hospital Mahamodara. Tel: 091-2245998
- Kurunegala Clinic: Teaching Hospital Kurunegala. Tel: 037-2224339
- Anuradhapura Clinic: Teaching Hospital Anuradhapura. Tel: 025-2236461
- Jaffna Clinic: Teaching Hospital Jaffna. Tel: 021-2217756
- Chilaw Clinic: District General Hospital Chilaw. Tel: 032-2220750
- Badulla Clinic: Teaching Hospital Badulla. Tel: 055-2222578
Do's & Don'ts
| โ๏ธ Things to do (Do) | โ Don'ts |
|---|---|
| If you have had unprotected sex, go to a hospital immediately and request PEP treatment within 72 hours. | Do not start using PrEP medication before you have been medically tested to confirm that you are HIV negative. |
| Use condoms along with PrEP medication for maximum protection every time you have sex. | Do not have unprotected sex before the number of days (7 or 21 days) required to build up sufficient protection in the body has been completed. |
| Remember to take your daily PrEP pills at the same time every day, without skipping. | Do not suddenly stop taking PrEP without your doctor's advice and testing. |
โ Some other questions you may have (FAQ)
Can using PrEP prevent pregnancy through sexual intercourse? โผ
No, PrEP does not have birth control capabilities. To prevent pregnancy, you must use condoms or another form of family planning.
What should I do if I miss a day of PrEP? โผ
Take the pill as soon as you remember. But if it is almost time for the next pill, do not take two pills at once to make up for the missed pill, but take the pill at the next regular time.
Is a prescription necessary to obtain PrEP? โผ
Yes, PrEP is a medication that must be prescribed by a doctor after testing kidney function and HIV status. Therefore, you should visit the nearest government STD clinic and see a doctor.
Do you charge money for PrEP and PEP medications from government clinics? โผ
No, all government STD clinics in Sri Lanka provide PrEP, PEP medication, counseling services, and blood tests completely free of charge.
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