Pre-Exposure Prophylaxis (PrEP) is a daily medication that provides high levels of protection from HIV. The science is in on this one too. If taken as prescribed, PrEP can be a successful HIV prevention strategy, although it does not protect against STIs or pregnancy.
At the moment, the only medication available and approved for use as PrEP in Australia is TruvadaTM. Although it isn’t currently available on the Pharmaceutical Benefits Scheme (PBS) there are PrEP demonstration projects (trials) in NSW, VIC and QLD that welcome trans men at risk of HIV infection. Other PrEP access options can be found here.
Truvada has no known contraindications with any transition-related hormones such as Primotestin and Reandron. It is an HIV medication that many trans people living with HIV have used for treatment over many years.
The current best expert opinion is that PrEP protects both front hole and anal penetration after 7 days. To maintain this protective level, people having receptive front hole sex need to keep taking Truvada daily, for people having receptive anal sex there is more flexibility, however, it is recommended that the medication be taken every day.
When and if you decide to stop taking Truvada as PrEP, make sure you keep taking it for 28 days after any risk event (such as condomless sex) before stopping the medication. This essentially turns PrEP into PEP and reduces the risk of seroconversion.
It’s also important to note that the HIV-negative partner in a serodiscordant relationship (i.e., where partners are of different statuses) where the HIV-positive person has an undetectable viral load is not eligible to participate in most of these Australian PrEP demonstration projects (except QLD) on the basis of having an HIV positive partner alone since the risk is so low.