According to the statistics released by HIV Prevention England and the Department of Health and Social care, trans people are more likely to become HIV-positive than cisgender people. This can be for many reasons, including lack of access to services, barriers to prevention methods and lack of knowledge of treatment. One method of HIV prevention all trans people should be aware of is PrEP. 

What is PrEP? 

PrEP stands for Pre-Exposure Prophylaxis. It's a pill that HIV-negative people can take that can stop you getting HIV. 

How do I take PrEP? 

You can take PrEP in a couple of different ways, depending on the type of sex you are having and how frequently: 

  • Taking PrEP regularly: one tablet a day, every day 
  • On demand/event-based PrEP: two tablets two to 24 hours before sex, one tablet 24 hours after sex and a further tablet 48 hours after sex. 

Both methods have shown to be very effective in preventing HIV.  

Where can I get PrEP? 

PrEP is now available for free from sexual health clinics in England. 

In Scotland, PrEP is available through sexual health clinics. Visit PrEPScot to find out how to get PrEP. 

In Wales, visit the Public Health Wales website to find your local sexual health clinic. 

Currently in Northern Ireland there is an initial consultation and assessment for a two-year pilot trial, based at a centralised service in Belfast.  

You can also buy PrEP. Information website iwantprepnow has a verified list of online sellers. 

Being trans and taking PrEP 

Trans women and transfeminine people:  

More studies are looking at PrEP for trans women, and although most previous studies have looked at anal sex, PrEP is also thought to be effective if you have had a vaginoplasty.  

Trans men and trans masculine people: 

If you haven’t had lower surgery, you need to take PrEP daily for at least six days a week, and you need to take it for a week before it reaches the best levels for protection. 

If a trans man is taking testosterone, it can reduce natural lubrication and make the tissue thinner inside the front hole. It’s unknown if this can make PrEP less effective or change how long it takes for PrEP to reach protective levels. That’s why daily PrEP is recommended.  

For anal sex studies have shown that on demand/event-based PrEP works as well as taking it daily. 

It’s safe to take PrEP: 

  • If you take gender-affirming hormones – it won’t stop any hormones you are taking from working 
  • If you get pregnant 
  • If you take birth control 
  • If you chest-feed. 

Further reading and advice 

For further information about sexual health for trans people, including services and testing, visit CliniQ.

For further HIV information and statistics both in the UK and worldwide in relation to trans people, visit NAM aidsmap.

For further advice about trans sexual healthcare including the THT Direct helpline, visit Terrence Higgins Trust.

For a full rundown on PrEP, including where to find it, visit Prepster.

To speak to people who may be going through the same thing as you or looking for the same information, visit the LGBT HERO Forums to find help, advice and to share your story.