Check that it works:
It’s important to know if PrEP is working. In clinical trials the risk reduction of HIV was 90% if it is taken regularly.
(1) HIV tests: every 6 months to check the medication is working
(2) Check compliance: we can teach you tricks to maximise the number of doses you remember to take. The more uninterrupted your PrEP is, the better it works.
PrEP monitoring
Award winning clinic for healthcare and business quality standards in 2016 & 2018
- What is PreP?
- How people get on PreP in Spain
- Tests we do in people taking PrEP
- Our service: the PrEPARADO programme
What is PreP?
Anti-HIV medication to avoid infection:
PrEP is a way of taking anti-HIV medication to reduce the possibility of getting infected by the virus during sex.
PrEP (“pre-exposure prophylaxis”), was first thought of as an option when it was shown that people with HIV who receive medication stop being infectious for others. They therefore started to wonder if it would work as a preventative.
If this medication is taken every day it slowly reduces the risk of getting infected with HIV in unprotected sex. Efficacy has been demonstrated in many studies and is a safe choice if monitored.
Interesting data from clinical trials:
The most important features seen in clinical studies were the following:
(1) Reduction of HIV risk in unprotected sex of around 90%
(2) The major impact on overall HIV reduction was in unprotected anal sex
(3) Better protection seen in those who took the tablets every day and didn’t skip doses
(4) Well tolerated, but kidney function needs monitoring due to side effects of the tablets
(5) More gonorrhea, chlamydia and syphilis are seen in people using PrEP so regular testing is recommended.
Read more below about how people obtain PrEP in Spain
How people get on PreP in Spain
It is still not available in the public health system:
The use of PrEP has been authorised by the ” Agencia del Medicamento y Productos Sanitarios” (Medication and Health Product Agency), but there has been no final decision taken regarding how it will be financed. Therefore, to date, it is still not available.
There are some clinical trials up and running studying PrEP and newer medications as PrEP candidates, and some people are managing to get the medication this way
But some people choose to buy it online:
According to our own investigation that we will publish in a conference this Summer 2018, many clients in Open House are already buying their own PrEP online. In this survey we performed we saw that none of these people were doing regular efficacy and safety checks.
Can PrEP be sent to Spain from another country?:
In article 72 of the Spanish law 29/2006 (26th July) it is stated that the import of medications is the exclusive right of pharmaceutical laboratories, and therefore it is impossible to send medication as quality and safety cannot be guaranteed.
In other countries however, importation is permitted and the cost of acquiring this drug is around 80€ per month.
Is online PrEP authentic?:
One of the most prestigious public STI clinics in London, the renowned “56 Dean Street” are the authors of the website www.iwantprepnow.co.uk
On their website you can read how they financed their own study to look at these online drugs and generate a Drug Therapeutic Monitoring report. The results show that overseas online medication (those tested) were authentic. You can download their report here.
Tests we do in people taking PrEP
Check that it’s safe:
PrEP can affect the kidneys. This was not seen very often in clinical trials but should be monitored. If you take this drug long term it can reduce your bone density too.
(1) Kidney function tests: every six months to check your kidneys are OK. This is a blood test.
(2) If you take PrEP for 5 years or more we recommend a bone density scan.
Look out for other infections:
Someone taking PrEP is probably going to have more unprotected sex than others. Therefore it is important to check them for chlamydia, gonorrhea and syphilis which are infections we often have without symptoms. Silent cases are especially common in the throat and rectum.
We should also look out for hepatitis C.
(1) Blood tests: syphilis and hepatitis C, Six monthly or annual testing.
(2) Gonorrhoea and chlamydia tests: we detect these infections by looking for their DNA. The sample may be urine, from the throat or rectum depending on which part of your body was exposed in sex. We can check all three if you like or just one site to keep costs down (see below).
Our service: the PrEPARADO programme
Only available in our Madrid clinic
Set-up visit
You will be here in the clinic for about 25 minutes.
You don’t have to see the doctor, but at any time you visit us we can always ask him/her to see you at no additional cost.
(1) Questionnaire about your general and sexual health
(2) Blood extraction
(3) Sample collection (urine, throat and/or rectum)
Follow-up visit:
You will be in the clinic for just 15 minutes.
(1) Questionnaire about how you’re doing with the PrEP
(2) Blood extraction
(3) Sample collection (urine, throat and/or rectum)
You should at least do the HIV and kidney function tests but we can organise sample collection if you would like to add those tests.
Do you need to speak to our doctor? No problem, you can always see him/her for free. But remember that they will be calling you tomorrow with your results.
We can do the following test for you:
HIV and kidney function = 75€
HIV and kidney function, syphilis and hepatitis C = 100€
These 4 blood tests + gonorrhea and chlamydia in one of the three sites (urine or throat or rectum) = 155€
If you prefer we check gonorrhea and chlamydia from two sites = 210€
If you would like a complete check-up from all three sites plus the blood tests = 265€
Results take just 24h and our doctor will call you to discuss them without you having to come back to the clinic.
The PrEPARADO programme: checks your PrEP works, that it’s safe, that there no other infections present and all in one speedy visit.