PrEP – taking medicine to prevent HIV
What PrEP is, who it is for, how to get it free in South Africa, how long before it protects you, and what the regular check-ups are for.
What PrEP is
PrEP stands for pre-exposure prophylaxis: medicine taken by an HIV-negative person, before any exposure, to stop HIV establishing an infection. Taken as prescribed it is highly effective. It is available free at public clinics in South Africa and through many other services.
The medicine used for oral PrEP in South Africa:
Tenofovir / Emtricitabine (TDF/FTC) — Truvada, Ricovir-EM
HIV-1 infection (NRTI backbone); HIV pre-exposure prophylaxis (PrEP)
Who it is for
PrEP is for anyone who is HIV negative and at ongoing risk of exposure. You do not have to belong to a category or justify yourself to qualify; wanting it is a reasonable basis for a conversation at a clinic.
- A partner living with HIV, especially one who is not on treatment or not yet virally suppressed.
- Sex without condoms, or condoms that are not used consistently.
- More than one partner, or a partner whose other partners you do not know about.
- A recent sexually transmitted infection.
- Anyone who feels at risk and would rather have the protection.
Starting, stopping, and how long it takes to work
- Go to a clinic and ask for PrEP. You will have an HIV test and some baseline checks, including kidney function.
- You will be told how long to take it before you are protected. This differs by the type of exposure, so ask specifically rather than assuming — it is not immediate.
- Take it as prescribed. PrEP taken inconsistently is much less protective, and this is the main reason it fails.
- Come back for the repeat visits. These include an HIV test each time and are what keeps it safe.
- If you want to stop, ask how — there is a period of continuing after the last exposure rather than stopping the same day.
- Side effects are usually mild and settle in the first weeks: nausea, headache or stomach upset.
- Tell the clinic about any kidney problems or other medicines you take.
- Missing an HIV test is not a small thing. It is the check that catches an infection early enough to switch you to full treatment.
Common questions
- Is PrEP free in South Africa?
- Yes, it is available free at public clinics and through many other services. You will have an HIV test and baseline checks before starting, and repeat visits with an HIV test each time.
- How long does PrEP take to work?
- It is not immediate, and the period differs by the type of exposure. Ask the clinic specifically how long to take it before you are protected rather than assuming.
- What is the difference between PrEP and PEP?
- PrEP is taken ongoing, before exposure, to prevent HIV. PEP is a short emergency course started within 72 hours after a specific exposure that has already happened. If you have already been exposed, you need PEP today.
Sources
- National Consolidated Guidelines for the Management of HIV in Adults, Adolescents, Children and InfantsNational Department of Health, South Africa
- National clinical guidelines and policy libraryNational Department of Health, South Africa
- Clinical and public health guidanceWorld Health Organization
- Medicines Online Directory and approved patient information leafletsSouth African Health Products Regulatory Authority
Last reviewed 11 August 2026.