But I Don’t Wanna Take a Pill Every Day… PrEP Dosing Options (for Anal Sex)

by | Jun 12, 2020 | PrEP 101

Picture it. You’re you, and you don’t remember to take your allergy pill every day. The one pill that can make the difference between you chatting it up with Sharon in reception or literally snotting all over Sharon’s always clean desk. Then there’s PrEP. The one pill you take every day to keep your sex life safe. Maybe you don’t have sex that often and don’t want to take it every day. But you definitely wanna be protected when you’re off on that upcoming booty holiday.

And then you say: “But sweet, intelligent blogger-my doctor says I must take PrEP every single day for the rest of my life, forever and ever to stay safe.”

And then I say: “Well, your doctor sounds wonderful; however, that isn’t necessarily true if you engage in anal sex.”

It’s true that our FDA guidelines have not yet caught up to France or Thailand’s  where intermittent and holiday PrEP usage is more popular. Even blokes down in Australia are enjoying “when-needed PrEP.” Just because these methods aren’t FDA approved (yet), it doesn’t mean they aren’t scientifically proven to work. PrEP can be taken 4 times per week and still remains around 96% effective at preventing HIV during anal sex.

If you are interested in PrEP and the options you have, here are 4 of them:

  1. Daily Dose. For the person that follows the guidelines and/or is not always sure when sex will happen or wants maximum protection. Who knows? That gorgeous ex may send a “hey, big head” text at any minute, and you’ve gotta be ready. This method also works best for people who engage in vaginal sex (although other methods are currently wrapping up clinical trials, this is the best method we have for people with vaginas right now.)
  2. Intermittent PrEP. This could also be called “Weekend PrEP.” This method is the 2-1-1 method. An easy way to explain it is 2 pills between 2 and 24 hours before having sex (so Friday morning if you’re going out Friday night), then one pill 24 hours after the first dose (Saturday morning), and another pill 24 hours after Saturday’s dose (or Sunday Morning). If you have sex after the last dose, keep taking PrEP once per day until a full 24 hours with no sex passes. Here’s a nifty infographic for ya to get that right:
(Image credit: sfaf.org)

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3. 4 for 4. Some people are taking PrEP only on days that start with T or S. That sounds like the end to a dirty limerick, but it’s true! This is particularly helpful if you only have sex a few times per month and feel like you are taking too many pills for one or two round of hanky-panky-baby-spank-me.

a. This may work best if you have been taking PrEP for over one week.

b. Recommended for anal sex, not recommended for frontal sex, although more research is needed.

4. Holiday PrEP. This method is closely related to Daily dosing but is only used during times of greater sex (greater as in frequency, not quality…I can’t help ya there!). So, if a person knows, for instance, they are going to see a long-distance partner or seek out a partner on vacation, or if a sexy time is just coming up for whatever reason, then PrEP can be scheduled. You take one week of PrEP before the sexy time, take it the week (or weeks, you lil’ horn-dog) of, then take it the week after (minimum of 3 weeks). Think of a week as 7 days before, 7 days of, and 7 days after the last bump and grind sesh (7-7-7 JACKPOT!)

Holy cannoli, PrEPMan (or woman or theydy or gentlefemme), look at all these options! When it comes to PrEP, there is no “one size fits all” solution for dosing. If you aren’t having sex (keep in mind, these options are for anal sex only) and know that you won’t be for any reason, you don’t have to take PrEP. PrEP lowers risks. If there is no risk, then what is there to lower? However, just because you aren’t sexually active now doesn’t mean you will remain that way. As always, consult your doctor, stay informed about your options, and trust yourself and your decision to stay safe.

Have more PrEP questions?

This sweet, intelligent blogger is open to chat. Give me at call at (216-714-2223) or fill out the form next to this blog.

Ask for help connecting to a doctor for PrEP.

Fiona Allan, University Hospitals
Call 216.286.7737
AKeem Rollins, MetroHealth
Call or Text 216.714.2223

Email AKeem at Metro for PrEP

Email Fiona at UH for PrEP