Worried About HIV... What Is PrEP, the HIV Prevention Medication You Can Take Daily?
At our STI clinic, we often hear people say they are worried about HIV. Among the diseases transmitted through sexual activity known as STIs, HIV requires lifelong treatment once contracted, so many people come in for a consultation out of concern.
There are several ways to prevent HIV, and among them there is a method of taking medication daily that has very high preventive efficacy and does not leave you depending on your partner.
We offer PrEP at a price that includes all the testing required for a PrEP prescription. We also take questions about how to take PrEP, drug interactions and anything else via LINE, 24 hours a day. Please feel free to visit us with peace of mind.
For those living far away, we offer online consultations and a delivery service for PEP.
Please feel free to consult us even outside regular consultation hours. For details, please see the link below.
When starting or continuing PrEP, you must always undergo appropriate testing. Prescriptions from facilities that do not perform the various tests, and personal imports without testing, carry the risk of HIV drug resistance and worsening of hepatitis B, and are dangerous. (For details, please see here)
We are the only clinic in the Kansai region recognized by PrEP in JAPAN, a research project of the Ministry of Health, Labour and Welfare’s AIDS Control Policy Research Program.
We are always available for consultations and questions regarding PrEP/PEP.
Price: 10,000 JPY
What is included:
– 1 bottle of PrEP (30 tablets), Descovy
– HIV test (same-day)
– hepatitis B test (same-day)
– syphilis test (by email)
– renal function test (by email)
Price: 19,000 JPY
What is included:
– 3 bottles of PrEP (90 tablets), Descovy
– HIV test (same-day)
– hepatitis B test (same-day)
– syphilis test (by email)
– renal function test (by email)
Price: 37,000 JPY
What is included:
– 6 bottles of PrEP (180 tablets), Descovy
– HIV test (same-day)
– hepatitis B test (same-day)
– syphilis test (by email)
– renal function test (by email)
– testing after 3 months (mail-in also available)
– With HIV infection, symptoms alone do not tell you whether you are infected. Once infected, continuous treatment is needed for life, so prevention is important.
– There are various ways to prevent diseases transmitted through sexual activity, but for HIV prevention, PrEP is important because its preventive efficacy is very high and it does not leave you depending on your partner.
– Taking 1 tablet once a day gives a preventive efficacy of over 99% (daily PrEP).
– We offer various PrEP testing + prescription packages. We also have a monitoring package for those who import personally.
– For those using a PrEP package, we provide syphilis testing free of charge and gonococcal and chlamydia testing at a special price, as a way to further reduce the risk of HIV infection.
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Note that the prices indicated in this page are all inclusive of tax.
What Is HIV Infection?
HIV stands for Human Immunodeficiency Virus.
HIV infection is a disease in which you are infected with the HIV virus and your body’s immune function declines, and it is one of the STIs transmitted through sexual activity.
Over the course of many years, the HIV virus destroys the immune cells in your body, and eventually you become prone to infection even by pathogens that do not normally cause infection, and every illness becomes harder to cure.
Without treatment, the decline in immune function eventually becomes severe and AIDS develops.
Treatment for HIV infection and AIDS has advanced dramatically. However, a complete cure is still not possible.
For this reason, prevention to avoid becoming infected with HIV is important.
How to Prevent STIs
The most reliable ways to prevent STIs are not to have sexual activity, and to have sex only with a partner who is known to be free of STIs.
However, that is often difficult, isn’t it? As other approaches, the following are generally cited as ways to prevent STIs.
Condoms, when used correctly, are highly effective for preventing STIs.
However, if a condom is not used from the very start of the act, or if it breaks during the act, the probability of infection rises.
Also, from the receptive partner’s perspective, there are risks such as the other person removing it during the act, making it a prevention method that depends on your partner.
For some STIs (such as human papillomavirus and hepatitis B), vaccination is effective.
There is no effective vaccine against HIV, but there is a medication called PrEP that, when taken regularly, has a preventive efficacy of over 99%.
What is PrEP?
PrEP (Pre-exposure prophylaxis) is an HIV prevention measure in which you take anti-HIV medication starting before sexual activity and so on, in order to reduce the risk of infection.
It is a prevention method recommended especially for people at high risk of contracting HIV, and it is now also recommended by the WHO (World Health Organization), which notes that “condoms are a prevention method that depends on your partner, whereas with PrEP you take the medication by your own choice and can prevent infection.”
– Those who sometimes do not use a condom
– Those whose partner sometimes will not use a condom
– Those who have an HIV-positive partner
– Those who have anal sex
– Those who have many sexual partners
– Those who work in the sex industry
Efficacy and How to Use PrEP
There are 2 ways to take PrEP. For those who have sexual activity 2 or more times a month, we recommend daily PrEP (taken every day).
If there is anything you are unsure about regarding how to take it, please be sure to ask a doctor.
Regardless of sexual intercourse, you take 1 tablet once a day at a time you decide for yourself.
Daily PrEP has a preventive efficacy of over 99% and is a method of use whose safety has been established.
This is a method of taking the medication before and after sexual intercourse. The preventive efficacy is reported to be 86%.
You take 2 tablets 2 to 24 hours before intercourse, 1 tablet 24 hours after that, and a further 1 tablet 24 hours after that.
If sexual activity continues for several days: continue taking it every 24 hours, and after the day of the last intercourse, continue taking 1 tablet each day for 2 days.
*The second dose is taken 24 hours after the first dose, not 24 hours after sexual activity.
We recommend taking daily PrEP.
On-demand PrEP must be taken correctly at fixed times, and HIV infections have been reported when doses were missed or not taken correctly.
With daily PrEP, even if the timing shifts or a dose is missed, the blood concentration of the medication is less likely to fall, so the preventive efficacy is less likely to decline.
For those who have sexual activity 2 or more times a month in particular, we recommend daily PrEP.
Types of PrEP
For PrEP, we use Descovy (a new drug).
With Truvada, which had been widely used, there are concerns about renal impairment and osteoporosis as side effects of long-term use, and particular care is needed with taking it for those who have renal impairment or osteoporosis.
Recently there has been a move to switch PrEP from Truvada to Descovy. This is because fewer side effects means almost no concerns with long-term use.
Side Effects of PrEP
Descovy, the new drug, has few side effects, and renal impairment and osteoporosis with long-term use are reported to be less frequent.
Nausea, diarrhea, etc.
Short-term: nausea, abdominal pain, diarrhea, headache, skin rash
Long-term: renal impairment, bone mineral loss, etc.
Prices for PrEP
We use generic PrEP and have made arrangements so that PrEP can be started inexpensively and safely.
The test results come as a package of same-day HIV and hepatitis B testing, plus syphilis and renal function testing whose results we convey later by email.
If you wish to use it on demand, please consider the PrEP 1-Month Package (30 tablets).
Price: 10,000 JPY
What is included:
– 1 bottle of PrEP (30 tablets), Descovy
– HIV test (same-day)
– hepatitis B test (same-day)
– syphilis test (by email)
– renal function test (by email)
Price: 19,000 JPY
What is included:
– 3 bottles of PrEP (90 tablets), Descovy
– HIV test (same-day)
– hepatitis B test (same-day)
– syphilis test (by email)
– renal function test (by email)
Price: 37,000 JPY
What is included:
– 6 bottles of PrEP (180 tablets), Descovy
– HIV test (same-day)
– hepatitis B test (same-day)
– syphilis test (by email)
– renal function test (by email)
– testing after 3 months (mail-in also available)
For those who import PrEP personally, we have prepared a monitoring consultation package.
Price: 5,000 JPY
What is included:
– HIV test (same-day)
– hepatitis B test (same-day)
– syphilis test (by email)
– renal function test (by email)
PrEP is strictly a method of preventing HIV. It has no preventive effect against STIs other than HIV, so regular STI testing is recommended.
Being infected with syphilis, gonococcal infection or chlamydia makes you more susceptible to HIV. This is because infection of the urethra, inside the vagina, the oral cavity or the anus causes inflammation of the mucous membranes, and HIV enters where the mucosal barrier has been weakened.
For those to whom we prescribe PrEP/PEP, we provide syphilis testing free of charge and gonococcal and chlamydia testing at a special price, as a way to further reduce the risk of HIV infection.
Gonorrhea and chlamydia (3 sites: genital, throat and anal): 3,000 JPY (normally 19,000 JPY)
Vaginal discharge test (vaginal candidiasis, trichomonas, bacterial vaginitis): 3,000 JPY (normally 4,000 JPY)
Prescribing PrEP and the Process
A PrEP prescription takes approximately 20 to 30 minutes, including everything from arrival at the clinic to payment.
Arrival at the Clinic
Please make an appointment through our clinic website or our official LINE. If you can complete the web medical questionnaire in advance, your consultation can proceed smoothly after you arrive.
*You can also be seen without an appointment, but you may have to wait. Please tell the reception desk that you would like PrEP.
Doctor's Medical Interview and Consultation
At the first visit, you will discuss with the doctor what kind of PrEP plan would be desirable.
Testing
In addition to same-day HIV testing and same-day hepatitis B testing, we perform standard syphilis testing and renal function testing (approximately 20-30 minutes).
Those coming for the second time or later will undergo testing before the doctor’s consultation.
Explanation of Results
The doctor will explain the rapid test results. Feel free to ask any questions or discuss any concerns.
Prescription of PrEP
Your medication will be handed to you at the reception desk when you pay, so please begin taking it.
If you continue taking the medication from the second visit onward, you will undergo the above testing after arriving at the clinic, and if there are no problems with the doctor’s consultation and the rapid tests, we can continue the prescription.
Q&A About PrEP
Below we have gathered frequently asked questions about PrEP.
What is the difference between generics and originator drugs?
A generic drug is a medication released after the patent on the originator drug expires, with the same active ingredient, quality, efficacy and equivalent safety as the originator.
The originator drug for PrEP is very expensive, at over 110,000 JPY for 1 month's supply, so we use generics in order to offer it to patients inexpensively.
Why is it cheaper than at other clinics?
We keep prices down by using generic drugs.
Also, out of a desire to see HIV prevention medication become widespread in Japan as well, we offer it as inexpensively as possible.
Which way of taking it is better, daily or on demand?
For those who have sexual activity 2 or more times a month, we recommend daily (taken every day). This is because, even if a dose is missed, the risk of infection is lower with daily.
Do I still need condoms while taking PrEP?
What PrEP can prevent is infection with the HIV virus only. It cannot prevent other STIs.
Even while on PrEP, please make a point of safe sexual behavior using condoms.
I forgot to take my medication. What should I do?
As soon as you notice you have forgotten, take it right away, and the next day take your medication at the usual time.
How should I store the medication?
The medication comes in a bottle containing a desiccant. Please store the bottle at room temperature. Please take care not to leave it in a refrigerator or in places that become hot, such as inside a car.
[Doctor Daisuke Shiojiri]
Director of Personal Health Clinic, Doctor of Medical Science.
At the National Center for Global Health and Medicine (Shinjuku, Tokyo) and Personal Health Clinic, they provide accurate, evidence-based knowledge on HIV, PrEP and other STI and STI testing matters, along with care that stays close to patients' feelings.
Born in Japan but raised in Kenya, Africa, they also hold a medical license there and carry out medical support and educational support activities.
They also see patients at our clinic as a part-time physician.
