HIV Prevention Medication (PrEP)
HIV/AIDS can be prevented by taking prevention medication.
Taking it before a possible infection event is called PrEP, and taking it after a possible infection event is called PEP.
For those who live far away, we offer telephone consultations and a delivery service.
What is PrEP?
PrEP (Pre-exposure prophylaxis) is an HIV prevention measure in which anti-HIV medication is taken before sexual activity and similar occasions in order to reduce the risk of infection.
It is a preventive method recommended particularly for people at high risk of contracting HIV, and it is now also recommended by the WHO (World Health Organization), on the grounds that “condoms leave prevention up to your partner, whereas with PrEP you take the medication by your own decision and protect yourself.”
– Those who sometimes do not use condoms
– Those whose partners sometimes will not use condoms
– Those who have an HIV-positive partner
– Those who have anal intercourse
– Those who have many sexual partners
– Those working in the sex industry (a special menu is also available)
PrEP Prices
We have introduced generic PrEP, so it can be purchased at an affordable price. In addition, every set includes the cost of the blood tests required to start and continue PrEP.
When starting or continuing PrEP, you must undergo appropriate testing. There is a risk of HIV virus resistance and of worsening hepatitis B.
(Price) = (Consultation fee) + (Set price)
– Consultation fee: 2,500 yen for a first visit, 1,000 yen for a follow-up visit (tax included)
– A doctor’s consultation is always required for a PrEP prescription.
Set Prices
| 1-Month Set | 3-Month Set | 6-Month Set |
|
|---|---|---|---|
| PrEP bottle (Descovy) | 1 bottle (30 tablets) | 3 bottles (90 tablets) | 6 bottles (180 tablets) |
| Price (tax included) | 10,000 yen | 19,000 yen | 37,000 yen |
| HIV test (same-day) | ◯ | ◯ | ◯ |
| Hepatitis B test (same-day) | ◯ | ◯ | ◯ |
| Syphilis test (email) | ◯ | ◯ | ◯ |
| Kidney function test (email) | ◯ | ◯ | ◯ |
| Test after 3 months | ― | ― | ◯* |
*Includes HIV, hepatitis B, syphilis and kidney function tests. If you do not wish to visit us again for the test after 3 months, we can also provide a mail-in kit (+500 yen).
Prices for Those Who Do Not Need Testing
For those who have had HIV and hepatitis B tests within 1 week and bring the results with them, we will prescribe PrEP at the following prices.
Price: 7,000 yen (tax included)
Only for those who bring the results of HIV and hepatitis B tests taken within 1 week
What is included:
– 1 PrEP bottle (30 tablets), Descovy
– (For those who wish) Kidney function test (email): an additional 500 yen (tax included)
Price: 16,000 yen (tax included)
Only for those who bring the results of HIV and hepatitis B tests taken within 1 week
What is included:
– 3 PrEP bottles (90 tablets), Descovy
– (For those who wish) Kidney function test (email): an additional 500 yen (tax included)
Test Set for Those Currently Using PrEP
For those who import PrEP personally, we offer a monitoring consultation set.
Price: 5,000 yen (tax included)
What is included:
– HIV test (same-day)
– Hepatitis B test (same-day)
– Syphilis test (email)
– Kidney function test (email)
For patients who purchase PrEP from us, we accept any and all questions via LINE 24 hours a day, such as how PrEP combines with other medications or how to take PrEP. Please feel free to contact us.
Prevention of Other STIs
PrEP is a method for preventing HIV only. It has no preventive effect against STIs other than HIV, so regular testing is recommended.
Being infected with syphilis, gonorrhea or chlamydia makes it easier to contract HIV. This is because infection of the urethra, vagina, mouth or anus causes inflammation of the mucous membranes, and HIV enters where the mucosal barrier has been weakened.
In addition, testing for other STIs such as gonorrhea and chlamydia is strongly recommended both when starting PrEP and after taking it.
For those to whom we prescribe PrEP/PEP, we provide syphilis testing free of charge and gonorrhea and chlamydia testing at a special price, as a way to further reduce the risk of HIV infection.
Gonorrhea and chlamydia (3 sites: genitals, throat and anus): 3,000 yen (usually 20,000 yen)
Vaginal discharge test (vaginal candidiasis, trichomonas and bacterial vaginitis): 3,000 yen (usually 4,500 yen)
Contraceptive injection (Depo-Provera): 8,000 yen/session* or 22,000 yen/3 sessions* (usually 9,000 yen/session or 25,000 yen/3 sessions)
*This special price is available to those who purchase PrEP, Doxy-PEP or vaginal candida prevention medication from us.
How to Take PrEP
How to Start PrEP
When starting PrEP, the guidelines require tests such as HIV, hepatitis B and kidney function tests at the first visit. (For details, please see here)
If these tests are not carried out, there is a risk of HIV virus resistance and of worsening hepatitis B.
For those starting PrEP, we perform same-day testing for HIV and hepatitis B, along with kidney function testing and quantitative syphilis testing.
We are the only clinic in Kansai recognized by PrEP in JAPAN, an AIDS policy research project of the Ministry of Health, Labour and Welfare.
Please feel free to visit us with peace of mind.
PrEP must not be used. After a confirmatory HIV test, HIV treatment is required.
PrEP itself can be used, but it must not be used on demand (a method of taking it only before and after sexual intercourse). Please ask a doctor for details.
You can use PrEP while receiving treatment. Please ask a doctor, including about treatment methods.
Ways of Taking PrEP
There are 2 ways to take PrEP. For those who have sexual intercourse 2 or more times a month, we recommend daily PrEP (taken every day).
If there is anything you do not understand about how to take it, please be sure to consult a doctor.
Regardless of sexual intercourse, take 1 tablet 1 time a day at a time you decide for yourself.
Daily PrEP has a preventive effect of over 99 percent and is a method of use whose safety has been established.
This is a method of taking it before and after sexual intercourse. The preventive effect is reported to be 86%.
Take 2 tablets 2 to 24 hours before sexual intercourse, then 1 tablet 24 hours after that, and another 1 tablet 24 hours after that.
Please fix the time you take it to the time you took the first 2 tablets.
If sexual activity continues for several days: continue taking it every 24 hours, and for 2 days from the day of the last sexual intercourse, keep taking 1 tablet each day.
The 2nd time you take it is not 24 hours after the sexual activity, but 24 hours after the 1st time you took it.
If you use on-demand PrEP incorrectly (for example, if you took 1 tablet instead of 2 tablets at the start, or if you could not take 1 tablet a day for 2 days after the activity ended, etc.), there is no preventive effect against HIV. If you are worried, please contact us via LINE.
Even in such cases, we accept inquiries via LINE, so you can use it with peace of mind.
We recommend taking daily PrEP.
On-demand PrEP must be taken correctly at set times, and HIV infections have been reported when doses were forgotten or not taken correctly.
With daily PrEP, even if the timing shifts or a dose is forgotten, the blood concentration of the medication is unlikely to fall, so the preventive effect is less likely to decline.
We especially recommend daily PrEP for those who have sexual intercourse 2 or more times a month.
Precautions While Taking PrEP
If you take PrEP continuously, have an HIV test 1 time every 3 months as a guide.
If you are not taking it correctly and you should happen to contract HIV and keep taking PrEP without noticing the infection, HIV will become resistant to the PrEP medication, which becomes a major obstacle to treatment.
If no doses are missed, a preventive effect close to 100% has been confirmed, but HIV infections due to missed doses and similar causes have been reported.
For those who are worried about forgetting to take PrEP, we recommend daily use (taking it every day).
How to Stop PrEP
If you want to stop PrEP, you must keep taking it for at least 2 days after the last risk activity before stopping.
To stop PrEP safely, taking it for about 1 week is safer.
Please consult with a doctor in advance if you are unsure.
Types of PrEP
We use Descovy (a new medication) as our PrEP.
Nausea, diarrhea, etc.
Short-term: nausea, abdominal pain, diarrhea, headache and skin rash
Long-term: kidney impairment, decreased bone mineral density, etc.
We generally prescribe the new medication Descovy (generic).
Truvada, an existing medication that has been widely used, carries a risk of impaired kidney function and osteoporosis when used long-term. Since 2019, after the new medication Descovy was approved by the FDA in the United States, there has been a gradual movement to switch PrEP from Truvada to Descovy (to use the PrEP with fewer side effects).
At present, generic Truvada has become difficult to obtain in Japan, so PrEP use will shift mainly to Descovy from now on.
European guidelines state that the use of Descovy for on-demand PrEP is permitted.
A doctor can give you a detailed explanation regarding side effects and the medication.
PrEP Prescription Flow
An in-person PrEP prescription takes approximately 30 minutes, from your arrival through to payment.
Visit
Please make an appointment through our website or Official LINE. If you answer 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.
Medical Interview and Consultation with a Doctor
At the first visit, you will discuss with the doctor what kind of PrEP plan would be most suitable.
Testing
In addition to same-day testing for HIV and hepatitis B, standard syphilis testing and kidney function testing are performed (approx. 20 minutes).
Those coming for the 2nd time or later will undergo testing before the doctor’s consultation.
Explanation of Results
The doctor will explain the results of the rapid test. Feel free to ask any questions or discuss any concerns.
PrEP Prescription
The medication will be handed to you at the reception desk when you pay, so please start taking it.
If you continue taking it from the 2nd time onward, you will undergo the above tests after arriving, and if there are no problems with the doctor’s consultation and the rapid test, we can continue to prescribe it.
Frequently Asked Questions
What is the difference between a generic and a brand-name product?
A generic (a later-released product) is a medication released after the patent on the brand-name product expires, with the same active ingredients and equivalent quality, efficacy and safety as the brand-name product.
The brand-name PrEP is extremely expensive, at over 110,000 yen for 1 month's supply, so we use generics in order to provide it to patients at a low price.
Why is it cheaper than at other clinics?
We keep costs down by using generic medications.
Also, out of a wish to see HIV prevention medication become widespread in Japan as well, we provide it as inexpensively as possible.
Which way of taking it is better, daily or on demand?
For those who have sexual intercourse 2 or more times a month, we recommend daily (taking it every day). This is because the risk of infection is lower with daily use even if a dose should be missed.
Are condoms still necessary while taking PrEP?
PrEP can only prevent infection with the HIV virus. It cannot prevent other STIs.
Even while on PrEP, please make an effort to practice safe sexual behavior using condoms.
I forgot to take my medication. What should I do?
Take it as soon as you notice you have forgotten, and the next day take your medication at the usual time.
How should the medication be stored?
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 a car that becomes hot, etc.
We also provide testing, treatment and prevention for STIs.