🛡️ Men's Health

PrEP — HIV Prevention Pill in Nigeria

Who should take it, how it works, and where to get it in Nigeria

Pre-exposure prophylaxis (PrEP) is a daily medication taken by HIV-negative people to prevent HIV infection. When taken consistently, oral PrEP reduces the risk of sexually acquired HIV by more than 99%. PrEP is recommended by WHO, Nigeria's Federal Ministry of Health, and is available at a growing number of PEPFAR-supported clinics in Nigeria — usually free of charge for eligible individuals. Despite its proven effectiveness, PrEP remains underutilised and unknown to most Nigerians who would benefit from it.

Signs and Symptoms

✓ PrEP is preventive medicine — it has no 'symptoms of effectiveness'

✓ Common side effects in first 4 weeks: nausea, headache, diarrhoea — usually mild and self-resolving

✓ Rare: kidney function changes — monitored with creatinine test every 6 months

✓ PrEP does NOT protect against other STIs (gonorrhoea, syphilis, chlamydia) — condoms still recommended

✓ PrEP does NOT cause HIV — the drugs in PrEP cannot give you HIV

✓ If started after recent exposure, PrEP is NOT appropriate — use PEP instead

Risk Factors

PrEP is recommended if you have ongoing substantial HIV risk:
HIV-negative partner of someone with HIV (especially if not on ART or detectable viral load)
Multiple sexual partners or inconsistent condom use in a high-prevalence area
Recent STI diagnosis (syphilis, gonorrhoea, herpes) indicating unprotected sex
Injection drug use with shared needles
Sex worker or client of sex worker
Men who have sex with men (MSM) in Nigeria — significantly elevated risk

When to Seek Help

Starting PrEPHIV test required before starting — you MUST be HIV-negative. Starting PrEP with undiagnosed HIV causes drug resistance

If you have unprotected sex while on PrEPPrEP protects if taken daily for at least 7 days before exposure (for anal sex) or 21 days (for vaginal sex). Occasional missed doses significantly reduce protection

Emergency — possible HIV exposure in last 72 hoursPrEP is NOT emergency medicine — use PEP (post-exposure prophylaxis) instead, available at most PEPFAR sites

Side effects that don't resolve after 4 weeksPersistent nausea, dark urine, or ankle swelling — attend clinic for review and possible regimen change

Every 3 months while on PrEPRoutine HIV test, STI screening, kidney function, and adherence counselling required to continue PrEP

Tests & Diagnosis

🧪 HIV test (mandatory)

Must be negative before starting PrEP — and every 3 months while on PrEP (in case of seroconversion)

🧪 Kidney function (creatinine)

At baseline and every 6 months — tenofovir (in standard PrEP) can affect kidneys in a small number of people

🧪 STI screening

Gonorrhoea, chlamydia, syphilis, hepatitis B — at PrEP start and every 3–6 months

🧪 Hepatitis B surface antigen

People with active hepatitis B who stop PrEP may have hepatitis B flare — needs specialist management

🧪 Blood pressure

At PrEP initiation and periodically — especially for older users

Treatment Options

Standard oral PrEP (daily)

Tenofovir disoproxil fumarate + Emtricitabine (TDF/FTC) — one tablet once daily. Brand name: Truvada. Generic versions widely available at PEPFAR sites in Nigeria

Alternative: TDF/3TC

Tenofovir + Lamivudine — generic, widely available in Nigeria. Equivalent efficacy to TDF/FTC for most users

Timing — when does protection begin?

Full protection for receptive anal sex: 7 days of daily dosing. Full protection for vaginal sex: 21 days. Protection is maintained as long as daily dosing continues

Event-driven PrEP (2+1+1)

Two pills 2–24 hours before sex, one pill 24 hours later, one pill 48 hours later. Only studied in MSM for anal sex — not recommended for vaginal sex or daily high-risk situations

Where to get PrEP in Nigeria

PEPFAR-supported sites (IHVN, AHNi, Heartland Alliance sites), some teaching hospitals and state HIV treatment centres. Ask at your nearest government hospital HIV clinic

PrEP discontinuation

If stopping PrEP, continue for 28 days after last potential exposure. HIV test 4–8 weeks after stopping

Frequently Asked Questions

Does PrEP mean I don't need condoms?

PrEP protects against HIV only — not other STIs. Gonorrhoea, syphilis, chlamydia, and herpes rates are rising even among PrEP users. Condoms provide dual protection. Many people on PrEP use condoms in new relationships and rely on PrEP alone in stable relationships where both partners have tested negative.

Can women take PrEP?

Yes. PrEP is equally effective in women. It is particularly recommended for women with HIV-positive partners (especially if not on ART), women who are unable to negotiate condom use, and women in sex work. PrEP is safe during pregnancy and breastfeeding.

Will people know I'm on PrEP?

PrEP pills look like any other tablet. Your HIV status and PrEP use are strictly confidential — clinicians cannot disclose without your consent. Many PrEP users choose not to disclose they are on PrEP, which is their right.

Is PrEP free in Nigeria?

PrEP is currently free at PEPFAR-funded sites in selected states (Lagos, Abuja, Kano, Rivers, Oyo, and others). Eligibility criteria apply. As the programme expands, more sites are being added. Ask at your nearest HIV treatment centre.