Starting PrEP in Adelaide: a plain-English guide

What is PrEP?

PrEP stands for pre-exposure prophylaxis. It is medication taken by someone to reduce the chances of acquiring HIV if they are exposed during sex. In Australia, PrEP is usually a tablet that can be taken daily, or “on-demand” around the time of sex.[1]

How well does PrEP work?

The evidence for PrEP is strong. When taken exactly as prescribed, PrEP can reduce the chance of acquiring HIV infection from sex by about 99%.[2,3] Taking into consideration that not everyone takes medication as prescribed, real-world effectiveness is about 86% at reducing HIV from sexual transmission.[4] “On-demand” PrEP taken before and after sex reduced HIV infection by a similar figure in men who have sex with men.[5]

In Australia, local studies have supported this. In a large study in New South Wales with over 3,000 participants followed up over one year, only two acquired HIV, and both were noted to not be taking the medication as prescribed.[6]

Who is PrEP for?

PrEP is worth considering if you do not have HIV and may possibly be exposed to HIV in the future. This may include:

• Men who have sex with men having receptive (bottom) condomless sex with a casual male partner
• Regular condomless sex with a person living with HIV who is not on treatment or has a detectable viral load
• Anyone who may share injecting drug equipment with a person with HIV or a person whose HIV status is unknown
• Men who have sex with men having casual sex where partners may be anonymous or unknown

Some people do not fit neatly into a “risk category” but still benefit from PrEP. That might be because their sex is occasional but higher risk, because their partner situation is complex, because they travel, or because PrEP reduces anxiety and helps them feel more in control of their sexual health.[1]

If your only HIV exposure is sex with a partner living with HIV who is on treatment and has a sustained undetectable viral load, the risk of sexual HIV transmission is effectively zero. This is often called U=U, meaning “undetectable equals untransmittable”. Some people still choose PrEP for extra reassurance or because their situation is not straightforward.[1,3]

How do I start PrEP in Adelaide?

Dr Christian Peut is a Specialist General Practitioner and PrEP prescriber in Adelaide, offering PrEP initiation and PrEP follow-up appointments in general practice.

If you are looking for a PrEP doctor in Adelaide, a PrEP GP in Adelaide, or want to start HIV pre-exposure prophylaxis, you can book an appointment to discuss daily PrEP, on-demand PrEP, baseline HIV and STI testing, kidney function testing, hepatitis screening, and ongoing three-monthly PrEP reviews.

If you want a shorter overview first, read PrEP in Adelaide: how to start with a GP.

PrEP can usually be started in a standard GP appointment. Please book specifically for “starting PrEP” so there is enough time to arrange the correct testing and explain how to take PrEP safely.

What happens at the first PrEP appointment?

The first appointment is usually straightforward. The aim is to confirm that PrEP is safe, appropriate and started correctly.

The most important step is confirming that you do not already have HIV. Starting PrEP when someone has undiagnosed HIV can complicate later treatment, so HIV testing is essential.

You will usually also have kidney function checked. Tenofovir-based PrEP is safe for most people, but kidney monitoring matters, especially if you have kidney disease, diabetes, high blood pressure, are older, or use other medicines that can affect the kidneys.

A good PrEP visit is also a sexual health check. Testing commonly includes HIV, syphilis, gonorrhoea and chlamydia, with samples taken from the sites that match the type of sex you have. That may include urine, throat swabs, rectal swabs, vaginal swabs or cervical swabs. Hepatitis A, B and C testing may also be relevant, with vaccination for hepatitis A and hepatitis B if needed.

Daily PrEP or on-demand PrEP?

There are two main oral PrEP strategies.

Daily PrEP means taking one tablet every day. It is the simplest option for many people and is suitable for people with ongoing or unpredictable HIV risk. Australian guidance recommends daily PrEP for all people at risk of HIV infection.[1]

On-demand PrEP, sometimes called “2-1-1 PrEP”, means taking two tablets 2–24 hours before sex, then one tablet 24 hours after the first dose, and one tablet 48 hours after the first dose. If sex continues over several days, the dosing changes slightly, so it is important to receive clear instructions before relying on it.[1,5] On-demand PrEP is not suitable for everyone, so it is best to discuss with your doctor which option is best suited to you.

What follow-up is needed?

PrEP is not just a one-off script. Ongoing review is part of safe prescribing.

Follow-up is usually every 3 months while you are taking PrEP. This generally includes repeat HIV testing, checking for symptoms of recent HIV infection, reviewing side effects and adherence, and testing for STIs such as syphilis, gonorrhoea and chlamydia.

Kidney function is usually checked at baseline and then periodically while taking PrEP.

The bottom line

PrEP is a highly effective way to prevent HIV, and starting PrEP in Adelaide can be done through a GP PrEP prescriber.

If you are looking for a PrEP prescriber in Adelaide, PrEP doctor in Adelaide, or PrEP GP for HIV prevention, Dr Christian Peut can provide PrEP initiation, baseline HIV and STI testing, daily or on-demand PrEP advice, and ongoing three-monthly PrEP reviews.

PrEP is also available in South Australia from the following prescribers: https://shinesa.org.au/prep-prescribers-list/[7]

This article provides general information only and is not a substitute for individual medical advice. If you may have been exposed to HIV in the last 72 hours, seek urgent advice about post-exposure prophylaxis (PEP) rather than waiting for a routine PrEP appointment.

References

1. Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine. Australian PrEP Guidelines [Internet]. Sydney: ASHM; 2025 [cited 2026 Jul 7]. Available from: https://ashm.org.au/resources/australian-prep-guidelines/

2. Centers for Disease Control and Prevention. PrEP [Internet]. Atlanta: CDC; [cited 2026 Jul 7]. Available from: https://www.cdc.gov/stophivtogether/hiv-prevention/prep.html

3. Berenger BM, Glaister K, Yang Q, Gill MJ, Hull M, Lachowsky N, et al. Prescribing pre-exposure prophylaxis in general practice. Aust J Gen Pract. 2021;50(7):472-477. doi:10.31128/AJGP-02-21-5829

4. McCormack S, Dunn DT, Desai M, Dolling DI, Gafos M, Gilson R, et al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection: effectiveness results from the PROUD study. Lancet. 2016;387(10013):53-60. doi:10.1016/S0140-6736(15)00056-2

5. Molina JM, Capitant C, Spire B, Pialoux G, Cotte L, Charreau I, et al.; ANRS IPERGAY Study Group. On-demand preexposure prophylaxis in men at high risk for HIV-1 infection. N Engl J Med. 2015;373(23):2237-46. doi:10.1056/NEJMoa1506273

6. Grulich AE, Guy R, Amin J, Jin F, Selvey C, Holden J, et al.; Expanded PrEP Implementation in Communities New South Wales research group. Population-level effectiveness of rapid, targeted, high-coverage roll-out of HIV pre-exposure prophylaxis in men who have sex with men: the EPIC-NSW prospective cohort study. Lancet HIV. 2018;5(11):e629-37. doi:10.1016/S2352-3018(18)30215-7

7. SHINE SA. South Australian HIV Pre-Exposure Prophylaxis PrEP Prescribers List [Internet]. Adelaide: SHINE SA; [cited 2026 Jul 7]. Available from: https://shinesa.org.au/prep-prescribers-list/