Grupo HPA Saude
National landline

Algarve

282 420 400

Alentejo

269 630 370

Madeira

291 003 300

waiting times

Hospital Particular Alvor

Over 1H30

Urgent Care

Hospital Particular Gambelas

Over 1H30

Urgent Care

00h59m

Paediatrics

Hospital Particular da Madeira

00h10m

Urgent Care

01h11m

Paediatrics

Madeira Medical Center

Unscheduled Medical Care

Pre-Exposure Prophylaxis (PrEP) Consultation for HIV

PrEP

 

What is PrEP?

Pre-Exposure Prophylaxis (PrEP) is an effective and safe HIV prevention measure aimed at individuals at increased risk of exposure. It involves taking a daily or intermittent antiretroviral medication prior to potentially risky sexual activity.

PrEP significantly reduces the likelihood of acquiring HIV when used correctly and with appropriate clinical supervision.

This service follows the guidelines of the Portuguese Directorate-General of Health (DGS Guideline No. 1/2024) and is available in private healthcare settings, in accordance with Decree No. 402/2023, which allows for its prescription by doctors of certain specialities.

PrEP is part of a combined prevention strategy, designed to protect sexual health based on the most up-to-date scientific evidence.

 

medical specialty available on the following units


Who should attend a PrEP consultation?

PrEP is recommended for adults and adolescents aged 16 and over who are HIV-negative but at higher risk of infection. This includes those who, in the past six months, have engaged in any of the following:

Unprotected sex (without consistent condom use), with:

  • Partners of unknown HIV status;
  • Partners with HIV infection who are not confirmed to have a sustained undetectable viral load or adherence to treatment.

Recent diagnosis of a sexually transmitted infection (e.g. syphilis, gonorrhoea, or chlamydia).
Use of Post-Exposure Prophylaxis (PEP) in the context of ongoing risk.
Use of psychoactive substances during sex (including in ChemSex contexts).
Injecting drug use with shared needles, syringes, or other non-sterile equipment.
Serodiscordant couples (one partner living with HIV and the other without) during pregnancy or family planning, if viral suppression in the HIV-positive partner is not guaranteed.
Individuals who, even if not meeting the above criteria, self-identify as being at risk and are clinically assessed as eligible.

 

 

 

What does a PrEP Consultation include?

Evaluation Pre-Exposure Prophylaxis

Evaluation 

Eligibility based on clinical and behavioural history.

 

 

Prescription Pre-Exposure Prophylaxis

Prescription 

Medication in line with national clinical guidance.

 

 

Monitoring Pre-Exposure Prophylaxis

Monitoring 

Regular monitoring every 3 months through laboratory tests to ensure safety and adherence.

 

 

Diagnosis and treatment HIV

Diagnosis and treatment 

Of sexually transmitted infections (STIs).

 

 

HIV Counselling

Counselling 

Sexual health counselling and risk reduction strategies, including vaccination.

 

 

Referral STIs

Referral 

Referral for psychological support, further screening, or other services when necessary.

 

 


First PrEP Consultation – What to Expect

In the first consultation, a comprehensive assessment will be conducted to ensure PrEP is appropriate and safe for you. This includes:

  • HIV test (a negative result is required to begin medication).
  • Screening for sexually transmitted infections (chlamydia, gonorrhoea, and syphilis).
  • Evaluation of kidney function to ensure treatment safety.
  • Screening for viral hepatitis (B and C) and immune status for hepatitis A, if applicable.
  • Review of current medications and any substance use that may interact with PrEP.
  • Personalised vaccination plan where necessary (hepatitis A and B, HPV, Monkeypox, and MenB).
  • Evaluation of motivation and capacity to adhere to preventive treatment.

PrEP Follow-up Consultations

Ongoing medical follow-up is essential to ensure PrEP remains safe, effective, and continuous.

Every 3 months:

  • 4th-generation HIV test
  • Syphilis screening
  • Screening for hepatitis B and C
  • Kidney function tests
  • Chlamydia and gonorrhoea testing (nucleic acid amplification tests - NAATs), depending on risk profile and symptoms
  • Sexual health counselling and adherence reinforcement

Every 6 to 12 months:

  • More comprehensive lab assessment, including liver function and other STIs, as medically indicated
  • Renal function assessment (serum creatinine, creatinine clearance, and urine sediment analysis), particularly in individuals aged 50 or older or with borderline kidney function (clearance < 90 ml/min) at PrEP initiation
  • Pregnancy test, when applicable
  • Monitoring of risk factors for kidney disease, such as high blood pressure and diabetes
  • Vaccine updates, if needed

 


How to Take PrEP

PrEP use is tailored to your risk profile and frequency of HIV exposure:

Daily regimen (continuous use) : 1 tablet per day. 

  • Recommended for those with frequent or unpredictable exposure.
  • Protection is effective after 7 consecutive days of use.

Intermittent regimen (“on demand” or 2+1+1 scheme):

Begin with 2 tablets taken between 2 and 24 hours before sex, followed by:

  • 1 tablet 24 hours later
  • 1 tablet 48 hours later

If new exposures occur, continue taking 1 tablet per day until 48 hours after the last sexual encounter.

Both regimens are effective when used correctly and must be prescribed by an experienced medical professional.

Are there any side effects with PrEP?

PrEP is generally well tolerated. However, some people may experience mild side effects during the first few weeks, such as:

  • Nausea
  • Abdominal discomfort or changes in bowel habits
  • Headache
  • Transient malaise

These symptoms are usually temporary and resolve on their own with continued use.

If symptoms persist or worsen, medical evaluation is advised to assess tolerance and ensure medication safety.

Kidney function and other relevant lab parameters are monitored regularly to ensure PrEP remains safe over time.