PrEP 2-1-1

How it works

PrEP 2-1-1 can be used for either:

• A one-off encounter that's planned in advance, or;
• A short planned period of hook ups (i.e. Pride weekend).

Here's how it works:

1. Take two PrEP pills 2-24 hours before sex
2. Have sex
3. If you've just had a one-off:
   1. Take one PrEP pill 24 hours after the first dose
4. If you're having a short period of sex:
   1. Take one PrEP pill 24 hours after the first dose;
   2. Then one PrEP pill every 24 hours while sexually active
   3. Once you're not sexually active, take one PrEP pill 24 hours after the previous dose - this is to make sure you're completely covered, as sexual periods differ in length
5. Take one final PrEP pill 24 hours after the previous dose

PrEP 2-1-1 is currently only shown to be effective for cisgender gay and bisexual men. People having receptive vaginal or front-hole sex will need to use a daily PrEP regime.⁠

Making sure it works

• Taking the pills as recommended is crucial to making 2-1-1 dosing work for you – use reminders and alarms.
• Use 2-1-1 with all sexual encounters. Don’t just pick and choose when to use 2-1-1.
• Continue taking 2-1-1 for as long as you’re sexually active.
• Switch to daily dosing if it’s going to be a better fit for you. Make sure you do this in consultation with your prescriber and have the required tests for HIV, STIs and kidney function first.
• Always make sure to take the last 2 doses after your last sexual encounter.
• If you miss a dose, immediately take 2 PrEP pills and contact your prescribing doctor/nurse.
• Some PrEP labels may state that, once opened, the medication must be used with 30 days. This is no longer the case; Medsafe have confirmed that PrEP may be used up until the expiry date on the bottle, and future prescriptions won’t include the ‘use within 30 days’ message. If you can’t see the expiry date, it may be under the prescription label from your pharmacy

Working with your prescriber

• Never start PrEP (whether daily or 2-1-1) without first testing for HIV. Discuss with your PrEP prescriber before switching from daily PrEP to PrEP 2-1-1 or vice versa.
• If you’re unsure if PrEP 2-1-1 is the best option for you, you can start with daily PrEP for 3 months and keep a "PrEP diary", noting down the days you had PrEP-requiring sex and whether you were able to plan or delay sex. Bring the diary to your first follow-up PrEP appointment and discuss with your PrEP prescriber whether PrEP 2-1-1 could be good for you.
• Even if you are on PrEP 2-1-1, the requirement to test every 3 months for HIV, STIs and kidney function remains the same. The fact that you might not need a new prescription because you have plenty of tablets using PrEP 2-1-1 does not mean you should delay your PrEP follow-ups.