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Anyone on Prep ? What is the procedure like and what is the cost ?

Guest PeterPrep

By Guest PeterPrep
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Guest Test

Guest Test

Posted
Posted
28 minutes ago, Guest PeterPrep said:

Hi there,

 

I'm thinking of going on Prep soon.

 

Anyone here knows what is the procedure like ? What is the cost ?

 

Thanks 🙏

 

Must test hiv-. 

Then buy the bottle of prep. 

 

Take when you want to have sex. 2-1-1 regime or if you have a daily sex.. Then just take everyday. 

 

Resupply your bottle when it runs out. 

Go for routine hiv test 

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LeanMature Proficient

LeanMature

Posted
Posted
On 2/8/2023 at 9:34 AM, Guest Test said:

 

Must test hiv-. 

Then buy the bottle of prep. 

 

Take when you want to have sex. 2-1-1 regime or if you have a daily sex.. Then just take everyday. 

 

Resupply your bottle when it runs out. 

Go for routine hiv test 

 

What is 2-1-1 regime ?

Don't read and response to guests' post

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doncoin Veteran

doncoin

Posted
Posted
4 hours ago, briefsnottrunks said:

Anyone experienced health issues from taking prep regularly?

 

I have shared before, after being on Truveda for years, last year, it started making me nauseous for no reason. I take it daily and didn't really change or mix it with other meds or had any major dietary changes. So my doctor recommended that I take a break and see what happens. Stopping Truveda helped stopped the sick/nausea, and then he prescribed Descovy instead which is so far so good.  

 

He has no explanation as to why experienced it, but that was the only major health issue I experienced.

Love. 

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Guest On demand prep

Guest On demand prep

Posted
Posted
On 2/9/2023 at 12:21 PM, LeanMature said:

 

What is 2-1-1 regime ?

 

The 2-1-1 is also called on demand prep. Many years ago, when prep was first introduced, patient need to take prep daily for it to works. It's expensive and causes long term liver problem etc. 

 

So the medical community started investigating what if the patient just take it on demand by overloading the body system with the medicine... 

 

They did a study and find that hey it works too. 

 

Yep. The scientific details, can Google. 

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Guest Billet

Guest Billet

Posted
Posted
2 hours ago, Guest On demand prep said:

 

The 2-1-1 is also called on demand prep. Many years ago, when prep was first introduced, patient need to take prep daily for it to works. It's expensive and causes long term liver problem etc. 

 

So the medical community started investigating what if the patient just take it on demand by overloading the body system with the medicine... 

 

They did a study and find that hey it works too. 

 

Yep. The scientific details, can Google. 

Nothing  is bullet proof. Scientific details at times might be another theorem. Just like covid vaccine, what are the real side effects are still unknown. Damaging facts will only surface after more than 10 years of clinical trials.

 

example will be talcum power cause cancer.

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Guest Guest

Guest Guest

Posted
Posted
18 hours ago, Guest Read said:

I read it somewhere that it will damage your kidney if you are taking it for long term.

Although taking long term damage kidney but it still won't stop people from taking. Because people can't go without sex. 

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LeanMature Proficient

LeanMature

Posted
Posted
On 2/11/2023 at 10:22 AM, Sticky&Sweet said:

I'm on demand prep because I don't have sex often.. but each time I take it I get nauseous. 

 

So most times I just stick to safe sex. I take prep maybe once every 3 months? Like if I'm going to the sauna and am afraid an accident might happen. 

 

Once every 3 months is able to offer protection or not ?

Don't read and response to guests' post

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Guest Protect self

Guest Protect self

Posted
Posted
18 hours ago, LeanMature said:

 

Once every 3 months is able to offer protection or not ?

 

He meant once every 3 months he will visit sauna to have sex. Then he take prep 2-1-1 on that visit. Then after that never do gay sex then don't take prep. Until 3 months later his backside itchy for cock. Then he 2-1-1 again lo. 

 

Anyway I also take. But I also do safe sex. Safe sex is not 100% safe. It might break. The top might stealth you. Etc. 

 

So taking prep on top of condom safe sex is double protection. 

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Firday Collaborator

Firday

Posted
Posted
On 2/9/2023 at 11:46 PM, doncoin said:

 

I have shared before, after being on Truveda for years, last year, it started making me nauseous for no reason. I take it daily and didn't really change or mix it with other meds or had any major dietary changes. So my doctor recommended that I take a break and see what happens. Stopping Truveda helped stopped the sick/nausea, and then he prescribed Descovy instead which is so far so good.  

 

He has no explanation as to why experienced it, but that was the only major health issue I experienced.

maybe need to

1.change your partner

2.age is catching up

3. get a permanent partner

4. fucking style 

5. mood

6. day or night

7. bed setting

 

 

 

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Guest Guest

Guest Guest

Posted
Posted
16 hours ago, Guest Protect self said:

Anyway I also take. But I also do safe sex. Safe sex is not 100% safe. It might break. The top might stealth you. Etc. 

 

So taking prep on top of condom safe sex is double protection. 

Huh... I tot men on prep bcos they wanted go raw.

So y waste money on prep when u still wan put on a condom? 

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Ryuki Community Regular

Ryuki

Posted
Posted

Before you on PreP you need to go for HIV screening to ensure that you are negative before doing so.

 

PreP is to be taken is 2-1-1 method. And some might go for PeP..

 

Depending on where you obtain your medicine and In Singapore I think you can get the generic cheaper than then original version and there is a few organization and medical facility doing that nowadays.

 

 

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Steve5380 Grand Master

Steve5380

Posted
Posted (edited)

Has anyone of you tried the new HIV PreP drug APRETUDE?   Is it available in Singapore?

 

https://www.medicalnewstoday.com/articles/drugs-apretude#_noHeaderPrefixedContent

 

Apretude is a brand-name prescription medication. It’s FDA-approved to help prevent HIV in people at risk of contracting HIV through sexual activity. This is called HIV pre-exposure prophylaxis (PrEP).

Apretude is approved for HIV PrEP in adults and adolescents ages 12 years and older who weigh at least 35 kilograms* (kg), which is about 77 pounds (lb). Your doctor will only prescribe Apretude for HIV PrEP if you test negative for HIV.

* One kg is about 2.2 lb.

Drug details

Apretude contains the active drug cabotegravir. It comes as a liquid suspension given as an intramuscular injection (an injection into your muscle) by your doctor or healthcare professional. You will receive your injections in your doctor’s office or clinic. For the first two injections, you’ll receive one injection each month. Then, you’ll typically receive one injection every 2 months.

Apretude is a long-acting injection. The drug may stay in your body for 12 months or longer after stopping treatment. Your doctor may want to check that cabotegravir doesn’t cause you bothersome side effects before you start treatment with Apretude. In this case, they may recommend taking cabotegravir tablets (Vocabria) for about 1 month before you start Apretude.

FDA approval

The Food and Drug Administration (FDA) first approved Apretude for PrEP in 2021. Apretude is the first long-acting injection to be approved for PrEP.

 

----- etc.

.

Edited by Steve5380
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Guest Tell me secretly

Guest Tell me secretly

Posted
Posted
7 hours ago, Steve5380 said:

Has anyone of you tried the new HIV PreP drug APRETUDE?   Is it available in Singapore?

 

 

Steve,  you seem very invested in this sort of topic.  May I ask whether you are infected with HIV?   Don't worry, I will keep your answer as secret.

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Steve5380 Grand Master

Steve5380

Posted
Posted
4 hours ago, Guest Tell me secretly said:

Steve,  you seem very invested in this sort of topic.  May I ask whether you are infected with HIV?   Don't worry, I will keep your answer as secret.

 

There is no secret.  I don't have HIV.   PreP IS NOT for people with HIV, and I have no investment here.

 

Yesterday I saw on TV an advertisement for this drug,  and I thought that it might be desirable for those who want extra protection as an alternative to the other drugs.  Apretude needs to be taken only once every 2 months by injection instead of having to swallow a daily pill,  and it is more effective than Truvada.

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Guest Roy Tan

Guest Roy Tan

Posted
Posted

https://the-singapore-lgbt-encyclopaedia.fandom.com/wiki/PrEP_in_Singapore

Pre-exposure prophylaxis (PrEP) is the use of medication to prevent the spread of disease in people who have not yet been exposed to a pathogen, usually a virus. The term typically refers to the specific employment of antiviral drugs as a strategy for HIV/AIDS prevention. PrEP is one of a number of HIV prevention strategies for people who are HIV negative but have a higher risk of acquiring HIV, including sexually active adults at increased risk of HIV infection, people who engage in drug injection, and serodiscordant couples.

When used as directed, PrEP has been shown to be highly efficacious, reducing the risk of acquiring HIV by up to 99%. However, the increase in the numbers of Singaporean men who have sex with men who take PrEP medication has unfortunately been accompanied by a decline in condom use during anal sex and this leaves them vulnerable to other sexually transmitted infections.

Truvada

Truvada is an antiretroviral drug combination of 300mg of tenofovir disoproxil fumarate (TDF) and 200mg of emtricitabine (FTC) formulated into tablets. It was approved for the pre-exposure prophylaxis of HIV infection (PrEP) in 2012 by the US Food and Drug Administration (FDA). Even though it has been available in Singapore since mid-2012, Truvada was reportedly offered only by a few clinics initially and given selectively, for instance, to the spouses and partners of people living with HIV/AIDS.

All that changed in late 2016 when Dr Dariusz Piotr Olszyna, a senior consultant at the National University Hospital's (NUH) Division of Infectious Diseases, announced that there was "overwhelming evidence and international guidelines which now recommend PrEP as an important tool in HIV prevention"[1]. Truvada has been shown to be 60-70% and, in some studies, up to 96% effective in preventing the transmission of HIV in gay men and other high-risk groups like sex workers, transgender women, intravenous drug users and HIV-negative partners in sero-discordant relationships[2]. It was gradually and sporadically introduced in parts of Asia in the mid-2010s. While PrEP is starting to transform HIV prevention in the United States, it has yet to be fully integrated into Asian programmes. Representatives from national AIDS programmes, health service providers and community groups from 18 Asian countries are currently exploring how to roll out PrEP in the region. The use of PrEP is now recommended in national guidelines in many countries. The World Health Organization recommended in 2015 that PrEP should be offered as an additional prevention choice for people at substantial risk of HIV infection as part of combination HIV prevention approaches, and in 2017 published an implementation tool to guide countries on the introduction and implementation of PrEP.

In November 2020, Rayner Tan, then a doctoral candidate at the Saw Swee Hock School of Public Health who had been conducting research in HIV and sexually transmitted infections, noted the steeper drops in yearly cases after 2017, attributing it to the rollout of PrEP in 2016[3]. Since 2018, annual incidence rates had been hovering in the low 300 range, down drastically from 434 cases in 2017. “Research underpinned both the efficacy of PrEP, as well as its acceptability and higher uptake among homosexual and bisexual men,” reported Tan. “If we are able to scale up access to HIV PrEP, our modelling studies at the school suggest that it is possible to eliminate the onward transmission of HIV as early as 2030."

Daily PrEP

Many Singaporeans take Truvada daily to prevent HIV infection if they have regular unprotected penile-vaginal or penile-anal sex, or as an extra precaution in addition to using condoms. Truvada is also prescribed by doctors to individuals belonging to the high-risk groups mentioned above. One tablet of the drug should be taken every day without fail for at least seven days before sex to ensure adequately high steady-state levels in the bloodstream for efficacious protection against HIV infection. Drug levels above the minimum effective concentration are seen in the rectal mucous membranes by 7 days and maximum intracellular drug levels are seen at 20 days of daily oral dosing. It may subsequently be consumed daily, if required, for life.

On-demand PrEP

Sexually active individuals who consider PrEP expensive may save on costs by practising what is called event-based PrEP or on-demand PrEP where 2 tablets of Truvada or its generic equivalent are taken 2 to 24 hours before anal sex, followed by 1 tablet 24 hours after sex, and another tablet 48 hours after sex. If having sex for an extended period of time, meaning potential exposure is sustained for more than a 24-hour period, 1 tablet is taken every 24 hours until the individual has 2 sex-free days. This dosage regimen has been proven to still be effective[4]. However, a qualifying caveat is that on-demand PrEP has only been investigated in and recommended for cisgender men who have sex with men[5].

Medical consultations

PrEP is offered by clinics as part of a comprehensive HIV/STI prevention package. The medication does not, however, protect against sexually transmitted infections (STI) other than HIV. Patients on any regimen need to be followed up regularly. Doctors advise screening every three months for HIV and other STIs like syphilis or gonorrhoea as early detection and treatment of HIV offer a good chance of survival. If a patient is already HIV-positive but does not know it and commences PrEP, it is very dangerous. The infection may be inadequately treated and the virus could become resistant. As PrEP is available only via prescription, Singaporeans who request it should automatically receive counselling as well. At NUH, patients get a comprehensive assessment of their HIV infection risk and individualised advice on how PrEP can help them in reducing the risk. Monitoring will continue for possible adverse effects. As Truvada may be toxic to the kidneys, renal function tests are done once every three to six months. Patients who have trouble remembering to take their medicine (poor adherence) or who want to stop PrEP should inform their doctors.

First visit

A 4th generation HIV test (p24 antigen/HIV antibody combination test) with the blood sample sent to a laboratory for a conventional HIV enzyme immunoassay (EIA) is done. Alternatively, for expediency, a 4th generation rapid test/point-of-care test (POCT) such as Alere Determine HIV-1/2 Ag/Ab Combo may be performed using fingerprick blood immediately in the clinic itself. If there was recent high-risk exposure, it is advisable not to rely on a rapid test as this is less sensitive than a conventional EIA and has a window period which is several days longer. If the last high-risk exposure occurred within 4 weeks prior to the first visit, the HIV test is repeated after 4 weeks because of the window period during which the presence of HIV in the body cannot be detected with the testing method used.

A renal function test which measures the concentration of serum creatinine is performed and the patient screened for syphilis, hepatitis B virus (HBV), hepatitis C virus (HCV), gonorrhoea, syphilis and chlamydia infection.

Patients are counselled on:

the efficacy of PrEP: "PrEP is highly effective if taken as prescribed as part of an overall HIV prevention strategy which includes the the use of condoms."
adherence or compliance to medication: "It is important to take PrEP every day for daily PrEP, and according to the schedule for on-demand PrEP for it to be effective."

engagement in follow-up care: "It is important to return for visits to get tested for HIV and assessed for adverse effects to the medication, as well as to renew the prescription so that PrEP therapy is not interrupted."
sexual health: "PrEP does not prevent other STIs, and regular testing and treatment for other STIs is needed to maintain sexual health. PrEP also does not prevent pregnancy and contraception should be used to prevent pregnancy if needed."

Subsequent visits

Three to six-monthly visits are advised. Patients continue to be screened for HIV, HBV, HCV, gonorrhoea, syphilis and chlamydia. Renal function tests are performed every 6 to 12 months.

A 3rd or 4th generation HIV test (either a rapid test/POCT or routine HIV EIA) is done once every 3 months.

To assess kidney function, the serum creatinine concentration is measured once every 12 months if the patient is less than 40 years old and/or the estimated glomerular filtration rate (eGFR) is greater than 90ml/min. If the patient is older than 40 years of age and/or the eGFR is less than 90ml/min, serum creatinine is measured 6 monthly.

STI screening once every 3 to 6 months and treatment of any detected syphilis, gonorrhoea and chlamydia. The frequency of screening will depend on the patient-reported sexual risk behaviour.

Measurement of anti-HCV antibodies every 12 monthly. Screening once every 3 months may be considered for patients with very high-risk behaviour such as MSM and transgender women.

Stopping PrEP

Assessment of the continuing need for PrEP: Doctors should determine the if the patient still requires PrEP based on an assessment of the patient's risk of contracting HIV every 12 monthly. Patients should continue taking daily PrEP for 28 days after the last sexual exposure putting them at risk of HIV infection before discontinuing the medication. Only cisgender MSM can safely stop PrEP after taking a dose 24 and 48 hours after the last at-risk exposure.
Referral to care for patients who seroconvert: All patients who test positive for HIV should be referred for treatment at a HIV care centre on an urgent basis. HIV-infected patients can be started on HIV medication without interruption.

When it has been decided that PrEP is to be stopped, doctors should consider repeating the test for hepatitis B surface antigen (HBsAg) unless there is documented immunity.

Patients who are HBsAg-positive should have their liver function and hepatitis B viral load monitored after cessation of PrEP as there is a risk of reactivation of hepatitis B infection.

Advice on re-initiation of PrEP: Patients should be counselled that they should consider restarting PrEP if the risk of HIV infection emerges once again.

Teno-Em

Teno-Em is a much cheaper, generic version of Truvada manufactured in Thailand by the Government Pharmaceutical Organization (GPO). It has the same composition as the original branded medication, namely, 300mg of tenofovir disoproxil fumarate and 200mg of emtricitabine.

Unlike most of the generic PrEP available worldwide, Teno-Em is the only PrEP formulation which is produced by a national government. PrEPSingapore.com is the sole authorised agent for the Thai GPO-manufactured Teno-Em for prescription orders. Its website allows Singaporeans to order directly from the Government Pharmaceutical Organization and to receive the medication at their homes at similar prices to Thai clinics, using Singapore prescriptions and partnering with various Singapore hospitals and clinics. It supports its service with refund and delivery guarantees.

Ricovir-EM

Ricovir-EM is another generic version of Truvada with exactly the same composition, manufactured in India by Mylan pharmaceuticals. It is imported into Singapore by PrEP Online (see below) and sold at a very affordable price of SGD$30 per bottle of 30 tablets.

Other generic drug combinations

Tavin-EM
Tafero EM
Tenvir-EM
Tenof EM

Availability in Singapore hospitals and clinics

On 29 November 2016, it was reported in TODAY newspaper that Truvada would be offered by Tan Tock Seng Hospital (TTSH) which was then seeing more than one in two people living with HIV in Singapore[6]. Two other establishments - the Department of STI Control (DSC Clinic) at Kelantan Lane and the Be Prepared Clinic (BePrEP Clinic) at the NUH Medical Centre, National University Hospital (NUH) - also planned to offer PrEP the following year[7],[8]. TTSH decided to offer PrEP in early 2016 and hospital staff had been putting procedures in place to provide the service in a systematic and comprehensive manner. By November 2016, the hospital had prescribed PrEP to one patient, a middle-aged man who found out about the service through word-of-mouth. TTSH was in the midst of revising the cost of the medication and senior medical social worker Amanda Yap explained that the introduction of PrEP allowed the hospital to play a powerful preventive role, reaching out to people at risk. Dr Tan Kok Kuan said an original Truvada tablet for PrEP cost about SGD$30 each, with additional charges for consultation and various tests.

Singapore, being a developed country, is not given the concession by major international pharmaceutical companies of officially being able to sell cheaper, generic versions of Truvada and other antiretroviral drugs before the patents and exclusivity granted to the original versions have expired[9]. This is unlike the case in developing countries such as Thailand or India, where local pharmaceutical companies have been licensed to manufacture generics, even before the drug patents have expired, on compassionate grounds because of their large prevalence of HIV infection and the lower per capita income.

Original, branded versions of Truvada are available at the pharmacies of the larger government medical establishments:

Department of STI Control (DSC Clinic) - The charge for a medical consultation is $100 to $200 per visit. Truvada at its pharmacy costs around $300 to $400 for a bottle of 30 tablets. Operating hours are from 8am to 12am and from 1pm to 4pm from Mondays to Fridays. It is closed on Saturdays and Sundays. Telephone number: 62939648. Email enquiries and appointments: apptdsc@nsc.com.sg. Address: 31 Kelantan Lane, Singapore 200031.
National University Hospital (NUH) - Started in 2016, the specialist Be Prepared Clinic (called BePrEP Clinic for short) at NUH prides itself in being a "confidential, holistic service that covers specialist expertise in Sexually Transmitted Infections (STIs) and HIV prevention". It not only provides PrEP medication but also offers counselling services. The consultation fee is $100 to $200 per visit and Truvada at its pharmacies is charged at $300 to $400 per bottle of 30 tablets. Its address is 5 Lower Kent Ridge Road, Singapore 119074. Telephone number: 91862301. Email enquiries and appointments: bpc@nuhs.edu.sg.

National Centre for Infectious Diseases (NCID) - Open from Mondays to Fridays, the PrEP Care Clinic at the NCID offers a comprehensive range of HIV and STI-related services. Each medical consultation costs $100 to $200 and Truvada at its pharmacy can be bought for $300 to $400 per bottle of 30 tablets. Its operating hours are from 8:30am to 5:30pm from Mondays to Fridays and from 8am to 12 noon on Saturdays. It is closed on Sundays and public holidays. Telephone number: 63577000. Email address: prepcare@ttsh.com.sg. It is located at Clinic J, Level 1, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore 308442.
Tan Tock Seng Hospital (TTSH)
Singapore General Hospital (SGH)

PrEP is also available at certain GP (general practitioner) clinics like the 10 branches of Dr. Tan & Partners[10],[11], Dr Tan Medical Center and Pulse Clinic Singapore. The cost of Truvada at these establishments is about SGD$900 for one month's supply, before GST. The drug may be obtained on the very first visit after a HIV test which can be completed within 15 minutes.

Other GP clinics offering PrEP are:

Prudence Family Clinic:[12]
DB Medical:[13]
Cross Street Medical Clinic:[14]
Anteh Dispensary:[15]
Government subsidy
Medisave cannot be used to pay for PrEP. However, in a move unanimously lauded by HIV doctors and activists, the Ministry of Health added 16 antiretroviral drugs used for the treatment of HIV, including Truvada and Edurant, to its list of subsidised drugs with effect from 1 September 2020, making them much more affordable for thousands of Singaporeans[16]. The 16 drugs were also added to the Medication Assistance Fund which allowed patients who could not afford them to draw from it to help pay for the cost. All subsidised patients who purchased any of the 16 drugs would henceforth receive 50% or 75% worth of subsidies, depending on their means test status. Prior to this, people living with HIV could only receive help from the Medication Assistance Fund on a case by case basis.

Buyers clubs

Much cheaper generic versions (less than one-tenth the price of the branded original) may be obtained through buyers clubs modelled after Dallas Buyers Club, as portrayed in the movie. There are several of these clubs in Singapore. One of them was organised by Rev. Yap Kim Hao of the Free Community Church which has a closeted cell group of HIV-positive churchgoers. A separate club (contactable at +65 97531592) which supplies generic antiretroviral drugs to people living with HIV is headed by a volunteer who sells generics at one of the cheapest prices available - one month's supply of generic Truvada costs SGD$70 (plus an additional SGD$50 for shipping and handling charges) as compared to over SGD$900 for the branded version sold at clinics. The price of one pill of Truvada is 30 Singapore dollars, equivalent to about SGD$55 in the UK, SGD$50 in the USA and SGD$35 in Canada. The cost of the generic version in Thailand is SGD$1 and just over SGD$2 after being imported into Singapore via the buyers clubs.

The Ministry of Health and Health Sciences Authority tacitly allow these buyers clubs to source for generic antiretroviral medication from overseas and have them shipped to the Action for AIDS (AfA) headquarters along Kelantan Lane, just opposite the Department of STI Control (DSC). From these stocks, representatives of the clubs can then procure the drugs for sale to individual buyers. AfA may be contacted via their hotline at: 6254 0212.

Bangkok

Some Singaporeans also travel to Bangkok, Thailand to buy Teno-Em, the generic version of Truvada, and to be followed up by the STI specialists there once every three months. Many catch a flight on Friday evening and return to Singapore by Sunday night. Places where generic antiretrovirals may be obtained include Bumrungrad Hospital (most expensive of all the options), the Bangkok Christian Hospital and the Thai Red Cross AIDS Research Center. The latter is colloquially referred to as the "snake farm" or "Sapha Ka Chat" in Thai. It is located along Angreedunang Road, at the junction opposite Surawong Road. The Thai Red Cross is reputed to offer the cheapest prices. However, one has to factor in the cost of airfare, accommodation, food and local transport.

One physician who prescribes and sells generic antiretrovirals is Dr. Natthakhet of Sathorn International Clinic, telephone/fax: +66 (0) 20093877, e-mail: sic56216@hotmail[dot]com. He used to work at the Thai Red Cross. Opening hours are from 5pm to 8pm on weekdays and 8:00am to around 6:00pm or 7:00pm on weekends. Many Singaporeans who are wary of the large crowds at the Thai Red Cross consult him.

The price of a bottle of original Truvada in Thailand is over SGD$100 whereas the generic Teno-Em costs less than half of that.

Bangkok clinics catering to English speakers
While most Singaporeans are familiar with Pulse Clinic, it is not the only clinic in Bangkok that patients can get PrEP from.

There are several clinics scattered across the city that offer PrEP, some of which cater to English-speaking visitors and expats. (Readers can find out more in this guide specially prepared by Dear Straight People: https://dearstraightpeople.com/2019/11/30/prep-guide-bangkok/ )

Bangkok pharmacies

Chula MD Pharmacy

A prescription for a bottle of Teno-Em, containing 30 tablets of the generic version of Truvada, can be filled for about SGD$30 without the need for haggling at Chula MD Pharmacy[17] (also known as Chula Bhesaj Drug Store), located about 5 minutes' walk from Sala Daeng BTS station. Its address is 942/25 Rama IV Road, Bang Rak, Bangkok 10500. Opening hours are from Mondays to Saturdays from 8:00am to 8:30pm. Telephone number: +66 2 233 5105. Chula's prices are amongst the cheapest as other pharmacies may charge as much as SGD$50 to $65 per bottle.

ChulaMDPharmacy003.jpg ChulaMDPharmacy002.jpg ChulaMDPharmacy004.jpg

(Leftmost photo and pricing information credit: Otto Fong.)
Johor Bahru
Caring Pharmacy
Caring Pharmacy in Malaysia also stocks antiretroviral drugs. The branch in Johor Bahru is located at G-104, G floor, R&F Mall, Mercu 1, Jalan Tanjung Puteri 1, R&F Tanjung Puteri 83000, Johor Bahru. Telephone number: 07-267 3725. It opens every day of the week from 10:00am to 10:00pm[18].

Dr. Singaraveloo of Johor Specialist Hospital, 39 B Jalan Abdul Samad, telephone number: 02-07 225 3000 ext. 4854 is a physician who sees HIV-related problems.

Klinik STI JB

Klinik STI JB offers PrEP and PEP services for Malaysians. It is located along Jalan Mahmoodiah in Johor Bahru. All tests for STIs and PrEP monitoring are done by the clinic, subsidised by Malaysia's Ministry Of Health. Patients only have to pay for the cost of the drugs. Non-Malaysians must fork out the full payment for consultations, tests and medication. Individuals requiring more information may telephone the clinic at +60 192371956 or visit their Facebook page: https://www.facebook.com/klinikstijb

Online suppliers

PrEP Singapore, PrEP Online, PrEP GLOBAL, Dynamix International and Pulse Clinic Online are more reliable and assuring alternatives to procuring medication from unaffiliated, independent suppliers who advertise themselves on Grindr and who may charge as much as SGD$75 per bottle of generic drugs from unverifiable sources.

PrEP Singapore

With the establishment of prepsingapore.com, an organisation which works with Singapore hospitals/clinics and Thailand's Government Pharmaceutical Organization in collaboration with Thai clinics to provide prescription generic medication at affordable prices, and sent to Singapore in accordance with regulations governing the importation of drugs for personal use, it is no longer necessary to travel to Bangkok for cost savings. The site supplies Truvada from Thailand at a third of the prices in Singapore. The Truvada generics are now available cheaply at around SGD65 for one month's supply and delivered to homes legitimately as prescription medication through prepsingapore.com. PrEP Singapore began from successful partnerships with Taiwanese hospitals providing generic Truvada via doctors from Thai clinics and directly from pharmaceutical manufacturers to protect the privacy and safety of their patients. It offers the full suite of customer assurance including customs declaration, refunds and service guarantees, and partners with Singapore sexual health clinics to provide similar prescription-based models.

PrEP Online

PrEP Online[19] was started by a group of PrEP users based in Europe and Asia who believe that access to PrEP should be made more convenient and affordable for people who need it all around the world. The group works with HIV and LGBT-related organisations around the world to provide up-to-date information on PrEP, and sources for PrEP directly from manufacturers to bring it to the community at the lowest prices.

PrEP GLOBAL

PrEP GLOBAL[20] (also known as PrEP Worldwide) is a Singapore-based company that offers PrEP at affordable prices with free shipping. Orders usually arrive within 3 days. If customers use the code "STEVEN", they can get an additional 10% off. The code "STEVEN" is only applicable for orders of SGD$115 and above so it is worthwhile using the code to get a 3-month supply. It offers Ricovir-EM (30 tablets per pack) from SGD$50 onwards and Tenvir-EM (30 tablets per pack) also from SGD$50 onwards.

Dynamix International

Dynamix International[21] is an import-export company established in Singapore in 2009. It delivers PrEP to a customer within 2 weeks. The products it offers are:

Tavin-EM at $57 per bottle (Price Buster offer)[22]
Ricovir-EM at $92 per bottle[23]
Tafero EM (generic Descovy) at $62 to $106.00 per bottle[24]
Tenvir-EM at $84.00 per bottle[25]
Pulse Clinic Online
https://www.pulse-clinic.com/buypreponline/

To save its Singaporean clients the hassle and expense of travelling to Thailand, the Bangkok-based Pulse Clinic began offering PrEP for sale online in the late 2010s. However, buyers must have the original prescription with the date and doctor's signature and Singapore Medical Council registration number (MCR no.), or the official report from a laboratory sent to its email address beforehand.

Up to three months of PrEP medication can be legally imported into Singapore for personal use. This includes:

Truvada by Gilead (TDF/FTC; Tenofovir disoproxil fumarate/Emtricitabine (2',3'-dideoxy-5-fluoro-3'-thiacytidine)
Generic versions of TDF/FTC (Teno-EM by Thailand's Government Pharmaceutical Organization, Ricovir-EM by Mylan, Tenof-EM by Hetero and Tavin-EM by Emcure)
Green Cross Pharmacy

Partial screen shot of Green Cross Pharmacy's website.

Some Singaporeans procure their medication online from Green Cross Pharmacy, an international supplier[26]. One month's supply of PrEP costs approximately USD$10 plus delivery charges.

Public education

Talks and seminars on PrEP are periodically conducted by Action for AIDS (AfA) and its subsidiaries like gayhealth.sg, DSC Clinic, Oogachaga, Drs. Tan & Partners, The Greenhouse SG, Lifeline SG, BePrep Clinic, the National Centre for Infectious Diseases and other organisations.

On 11 June 2022 from 10am to 12 noon, gayhealth.sg conducted a PrEP workshop held as part of Pink Fest 2022 which was attended at full capacity[27]. It sought to provide participants with knowledge on everything PrEP-related. Held at the Action For AIDS office, workshop participants also got the opportunity to take part in a year-long study during which they received subsidised PrEP medication and consultations.

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2 hours ago, Guest Roy Tan said:

https://the-singapore-lgbt-encyclopaedia.fandom.com/wiki/PrEP_in_Singapore

Pre-exposure prophylaxis (PrEP) is the use of medication to prevent the spread of disease in people who have not yet been exposed to a pathogen, usually a virus. The term typically refers to the specific employment of antiviral drugs as a strategy for HIV/AIDS prevention. PrEP is one of a number of HIV prevention strategies for people who are HIV negative but have a higher risk of acquiring HIV, including sexually active adults at increased risk of HIV infection, people who engage in drug injection, and serodiscordant couples.

When used as directed, PrEP has been shown to be highly efficacious, reducing the risk of acquiring HIV by up to 99%. However, the increase in the numbers of Singaporean men who have sex with men who take PrEP medication has unfortunately been accompanied by a decline in condom use during anal sex and this leaves them vulnerable to other sexually transmitted infections.

Truvada

Truvada is an antiretroviral drug combination of 300mg of tenofovir disoproxil fumarate (TDF) and 200mg of emtricitabine (FTC) formulated into tablets. It was approved for the pre-exposure prophylaxis of HIV infection (PrEP) in 2012 by the US Food and Drug Administration (FDA). Even though it has been available in Singapore since mid-2012, Truvada was reportedly offered only by a few clinics initially and given selectively, for instance, to the spouses and partners of people living with HIV/AIDS.

All that changed in late 2016 when Dr Dariusz Piotr Olszyna, a senior consultant at the National University Hospital's (NUH) Division of Infectious Diseases, announced that there was "overwhelming evidence and international guidelines which now recommend PrEP as an important tool in HIV prevention"[1]. Truvada has been shown to be 60-70% and, in some studies, up to 96% effective in preventing the transmission of HIV in gay men and other high-risk groups like sex workers, transgender women, intravenous drug users and HIV-negative partners in sero-discordant relationships[2]. It was gradually and sporadically introduced in parts of Asia in the mid-2010s. While PrEP is starting to transform HIV prevention in the United States, it has yet to be fully integrated into Asian programmes. Representatives from national AIDS programmes, health service providers and community groups from 18 Asian countries are currently exploring how to roll out PrEP in the region. The use of PrEP is now recommended in national guidelines in many countries. The World Health Organization recommended in 2015 that PrEP should be offered as an additional prevention choice for people at substantial risk of HIV infection as part of combination HIV prevention approaches, and in 2017 published an implementation tool to guide countries on the introduction and implementation of PrEP.

In November 2020, Rayner Tan, then a doctoral candidate at the Saw Swee Hock School of Public Health who had been conducting research in HIV and sexually transmitted infections, noted the steeper drops in yearly cases after 2017, attributing it to the rollout of PrEP in 2016[3]. Since 2018, annual incidence rates had been hovering in the low 300 range, down drastically from 434 cases in 2017. “Research underpinned both the efficacy of PrEP, as well as its acceptability and higher uptake among homosexual and bisexual men,” reported Tan. “If we are able to scale up access to HIV PrEP, our modelling studies at the school suggest that it is possible to eliminate the onward transmission of HIV as early as 2030."

Daily PrEP

Many Singaporeans take Truvada daily to prevent HIV infection if they have regular unprotected penile-vaginal or penile-anal sex, or as an extra precaution in addition to using condoms. Truvada is also prescribed by doctors to individuals belonging to the high-risk groups mentioned above. One tablet of the drug should be taken every day without fail for at least seven days before sex to ensure adequately high steady-state levels in the bloodstream for efficacious protection against HIV infection. Drug levels above the minimum effective concentration are seen in the rectal mucous membranes by 7 days and maximum intracellular drug levels are seen at 20 days of daily oral dosing. It may subsequently be consumed daily, if required, for life.

On-demand PrEP

Sexually active individuals who consider PrEP expensive may save on costs by practising what is called event-based PrEP or on-demand PrEP where 2 tablets of Truvada or its generic equivalent are taken 2 to 24 hours before anal sex, followed by 1 tablet 24 hours after sex, and another tablet 48 hours after sex. If having sex for an extended period of time, meaning potential exposure is sustained for more than a 24-hour period, 1 tablet is taken every 24 hours until the individual has 2 sex-free days. This dosage regimen has been proven to still be effective[4]. However, a qualifying caveat is that on-demand PrEP has only been investigated in and recommended for cisgender men who have sex with men[5].

Medical consultations

PrEP is offered by clinics as part of a comprehensive HIV/STI prevention package. The medication does not, however, protect against sexually transmitted infections (STI) other than HIV. Patients on any regimen need to be followed up regularly. Doctors advise screening every three months for HIV and other STIs like syphilis or gonorrhoea as early detection and treatment of HIV offer a good chance of survival. If a patient is already HIV-positive but does not know it and commences PrEP, it is very dangerous. The infection may be inadequately treated and the virus could become resistant. As PrEP is available only via prescription, Singaporeans who request it should automatically receive counselling as well. At NUH, patients get a comprehensive assessment of their HIV infection risk and individualised advice on how PrEP can help them in reducing the risk. Monitoring will continue for possible adverse effects. As Truvada may be toxic to the kidneys, renal function tests are done once every three to six months. Patients who have trouble remembering to take their medicine (poor adherence) or who want to stop PrEP should inform their doctors.

First visit

A 4th generation HIV test (p24 antigen/HIV antibody combination test) with the blood sample sent to a laboratory for a conventional HIV enzyme immunoassay (EIA) is done. Alternatively, for expediency, a 4th generation rapid test/point-of-care test (POCT) such as Alere Determine HIV-1/2 Ag/Ab Combo may be performed using fingerprick blood immediately in the clinic itself. If there was recent high-risk exposure, it is advisable not to rely on a rapid test as this is less sensitive than a conventional EIA and has a window period which is several days longer. If the last high-risk exposure occurred within 4 weeks prior to the first visit, the HIV test is repeated after 4 weeks because of the window period during which the presence of HIV in the body cannot be detected with the testing method used.

A renal function test which measures the concentration of serum creatinine is performed and the patient screened for syphilis, hepatitis B virus (HBV), hepatitis C virus (HCV), gonorrhoea, syphilis and chlamydia infection.

Patients are counselled on:

the efficacy of PrEP: "PrEP is highly effective if taken as prescribed as part of an overall HIV prevention strategy which includes the the use of condoms."
adherence or compliance to medication: "It is important to take PrEP every day for daily PrEP, and according to the schedule for on-demand PrEP for it to be effective."

engagement in follow-up care: "It is important to return for visits to get tested for HIV and assessed for adverse effects to the medication, as well as to renew the prescription so that PrEP therapy is not interrupted."
sexual health: "PrEP does not prevent other STIs, and regular testing and treatment for other STIs is needed to maintain sexual health. PrEP also does not prevent pregnancy and contraception should be used to prevent pregnancy if needed."

Subsequent visits

Three to six-monthly visits are advised. Patients continue to be screened for HIV, HBV, HCV, gonorrhoea, syphilis and chlamydia. Renal function tests are performed every 6 to 12 months.

A 3rd or 4th generation HIV test (either a rapid test/POCT or routine HIV EIA) is done once every 3 months.

To assess kidney function, the serum creatinine concentration is measured once every 12 months if the patient is less than 40 years old and/or the estimated glomerular filtration rate (eGFR) is greater than 90ml/min. If the patient is older than 40 years of age and/or the eGFR is less than 90ml/min, serum creatinine is measured 6 monthly.

STI screening once every 3 to 6 months and treatment of any detected syphilis, gonorrhoea and chlamydia. The frequency of screening will depend on the patient-reported sexual risk behaviour.

Measurement of anti-HCV antibodies every 12 monthly. Screening once every 3 months may be considered for patients with very high-risk behaviour such as MSM and transgender women.

Stopping PrEP

Assessment of the continuing need for PrEP: Doctors should determine the if the patient still requires PrEP based on an assessment of the patient's risk of contracting HIV every 12 monthly. Patients should continue taking daily PrEP for 28 days after the last sexual exposure putting them at risk of HIV infection before discontinuing the medication. Only cisgender MSM can safely stop PrEP after taking a dose 24 and 48 hours after the last at-risk exposure.
Referral to care for patients who seroconvert: All patients who test positive for HIV should be referred for treatment at a HIV care centre on an urgent basis. HIV-infected patients can be started on HIV medication without interruption.

When it has been decided that PrEP is to be stopped, doctors should consider repeating the test for hepatitis B surface antigen (HBsAg) unless there is documented immunity.

Patients who are HBsAg-positive should have their liver function and hepatitis B viral load monitored after cessation of PrEP as there is a risk of reactivation of hepatitis B infection.

Advice on re-initiation of PrEP: Patients should be counselled that they should consider restarting PrEP if the risk of HIV infection emerges once again.

Teno-Em

Teno-Em is a much cheaper, generic version of Truvada manufactured in Thailand by the Government Pharmaceutical Organization (GPO). It has the same composition as the original branded medication, namely, 300mg of tenofovir disoproxil fumarate and 200mg of emtricitabine.

Unlike most of the generic PrEP available worldwide, Teno-Em is the only PrEP formulation which is produced by a national government. PrEPSingapore.com is the sole authorised agent for the Thai GPO-manufactured Teno-Em for prescription orders. Its website allows Singaporeans to order directly from the Government Pharmaceutical Organization and to receive the medication at their homes at similar prices to Thai clinics, using Singapore prescriptions and partnering with various Singapore hospitals and clinics. It supports its service with refund and delivery guarantees.

Ricovir-EM

Ricovir-EM is another generic version of Truvada with exactly the same composition, manufactured in India by Mylan pharmaceuticals. It is imported into Singapore by PrEP Online (see below) and sold at a very affordable price of SGD$30 per bottle of 30 tablets.

Other generic drug combinations

Tavin-EM
Tafero EM
Tenvir-EM
Tenof EM

Availability in Singapore hospitals and clinics

On 29 November 2016, it was reported in TODAY newspaper that Truvada would be offered by Tan Tock Seng Hospital (TTSH) which was then seeing more than one in two people living with HIV in Singapore[6]. Two other establishments - the Department of STI Control (DSC Clinic) at Kelantan Lane and the Be Prepared Clinic (BePrEP Clinic) at the NUH Medical Centre, National University Hospital (NUH) - also planned to offer PrEP the following year[7],[8]. TTSH decided to offer PrEP in early 2016 and hospital staff had been putting procedures in place to provide the service in a systematic and comprehensive manner. By November 2016, the hospital had prescribed PrEP to one patient, a middle-aged man who found out about the service through word-of-mouth. TTSH was in the midst of revising the cost of the medication and senior medical social worker Amanda Yap explained that the introduction of PrEP allowed the hospital to play a powerful preventive role, reaching out to people at risk. Dr Tan Kok Kuan said an original Truvada tablet for PrEP cost about SGD$30 each, with additional charges for consultation and various tests.

Singapore, being a developed country, is not given the concession by major international pharmaceutical companies of officially being able to sell cheaper, generic versions of Truvada and other antiretroviral drugs before the patents and exclusivity granted to the original versions have expired[9]. This is unlike the case in developing countries such as Thailand or India, where local pharmaceutical companies have been licensed to manufacture generics, even before the drug patents have expired, on compassionate grounds because of their large prevalence of HIV infection and the lower per capita income.

Original, branded versions of Truvada are available at the pharmacies of the larger government medical establishments:

Department of STI Control (DSC Clinic) - The charge for a medical consultation is $100 to $200 per visit. Truvada at its pharmacy costs around $300 to $400 for a bottle of 30 tablets. Operating hours are from 8am to 12am and from 1pm to 4pm from Mondays to Fridays. It is closed on Saturdays and Sundays. Telephone number: 62939648. Email enquiries and appointments: apptdsc@nsc.com.sg. Address: 31 Kelantan Lane, Singapore 200031.
National University Hospital (NUH) - Started in 2016, the specialist Be Prepared Clinic (called BePrEP Clinic for short) at NUH prides itself in being a "confidential, holistic service that covers specialist expertise in Sexually Transmitted Infections (STIs) and HIV prevention". It not only provides PrEP medication but also offers counselling services. The consultation fee is $100 to $200 per visit and Truvada at its pharmacies is charged at $300 to $400 per bottle of 30 tablets. Its address is 5 Lower Kent Ridge Road, Singapore 119074. Telephone number: 91862301. Email enquiries and appointments: bpc@nuhs.edu.sg.

National Centre for Infectious Diseases (NCID) - Open from Mondays to Fridays, the PrEP Care Clinic at the NCID offers a comprehensive range of HIV and STI-related services. Each medical consultation costs $100 to $200 and Truvada at its pharmacy can be bought for $300 to $400 per bottle of 30 tablets. Its operating hours are from 8:30am to 5:30pm from Mondays to Fridays and from 8am to 12 noon on Saturdays. It is closed on Sundays and public holidays. Telephone number: 63577000. Email address: prepcare@ttsh.com.sg. It is located at Clinic J, Level 1, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore 308442.
Tan Tock Seng Hospital (TTSH)
Singapore General Hospital (SGH)

PrEP is also available at certain GP (general practitioner) clinics like the 10 branches of Dr. Tan & Partners[10],[11], Dr Tan Medical Center and Pulse Clinic Singapore. The cost of Truvada at these establishments is about SGD$900 for one month's supply, before GST. The drug may be obtained on the very first visit after a HIV test which can be completed within 15 minutes.

Other GP clinics offering PrEP are:

Prudence Family Clinic:[12]
DB Medical:[13]
Cross Street Medical Clinic:[14]
Anteh Dispensary:[15]
Government subsidy
Medisave cannot be used to pay for PrEP. However, in a move unanimously lauded by HIV doctors and activists, the Ministry of Health added 16 antiretroviral drugs used for the treatment of HIV, including Truvada and Edurant, to its list of subsidised drugs with effect from 1 September 2020, making them much more affordable for thousands of Singaporeans[16]. The 16 drugs were also added to the Medication Assistance Fund which allowed patients who could not afford them to draw from it to help pay for the cost. All subsidised patients who purchased any of the 16 drugs would henceforth receive 50% or 75% worth of subsidies, depending on their means test status. Prior to this, people living with HIV could only receive help from the Medication Assistance Fund on a case by case basis.

Buyers clubs

Much cheaper generic versions (less than one-tenth the price of the branded original) may be obtained through buyers clubs modelled after Dallas Buyers Club, as portrayed in the movie. There are several of these clubs in Singapore. One of them was organised by Rev. Yap Kim Hao of the Free Community Church which has a closeted cell group of HIV-positive churchgoers. A separate club (contactable at +65 97531592) which supplies generic antiretroviral drugs to people living with HIV is headed by a volunteer who sells generics at one of the cheapest prices available - one month's supply of generic Truvada costs SGD$70 (plus an additional SGD$50 for shipping and handling charges) as compared to over SGD$900 for the branded version sold at clinics. The price of one pill of Truvada is 30 Singapore dollars, equivalent to about SGD$55 in the UK, SGD$50 in the USA and SGD$35 in Canada. The cost of the generic version in Thailand is SGD$1 and just over SGD$2 after being imported into Singapore via the buyers clubs.

The Ministry of Health and Health Sciences Authority tacitly allow these buyers clubs to source for generic antiretroviral medication from overseas and have them shipped to the Action for AIDS (AfA) headquarters along Kelantan Lane, just opposite the Department of STI Control (DSC). From these stocks, representatives of the clubs can then procure the drugs for sale to individual buyers. AfA may be contacted via their hotline at: 6254 0212.

Bangkok

Some Singaporeans also travel to Bangkok, Thailand to buy Teno-Em, the generic version of Truvada, and to be followed up by the STI specialists there once every three months. Many catch a flight on Friday evening and return to Singapore by Sunday night. Places where generic antiretrovirals may be obtained include Bumrungrad Hospital (most expensive of all the options), the Bangkok Christian Hospital and the Thai Red Cross AIDS Research Center. The latter is colloquially referred to as the "snake farm" or "Sapha Ka Chat" in Thai. It is located along Angreedunang Road, at the junction opposite Surawong Road. The Thai Red Cross is reputed to offer the cheapest prices. However, one has to factor in the cost of airfare, accommodation, food and local transport.

One physician who prescribes and sells generic antiretrovirals is Dr. Natthakhet of Sathorn International Clinic, telephone/fax: +66 (0) 20093877, e-mail: sic56216@hotmail[dot]com. He used to work at the Thai Red Cross. Opening hours are from 5pm to 8pm on weekdays and 8:00am to around 6:00pm or 7:00pm on weekends. Many Singaporeans who are wary of the large crowds at the Thai Red Cross consult him.

The price of a bottle of original Truvada in Thailand is over SGD$100 whereas the generic Teno-Em costs less than half of that.

Bangkok clinics catering to English speakers
While most Singaporeans are familiar with Pulse Clinic, it is not the only clinic in Bangkok that patients can get PrEP from.

There are several clinics scattered across the city that offer PrEP, some of which cater to English-speaking visitors and expats. (Readers can find out more in this guide specially prepared by Dear Straight People: https://dearstraightpeople.com/2019/11/30/prep-guide-bangkok/ )

Bangkok pharmacies

Chula MD Pharmacy

A prescription for a bottle of Teno-Em, containing 30 tablets of the generic version of Truvada, can be filled for about SGD$30 without the need for haggling at Chula MD Pharmacy[17] (also known as Chula Bhesaj Drug Store), located about 5 minutes' walk from Sala Daeng BTS station. Its address is 942/25 Rama IV Road, Bang Rak, Bangkok 10500. Opening hours are from Mondays to Saturdays from 8:00am to 8:30pm. Telephone number: +66 2 233 5105. Chula's prices are amongst the cheapest as other pharmacies may charge as much as SGD$50 to $65 per bottle.

ChulaMDPharmacy003.jpg ChulaMDPharmacy002.jpg ChulaMDPharmacy004.jpg

(Leftmost photo and pricing information credit: Otto Fong.)
Johor Bahru
Caring Pharmacy
Caring Pharmacy in Malaysia also stocks antiretroviral drugs. The branch in Johor Bahru is located at G-104, G floor, R&F Mall, Mercu 1, Jalan Tanjung Puteri 1, R&F Tanjung Puteri 83000, Johor Bahru. Telephone number: 07-267 3725. It opens every day of the week from 10:00am to 10:00pm[18].

Dr. Singaraveloo of Johor Specialist Hospital, 39 B Jalan Abdul Samad, telephone number: 02-07 225 3000 ext. 4854 is a physician who sees HIV-related problems.

Klinik STI JB

Klinik STI JB offers PrEP and PEP services for Malaysians. It is located along Jalan Mahmoodiah in Johor Bahru. All tests for STIs and PrEP monitoring are done by the clinic, subsidised by Malaysia's Ministry Of Health. Patients only have to pay for the cost of the drugs. Non-Malaysians must fork out the full payment for consultations, tests and medication. Individuals requiring more information may telephone the clinic at +60 192371956 or visit their Facebook page: https://www.facebook.com/klinikstijb

Online suppliers

PrEP Singapore, PrEP Online, PrEP GLOBAL, Dynamix International and Pulse Clinic Online are more reliable and assuring alternatives to procuring medication from unaffiliated, independent suppliers who advertise themselves on Grindr and who may charge as much as SGD$75 per bottle of generic drugs from unverifiable sources.

PrEP Singapore

With the establishment of prepsingapore.com, an organisation which works with Singapore hospitals/clinics and Thailand's Government Pharmaceutical Organization in collaboration with Thai clinics to provide prescription generic medication at affordable prices, and sent to Singapore in accordance with regulations governing the importation of drugs for personal use, it is no longer necessary to travel to Bangkok for cost savings. The site supplies Truvada from Thailand at a third of the prices in Singapore. The Truvada generics are now available cheaply at around SGD65 for one month's supply and delivered to homes legitimately as prescription medication through prepsingapore.com. PrEP Singapore began from successful partnerships with Taiwanese hospitals providing generic Truvada via doctors from Thai clinics and directly from pharmaceutical manufacturers to protect the privacy and safety of their patients. It offers the full suite of customer assurance including customs declaration, refunds and service guarantees, and partners with Singapore sexual health clinics to provide similar prescription-based models.

PrEP Online

PrEP Online[19] was started by a group of PrEP users based in Europe and Asia who believe that access to PrEP should be made more convenient and affordable for people who need it all around the world. The group works with HIV and LGBT-related organisations around the world to provide up-to-date information on PrEP, and sources for PrEP directly from manufacturers to bring it to the community at the lowest prices.

PrEP GLOBAL

PrEP GLOBAL[20] (also known as PrEP Worldwide) is a Singapore-based company that offers PrEP at affordable prices with free shipping. Orders usually arrive within 3 days. If customers use the code "STEVEN", they can get an additional 10% off. The code "STEVEN" is only applicable for orders of SGD$115 and above so it is worthwhile using the code to get a 3-month supply. It offers Ricovir-EM (30 tablets per pack) from SGD$50 onwards and Tenvir-EM (30 tablets per pack) also from SGD$50 onwards.

Dynamix International

Dynamix International[21] is an import-export company established in Singapore in 2009. It delivers PrEP to a customer within 2 weeks. The products it offers are:

Tavin-EM at $57 per bottle (Price Buster offer)[22]
Ricovir-EM at $92 per bottle[23]
Tafero EM (generic Descovy) at $62 to $106.00 per bottle[24]
Tenvir-EM at $84.00 per bottle[25]
Pulse Clinic Online
https://www.pulse-clinic.com/buypreponline/

To save its Singaporean clients the hassle and expense of travelling to Thailand, the Bangkok-based Pulse Clinic began offering PrEP for sale online in the late 2010s. However, buyers must have the original prescription with the date and doctor's signature and Singapore Medical Council registration number (MCR no.), or the official report from a laboratory sent to its email address beforehand.

Up to three months of PrEP medication can be legally imported into Singapore for personal use. This includes:

Truvada by Gilead (TDF/FTC; Tenofovir disoproxil fumarate/Emtricitabine (2',3'-dideoxy-5-fluoro-3'-thiacytidine)
Generic versions of TDF/FTC (Teno-EM by Thailand's Government Pharmaceutical Organization, Ricovir-EM by Mylan, Tenof-EM by Hetero and Tavin-EM by Emcure)
Green Cross Pharmacy

Partial screen shot of Green Cross Pharmacy's website.

Some Singaporeans procure their medication online from Green Cross Pharmacy, an international supplier[26]. One month's supply of PrEP costs approximately USD$10 plus delivery charges.

Public education

Talks and seminars on PrEP are periodically conducted by Action for AIDS (AfA) and its subsidiaries like gayhealth.sg, DSC Clinic, Oogachaga, Drs. Tan & Partners, The Greenhouse SG, Lifeline SG, BePrep Clinic, the National Centre for Infectious Diseases and other organisations.

On 11 June 2022 from 10am to 12 noon, gayhealth.sg conducted a PrEP workshop held as part of Pink Fest 2022 which was attended at full capacity[27]. It sought to provide participants with knowledge on everything PrEP-related. Held at the Action For AIDS office, workshop participants also got the opportunity to take part in a year-long study during which they received subsidised PrEP medication and consultations.

Seriously .... I yet to finish 2nd paragraph and I fell asleep. 

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StockBottom Rising Star

StockBottom

Posted
Posted

Any place in SG where one can do the pre-PrEP consulation and tests at a reasonable cost? All the official hospitals/private clinics seem to charge a lot, not to mention the astronomical price of the original Truvada they would surely want you to get from them.

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Peterjty Rookie

Peterjty

Posted
Posted (edited)
On 3/10/2023 at 12:11 PM, StockBottom said:

Any place in SG where one can do the pre-PrEP consulation and tests at a reasonable cost? All the official hospitals/private clinics seem to charge a lot, not to mention the astronomical price of the original Truvada they would surely want you to get from them.

DSC clinic 

NUH PrEP clinic

NCID PrEP clinic

 

the lab tests + consult should be just a bit more than $100.

they will give you a prescription to go to buyers club to purchase one bottle around $70-80 (30 tabs)

 

I work in this field (I do not sell prep). Pm me if you need any advice :)

Edited by Peterjty
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TopChinese Enthusiast

TopChinese

Posted
Posted
On 2/9/2023 at 5:52 PM, briefsnottrunks said:

Anyone experienced health issues from taking prep regularly?

 

I always take PrEP after food. Eating on an empty stomach can cause bowel issues.

 

Otherwise no issues, except for that warm feeling knowing I don't have to worry about whether the other guys are honest.  

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mate69 Mentor

mate69

Posted
Posted

As mentioned above, the good thing about PrEP is:

 

- you take it, whether or not you are top or btm

- you don't have to wonder if your sex partner is on PrEP or not

(PrEP protects YOU, not the other party, as someone told me before)

- this applies even if you intend to cum (you are top) inside the ass, or if you wanna take cum (you are btm) inside your ass

 

As always, go with what you're most comfortable with

 

 

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Guest Delusional

Guest Delusional

Posted
Posted

I feel like the world has changed. 

In the past, any safe gay sex is with condom. If you bareback, you are considered unsafe. 

 

Just last week I started to engage in gay sex again. With condom. No I'm not on prep cause I don't have gay sex often and no, I always use condom. I come from the era where condom less sex = aids =death. 

 

Yet i was rejected by the younger guy because according to him, I'm unsafe if I don't use prep. 

 

So in today world if you are on prep and engage in bareback, you're safe. 

 

If you are not prep but always use condom. Always. You're considered unsafe. 

 

What a sad delusion the younger generation lives in. 

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Guest guest

Guest guest

Posted
Posted
On 2/22/2023 at 2:56 PM, Guest Roy Tan said:

Some Singaporeans procure their medication online from Green Cross Pharmacy, an international supplier[26]. One month's supply of PrEP costs approximately USD$10 plus delivery charges.

 

 

One month supply only costs USD$10? Sure or not? That is cheaper than buying condoms 🤩

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Guest Roy Tan

Guest Roy Tan

Posted
Posted
On 3/20/2023 at 2:01 PM, Guest guest said:

 

One month supply only costs USD$10? Sure or not? That is cheaper than buying condoms 🤩

Yes, it's true. 28 tablets cost US$9.95.

There are various sizes of bottles ranging from 28 tablets to 168 tablets per bottle. Price range US$9.95 to US$59.70.

You can check the prices on their website:

https://www.greencrosspharmacy.online/prep-en

Cheers,

Roy.

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Guest Prep

Guest Prep

Posted
Posted
On 3/20/2023 at 2:01 PM, Guest guest said:

 

One month supply only costs USD$10? Sure or not? That is cheaper than buying condoms 🤩

The Green Cross Pharmacy and Dynamic International works. You use condoms to prevent herpes, syphillis and other disease, it is on the off chance the bottom kena someone ejaculating inside them. 

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Guest Lol

Guest Lol

Posted
Posted
On 10/1/2023 at 5:35 PM, Guest Prep said:

The Green Cross Pharmacy and Dynamic International works. You use condoms to prevent herpes, syphillis and other disease, it is on the off chance the bottom kena someone ejaculating inside them. 

 

Prep is for personal safety.

How you know the top didn't stealth and remove the condom while fucking you... 

 

I once told my top I'm on prep and guess what he did? He removed the condom and bareback me. I asked him why he do that. He said cause I'm on prep... He assumed I wanted raw. He is also on prep. 

 

So ever since I decided to just lie to them that I'm not on prep. For my own safety. 

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Blue_Sky Newbie

Blue_Sky

Posted
Posted

A quick share of my experience on the journey to be on PreP - since 2020.

 

There is a NUH BePreP Clinic hotline (+65 9186 2310) that one can call for more information.

From the call, I spoke to a doctor and was advised to do the following:

1. Do an anomynous HIV test (Cost: $32.00) with DSC Clinic to check and confirm that one is HIV negative.

2. Go to any Polyclinic and request for a Referral Letter (Cost: $11.20) addressed to NUH Infectious Disease (UMC) with a note to be referred to BePreP Clinic specifically. This will help to provide some subsidies with related treatment with NUH.

3. Call BePreP Clinic hotline (+65 9186 2310) to inform doctor of the progress/results of point 1 and 2; an appointment will be arranged to see a consultant at NUH.

 

At NUH, I was asked to do a blood test - a kind of assessment and baseline check - for Creatinine, HIV Antigen/Antibody, Hep B Antigen/Antibody. The original bill was about $182, and with the subsidies from the referral letter, I paid about $74. After waiting for a couple of days, I was informed by the consultant that my test results had passed; a prescription of 3 months of Tenofovir Disoproxil Fumarate was subsequently provided. The consultant also recommended that I can get my medication online through PreP Singapore (https://prepsingapore.com/en/). It cost about $271 for the 3 bottles, inclusive of shipping charges.

 

For the first 3 months, I took the one tablet daily as instructed. Then I went back to NUH for my first 3-monthly blood test for Creatine and HIV (Original cost was about $35; after subsidised it cost about $18) to monitor for any signs of kidney issues. Once all is good, a new prescription of 3 months Tenofovir Disoproxil Fumarate was provided, and the cycle goes on. So basically for the last 2 years or so, I have been returning to NUH once every 3 months for a blood test (Creatine and HIV) and prescription. And for every alternative visits (i.e. at once every 6 months), I will get to speak with the consultant for an assessment to see how I am doing (both physically and mentally). The cost for the tests including the consultation fee was originally about $112, and with subsidies it was about $51).

 

Personally, I like that the entire process has been quite painless, and the support provided by the staff of NUH BePreP clinic has been tremendous.

 

Hope this information can help some of you in your decision to go on PreP. 

Stay Safe.

 

 

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mate69 Mentor

mate69

Posted
Posted
24 minutes ago, DrizzlingBoy said:

Hi, I recently just bought prep from https://prepsingapore.com/en/ and I had side effect. I guess the body rejected the prep. 
 

I planning to sell it at cost price, shipping fee I will waived off. I got 2 bottle not opened, if anyone interested do let me know. 
 

$68.50 per bottle. Teno-EM (Generic PrEP)

 

what side effects did u have?

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doncoin Veteran

doncoin

Posted
Posted
10 minutes ago, DrizzlingBoy said:

Headache within an hour than start vomiting whole day till I have to be on diet with empty stomach overnight to clear the PrEP

 

 

This is something you should bring to your doctor's attention. There are different brands of Prep, as I have shared, I was on Truvada for about 2 years and all of sudden, my body started reacting to it negatively. So my doctor switched my presciption to Descovy, which works well. Discuss with your doctor the side effects, and see if you can switch to a different medication. 

Love. 

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DrizzlingBoy Rookie

DrizzlingBoy

Posted
Posted
6 hours ago, doncoin said:

 

 

This is something you should bring to your doctor's attention. There are different brands of Prep, as I have shared, I was on Truvada for about 2 years and all of sudden, my body started reacting to it negatively. So my doctor switched my presciption to Descovy, which works well. Discuss with your doctor the side effects, and see if you can switch to a different medication. 

Ok thanks for the advice! 😊 I will be going DSC this week to consult the doctor. 

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