PrEP in Singapore: What It Is, Who It's For, and How to Get Started
Pre-Exposure Prophylaxis (PrEP) is a medication that helps prevent Human Immunodeficiency Virus (HIV) infection before you're exposed to the virus. When taken correctly, it is more than 99% effective at preventing HIV through sexual activity, making it one of the most effective HIV prevention tools available today.
Even so, many people aren't sure whether PrEP is right for them. Is it only for certain groups? How do you get it in Singapore? What tests are needed before you start?
Here's what you need to know.
What is PrEP?
PrEP is a prescription medication for people who are HIV-negative and wish to lower their risk of getting HIV. It works by stopping the virus from establishing an infection if you are exposed to HIV during sex. For PrEP to work well, the medication needs to be taken prior to sexual exposure and as prescribed. PrEP is not HIV treatment, and is not a substitute for HIV treatment if someone is already infected. Instead, it is designed to prevent infection from happening in the first place.
Daily vs on-demand PrEP
Most people take one tablet every day. Daily PrEP provides continuous protection and is the option most commonly recommended because it's simple to follow.
Some people may also be suitable for on-demand PrEP, sometimes called event-driven or "2-1-1" dosing. This involves taking the medication around planned sexual activity rather than every day.
It is important to discuss the best option with your doctor before starting treatment.
What PrEP doesn't protect against
PrEP is highly effective against HIV, but it protects against only HIV. It doesn't prevent other sexually transmitted infections (STIs) such as gonorrhoea, chlamydia, syphilis or herpes, and it also doesn't prevent pregnancy. Therefore, condoms remain an important part of safe sex because they provide protection against infections that PrEP doesn't cover.
Who should consider PrEP?
One of the biggest misconceptions about PrEP is that it is only meant for certain groups of people. The fact is, PrEP is recommended based on your level of HIV risk, not your identity or relationship status.
You may want to consider PrEP if you:
have multiple sexual partners
don't always use condoms
have a partner living with HIV
have sex with partners whose HIV status is unknown
have recently been diagnosed with another STI
expect a period where your risk of HIV exposure may increase
Not everyone needs to stay on PrEP permanently. Some people take it during periods when they're more sexually active or anticipate a higher risk of exposure, then stop later under medical guidance. The decision is always individual and should be based on a discussion with your doctor.
Do I still need condoms?
PrEP is extremely effective at preventing HIV, but it doesn't protect against other STIs. Condoms help reduce the risk of infections such as gonorrhoea, chlamydia and syphilis, so the two methods work well together rather than replacing one another.
How do I start PrEP in Singapore?
Before treatment begins, your doctor will first confirm whether PrEP is safe and appropriate for you. This usually starts with a confidential consultation covering your medical history, sexual health, and any recent HIV exposures.
Tests before starting
Before prescribing PrEP, doctors will usually recommend:
HIV test to confirm HIV-negative status
STI screening where appropriate
Kidney and liver function tests if necessary
Follow-up while taking PrEP
PrEP isn't a medication that's prescribed indefinitely without review. Most patients return every 3 to 6 months for follow-up, during which a repeat HIV test is performed, and screening for other STIs or a kidney function test when appropriate. During the follow-up, it is also a good opportunity to review any side effects to the medication or if there have been changes to your sexual health and risk profile.
Can I get PrEP through a teleconsult?
It is possible to get PrEP through a teleconsult, particularly for follow-up appointments. However, blood tests are still required before starting treatment and at regular intervals afterwards. Your doctor may combine teleconsultations with laboratory testing at a clinic or diagnostic centre.
How much does PrEP cost in Singapore?
The overall cost of PrEP includes the medication itself as well as the consultations and blood tests needed to monitor treatment safely.
Besides the medication, you should also expect costs for:
Consultation fee
Follow-up reviews
Kidney function test if required
STI screening if required
The exact cost varies between clinics and depends on the type of medication prescribed and the investigations required.
Can I use Medisave or insurance?
Unfortunately, Medisave cannot be used for PrEP as it is considered a supplementary preventive option. Similarly, consultation fees and laboratory tests must also be paid fully out-of-pocket, although some private insurance plans may offer reimbursement for these components.
Frequently asked questions
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Some clinics offer online consultations for PrEP, but laboratory tests are still needed prior to initiating treatment. A doctor will usually need to review your HIV test and other results before prescribing the medication.
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Missing an occasional dose doesn't necessarily mean you've lost all protection. If you're taking daily PrEP, take your next dose as scheduled unless your doctor advises otherwise. If you've missed several doses or think you've been exposed to HIV, seek medical advice promptly as Post-Exposure Prophylaxis (PEP) may sometimes be necessary.
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Yes, PrEP doesn't have to be lifelong. You may stop when you are no longer at increased risk of HIV exposure. However, because protection doesn't disappear immediately, and timing is important when stopping or restarting treatment, it's best to discuss this with your doctor first.
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Most people tolerate PrEP very well. Some people experience mild nausea, headaches or stomach discomfort during the first few weeks, but these side effects are usually temporary.
Final thoughts
PrEP has become one of the most effective ways to prevent HIV, giving people greater control over their sexual health. When combined with regular medical follow-up and safe sex practices, it offers reliable protection for those at risk of HIV exposure.
If you're considering PrEP, the first step is simply to speak with a doctor. A confidential consultation can help you understand your level of risk, answer any questions you have, and determine whether PrEP is the right choice for you.
