Q：什麼是暴露前預防性投藥 (PrEP) 啊？

A：PrEP類似事前避孕藥，未感染愛滋病毒的人(愛滋病毒篩檢呈陰性者)，經醫師評估後服用抗病毒藥物（tenofovir以及emtricitabine），在體內有足夠藥物濃度時，可降低九成的愛滋感染率。

Q: What is PrEP?

A: PrEP means pre-exposure prophylaxis, and it’s the use of a specific anti-HIV medication combination (tenofovir and emtricitabine) that keeps HIV negative people from becoming infected. Taking PrEP correctly can reduce 90% of HIV infection.

Q：誰可以使用PrEP呢？

A：不論男性或女性、發生性行為的對象是同性還是異性，只要是未感染愛滋病毒(愛滋病毒篩檢呈陰性者)，都可以透過使用PrEP來預防愛滋。

Q: Who can take PrEP?

A:, ANYONE who is HIV-negative and wants to protect himself or herself agaist HIV can use PrEP, regardless gender or sexual orientation.

Q：應該怎麼使用PrEP呢？

A：基本上所有人都建議每日服用PrEP以維持藥物濃度。最新的iPERGAY研究指出，男男性行為者且非B肝帶原者也可以「依需求時使用 (on-demand PrEP)」 ，也就是性行為2-24小時前服用兩顆藥物，性行為後24小時與48小時後再各服用一顆藥物。若性行為時間達兩天以上，則除事前兩顆藥物，期間每24小時需服用一顆藥物，直到最後一天性行為後，再加兩天各一顆藥物為止。

Q: How to take PrEP?

A: Taking PrEP on a daily basis is recommended for everyone. The iPERGAY study also found it’s effective to use “on-demand” PrEP for men who have sex with men (MSM) without hepatitis B. On-demand PrEP is to take two pills 2-24 hours before sex, and take one pill 24 hours and another one 48 hours after sex. If having sex more than 1 day, then take one pill every 24 hours during sex, and take a pills two day after the last time.

Q：PrEP會有副作用嗎？

A：常見的副作用包括頭暈、噁心、及腸胃不適等。大部份的副作用相當輕微，不會到讓使用者因此停藥的程度。少數使用者可能會發生可逆的骨質流失（約1%）或腎臟功能異常（約0.5%），停藥後就會恢復，所以也需定期回診追蹤腎功能。

Q: Does PrEP cause any side effect?

A: Most common side effects include dizziness, nausea, and stomach upset. Most of the side effects are mild to moderate, and few people will discontinue PrEP due to the side effects. Very few people have decreased bone mineral density (around 1%) and abnormal kidney function (around 0.5%). These side effects are reversible and will disappear after stopping PrEP. Therefore it’s important to follow up the kidney function you're your doctor regularly.

Q：PrEP是百分百有效的嗎？

A：沒有任何一種方法可以百分之百預防愛滋，然而如果依照醫師的指示使用PrEP，還是能夠有效地預防感染愛滋。PrEP無法預防其他性病，例如C型肝炎、梅毒、淋病或披衣菌，因此定期接受性病篩檢也是很重要的。

Q: Is PrEP 100% effective against HIV?

A: Not any method can provide 100% protection against HIV, yet PrEP is very effective to prevent HIV infection if it’s taken according to the doctor’s recommendation. PrEP cannot prevent other STDs, such as hepatitis C, syphilis, gonorrhea or Chlamydia; hence it’s important to check HIV and other STDs regularly.

Q：PrEP和PEP（暴露後預防性投藥）有什麼差別啊？

A：PrEP和PEP都是讓未感染愛滋（HIV陰性）的人，使用抗病毒藥物來預防感染愛滋的方式。PrEP是「暴露前」使用，也就是在發生性行為前就要服藥，服用的藥物是兩種成分的組合，也就是tenofovir以及emtricitabine。PEP是「暴露後」使用，是在已經發生了未保護的性行為後補救的方式，在暴露後72小時內就要使用，服用的藥物通常是至少三種成分以上的組合。

Q: What are the differences between PrEP and PEP (post-exposure prophylaxis)?

A: Both PrEP and PEP are used by only HIV-negative people to prevent HIV infection. PrEP is “pre-exposure prophylaxis” and should be used BEFORE sex. PrEP contains two active components against HIV, i.e. tenofovir and emtricitabine. PEP is “post-exposure prophylaxis”, and must be taken within 72 hours AFTER unprotected sex. PEP contains three or more active components against HIV.

Q：在臺灣PrEP有健保給付嗎？

A：目前在臺灣PrEP沒有健保給付，屬於自費項目。原廠的PrEP藥物舒發泰®一罐30顆自費價格約為新台幣10,000-12,000元。

Q: Is PrEP covered by National Health Insurance in Taiwan?

A: So far PrEP is not covered by National Health Insurance in Taiwan, and the cost of brand Truvada® is around 10,000-12,000 NTD per bottle (30 pills).

Q：在臺灣要如何取得PrEP呢？

A：目前在台灣約有41家指定醫院與其他診所可以取得PrEP (暴露前預防性投藥名單)。臺灣疾病管制署、縣市衛生局與全國不同的研究單位也持續有PrEP相關的研究計劃進行。我們的網站會定期更新提供PrEP的醫療院所與研究計劃的資訊。

Q: How to get PrEP in Taiwan?

A: So far there are 41 hospitals and clinics providing PrEP service in Taiwan (PrEP service ). Our website will update the information regularly on PrEP providers throughout Taiwan and demonstration projects available from Taiwan CDC, local public heath departments, and research centers.

Q：在臺灣如何取得PrEP的學名藥？

A：由於目前原廠的PrEP藥物舒發泰®在臺灣的專利權還沒有過期，所以在臺灣沒有販售PrEP的學名藥。然而以個人身份購買國外的學名藥帶回台灣自行使用是合法的。民眾除了可以在國外購買合理數量的學名藥自行攜帶回台灣使用之外，也可以透過國外醫療單位的網站訂購學名藥。學名藥一罐30顆的價格大概介於新台幣1,200-2,000元左右。由於國外的學名藥在臺灣沒有藥證，所以產生副作用時不符合國內藥害救濟法的條件。

在泰國當地可提供外國人檢驗及購買PrEP學名藥的醫療單位： Thai Red Cross AIDS Research Center – Anonymous Clinic (http://en.trcarc.org/Homepage/?page⋯⋯) Silom Pulse Clinic (https://www.prep4you.org/chn-order) Bangkok Health Hub (http://www.bangkokhealthhub.com/) Love Foundation (http://prepfirst.org/tw)

在臺灣可提供線上訂購PrEP學名藥的網站： PrEP4YOU by Pulse Clinic (https://www.prep4you.org/chn-order) PrEP Taiwan (http://preptaiwan.org/)

Q: How to get generic PrEP in Taiwan?

A: At present no generic PrEP is available in Taiwan because the patent of Truvada® hasn’t expired yet. Nevertheless, it’s legal to purchase generic PrEP abroad and carry it back to Taiwan as long as it’s within reasonable quantity and for individual use only. Besides flying abroad and buying generic PrEP, you can also order generic PrEP on several online websites and let the organizations ship the drug to Taiwan. The cost of generic PrEP is around 1,200 - 2,000 NTD per bottle (30 pills). Due to lack of license in Taiwan, any side effects due to generic PrEP don’t apply to the Drug Injury Relief Law.

Clinics in Thailand where you can get tests and buy generic PrEP: Thai Red Cross AIDS Research Center – Anonymous Clinic (http://en.trcarc.org/Homepage/?page⋯⋯) Silom Pulse Clinic (https://www.silompulse.com/) Bangkok Health Hub (http://www.bangkokhealthhub.com/) Love Foundation (http://lovefoundation.or.th/en)

Online websites to order generic PrEP: PrEP4YOU by Pulse Clinic (https://www.prep4you.org/) PrEP Taiwan (http://preptaiwan.org/)

Q：我準備好要開始服用PrEP了，應該要注意什麼呢？

A：首先要確認自己是否有感染愛滋，以及有沒有B型肝炎帶原。開始服用後應該要遵從醫師的指示，每天規律服用或是依照「依需求時使用 (on-demand PrEP)」的方式服用PrEP。在服用的過程中要三個月定期回診檢驗愛滋、肝腎功能與其他性病。最後，如果考慮停止使用PrEP的話，應該繼續定期回診，並且與醫師討論其他預防愛滋的方式。

Q: I’m ready to start PrEP now. Is there anything I should know?

A: First, you should make sure you are HIV-negative and whether you have hepatitis B before you start PrEP. Once you start PrEP, you should follow the doctor’s recommendation and take PrEP daily or as on-demand use regularly. Be sure to return to the clinic to follow up HIV, kidney and liver functions, and other STDs every 3 months. If you consider to stop PrEP, it’s still important to return to the clinic to follow up regularly and discuss with your doctor about other preventive methods for HIV.

Q：如果我用PrEP了，我還需要戴保險套嗎？

A：保險套和PrEP都是有效預防愛滋的方式，不是互斥的選項，保險套和PrEP兩者一起使用可以達到最大保護的效果，然而，端看個人偏好，選擇保險套或PrEP其一，或是兩者同時使用來預防愛滋總比沒有採取任何的保護措施來得好。此外，除了愛滋之外，使用保險套還可以避免感染其他性病以及懷孕。

Q: Should I still wear condom if I’m using PrEP?

A: Condom and PrEP are both effective ways to prevent HIV infection and are not mutually exclusive. You can use condom with PrEP to achieve the most effectiveness for prevention. Nevertheless, depending on personal preference, choosing either condom or PrEP, or even both condom and PrEP for prevention is still more reasonable than not taking any preventive measure at all. In addition, condom is effective against other STDS and can be used to avoid pregnancy.

若有任何問題歡迎來信或私訊粉絲頁 Please contact us if you have any question