Can people who inject drugs use PrEP?

The World Health Organization guidelines recognise people who inject drugs as a group who should be offered PrEP. United Kingdom and United States guidelines recommend it if you might share injecting equipment. In the US it is also recommended if you have an injection partner living with HIV. However, access remains uneven, and PrEP is still hard to get in many countries.

The most common form of PrEP is a pill containing tenofovir disoproxil and emtricitabine. Long-acting injections have been approved in some countries, but they have only been tested to prevent HIV during sex, and there is currently no evidence on their effectiveness for preventing HIV passed on through injecting.

The only rigorous study testing PrEP efficacy among people who inject drugs took place in Bangkok and was published in 2013. Once-daily oral PrEP containing tenofovir on its own was found to reduce the risk of getting HIV by around 74% when taken as prescribed.

PrEP protects you from HIV both when injecting and during sex, but it does not prevent hepatitis C transmission.

PrEP does not interact with methadone or buprenorphine, nor does it reduce their effects. You can find more information on interactions and possible side effects in our PrEP pages.

Depending on your country and available services, the process for getting PrEP as someone who injects drugs can sometimes be complex and involve several appointments or steps before you can start. If a health professional refuses to prescribe you PrEP, you could show them the guidelines shared above. Harm reduction services and related organisations may also help you understand what the requirements are and where you need to go.