PrEP & PEP Navigation For People Who Use Drugs

Navigating PrEP (pre-exposure prophylaxis) and Pep (post exposure prophylaxis) as a PWUD has its fair share of challenges, particularly around accessing services that are understanding, non-judgmental and compassionate towards PWUD. There is also the concern of not knowing how illicit drugs interact with PrEP medication, let alone being able to freely engage in such a conversation. 

As well as risking adverse drug interactions, taking recreational drugs increases the chance you will miss doses of your HIV treatments. 

While research is still emerging, current scientific understanding suggests that occasional recreational drug use is unlikely to significantly reduce PrEP’s effectiveness, especially when taken consistently as prescribed. PrEP builds a protective barrier over time through daily dosing, and while occasional drug use might slightly lower protection, this typically rebounds once consistent use resumes. 

However, PrEP is not foolproof. Adherence lapses, drug interactions, and increased risk behaviors—common with some drug use—can reduce its protective benefits.  

Ultimately, all drugs whether illicit, prescribed or over the counter are broken down in the liver and eliminated through the kidneys. What this means is, that while it’s impossible to know how well the liver and kidneys break down each drug on an individual basis, some drugs impair liver and kidney function worse than others and the potency and amount of the drug can also have an impact. 

This is why HIV harm reduction is essential, especially for people who use drugs. 

Key components include: 

• Consistent condom use to prevent HIV and other STIs not covered by PrEP 
• Routine sexual health screenings every 3 months 
• PEP (Post-Exposure Prophylaxis) for emergency protection after potential high-risk exposure 
• Safe injecting practices, always use a new sterile fit for every hit, and avoid sharing equipment.