Travel Sexual Health Guide: PrEP, PEP and Doxy-PEP Before, During and After Your Trip

Planning ahead lowers your risk of HIV and other sexually transmitted infections (STIs) on a trip. This guide goes in the order you will need it: before you travel, before sex, during sex, after sex, and what to do in an emergency. It also explains how to use each item in the Travel Sexual Health Kit.

1. Before you travel

• Check your vaccinations. Ask your doctor whether hepatitis A, hepatitis B or HPV vaccination is right for you.
• Get a baseline screen. You need an HIV test before PrEP anyway, and a baseline STD screen gives you a result to compare against when you come home.
• Read this guide first. Know how to use each item before you need it.
• Pack your medicines properly. Keep them in their original labelled packs with the prescription or a doctor's letter, and check what your destination allows you to bring in.
• Save our number. Message the clinic on WhatsApp if you have questions about your medicines while you are away.

2. Before sexual activity

PrEP: protection against HIV

PrEP is medicine that helps prevent HIV when you take it before an exposure.

You may consider PrEP if:

• you expect sex that may expose you to HIV
• you want extra protection against HIV

Before taking PrEP:

• Confirm you are HIV-negative. Taking PrEP with undiagnosed HIV can make the virus resistant to treatment.
• If you have hepatitis B, speak to the clinic before starting.
• The 2+1+1 method is not suitable for everyone. Follow your doctor's advice.

How to take PrEP: the 2+1+1 method

The 10 PrEP tablets in the travel kit are meant for the 2+1+1 method, also called on-demand PrEP, unless your doctor has prescribed daily PrEP.

• 2 tablets 2 to 24 hours before sex.
• 1 tablet 24 hours after the first dose.
• 1 tablet 48 hours after the first dose.
• If sex continues over several days, keep taking 1 tablet every 24 hours, then 1 tablet a day for 2 days after the last sex.

Example: if sex is planned for Saturday at 10 PM, take the first 2 tablets between Friday 10 PM and Saturday 8 PM.

Remember:

• Take the follow-up doses on time. Missing them leaves you unprotected.
• The 2+1+1 method is for eligible people, particularly for anal sex.
• PrEP does not prevent other STIs. Use condoms as well.

Optional add-on: tadalafil for erections

Only if you added tadalafil to your order.

• How to take: only the dose prescribed.
• When it works: usually within 30 to 60 minutes. Sexual stimulation is still needed.
• Common side effects: headache, facial flushing, indigestion, blocked nose or back pain.

Safety:

• Never take it with nitrate medicines for chest pain or with poppers.
• Avoid heavy drinking.
• Do not combine it with other erectile dysfunction medicines unless your doctor says so.
• It does not prevent HIV or other STIs.

Get emergency help for chest pain, sudden loss of vision or hearing, or an erection lasting more than 4 hours. If you have chest pain after taking tadalafil, tell the emergency staff and do not take nitrates yourself.

3. During sexual activity

Use condoms

• Use a new condom correctly, from start to finish, for every act.
• Check the expiry date and that the wrapper is intact.
• Use water-based or silicone-based lubricant with latex condoms.
• Condoms lower the risk of HIV and many STIs, but do not remove every risk.
• If you or your partner have worrying symptoms, avoid sex until you have seen a doctor.

Hygiene items in the kit

• Hand sanitiser: for your hands when soap and water are not available.
• Mouthwash: for fresh breath before or after kissing. It is for hygiene only and does not prevent STIs.

4. After sexual activity

Doxy-PEP: within 72 hours after sex

Doxy-PEP is an antibiotic that may lower the risk of some bacterial STIs. Use it only if your doctor has prescribed it for you.

• Dose: 2 tablets of doxycycline 100 mg (200 mg in total), as soon as possible and within 72 hours after sex.
• Do not take more than 200 mg in 24 hours unless your doctor tells you to.
• It can lower the risk of syphilis, chlamydia and gonorrhoea, but it does not give full protection.
• It does not prevent HIV, herpes or HPV.

To reduce side effects:

• Take it with food and a full glass of water.
• Stay upright for at least 30 minutes afterwards.
• Keep it apart from antacids and supplements containing calcium, iron or magnesium, as your pharmacist advises.
• Protect your skin from the sun.

Doxy-PEP is not suitable for everyone, and the evidence differs between groups of people. Your doctor decides whether it is right for you.

Testing and symptoms

Mouthwash, genital washing and hand sanitiser do not prevent STIs. Testing is how you find out. Your doctor may recommend:

• HIV testing
• Syphilis blood testing
• Gonorrhoea and chlamydia testing at the sites that were exposed
• Hepatitis testing where needed

Some infections cannot be detected straight after exposure, so your doctor will tell you whether to repeat a test later. Test when advised even if you feel fine.

See a doctor if you notice:

• Unusual discharge from the penis, vagina or rectum
• Pain or burning when urinating
• Genital sores, blisters, ulcers or a rash
• Testicular pain or swelling
• Rectal pain, discharge or bleeding
• Fever or other unexplained symptoms after a possible exposure

Do not self-treat with leftover antibiotics. Different infections need different tests and treatments.

5. Emergency: condom broke or unprotected sex?

If you are taking PrEP

• Taken every dose on time? PEP is usually not needed if your PrEP regimen was protecting you.
• Missed a dose, started late or unsure? Get urgent medical assessment.
• Keep taking your prescribed doses unless a doctor tells you otherwise.

If you are not taking PrEP, or are unsure you were protected

1. Get urgent medical assessment for HIV post-exposure prophylaxis (PEP).
2. Start PEP as soon as possible, ideally within 24 hours and no later than 72 hours after exposure.
3. Do not wait for symptoms, or for the other person's test results.
4. If you are prescribed PEP, finish the full course and attend your follow-up appointments.

Important: doxy-PEP is not a substitute for HIV PEP. The 2+1+1 method does not cover every type of exposure, so a doctor should assess yours. If more than 72 hours have passed, still get advice on testing and follow-up.

If you are in Kuala Lumpur, message the clinic on WhatsApp and say it is about PEP, so we treat it as urgent. You can read more on our HIV PrEP and PEP page.

6. Frequently asked questions

Does PrEP prevent all STIs?

No. PrEP is for HIV prevention. Condoms, regular testing and other prevention measures remain important.

Does doxy-PEP mean I do not need condoms?

No. It does not prevent every STI, and its benefits and limitations depend on the individual.

Can I take doxy-PEP whenever I want?

No. Use it only according to your doctor's prescription and instructions.

What if I have no symptoms?

You may still have an STI. Follow the recommended screening schedule even if you feel well.

This page provides general educational information and does not replace individual medical assessment or your prescribed medication instructions. Seek urgent medical care for a possible HIV exposure.