Medically reviewed by Dr. Ponlawat Pitsuwan, Physician, Takecare Clinic Phuket. Last reviewed: September 2026.
More long-stay visitors now ask me about PrEP before they arrive in Thailand rather than after a scare, and I think that is the right way round. Starting PrEP safely means checking HIV status, kidney function and hepatitis B first, so it is worth planning a little ahead.
We meet two kinds of PrEP patient in Phuket. The first already takes it at home and has run short because a trip was extended or a bag went missing. The second has been meaning to start for a while and finds a long holiday is the moment to ask. Both need the same careful first step, an HIV test on the day, because PrEP started during an undiagnosed infection can leave the virus resistant to the very drugs being used. After that, the process is straightforward, and choosing PrEP is a normal, sensible health decision.
How PrEP prevents HIV
The standard PrEP tablet combines two antiretroviral medicines, tenofovir disoproxil and emtricitabine. Taken regularly, they build up in the tissues where HIV would enter, so if the virus arrives it cannot establish an infection. Taken as prescribed, PrEP is highly effective against HIV acquired through sex, and protection drops sharply when doses are missed. It does not protect against other sexually transmitted infections or pregnancy. PrEP is taken before exposure and continued while the risk lasts, which is the opposite of PEP, the emergency course taken after an exposure.
Daily or event-driven: choosing how to take it
Daily PrEP suits everyone at ongoing risk, including women, trans and non-binary people, and people who inject drugs. Event-driven PrEP, known as 2-1-1, is an option only for cis men who have sex with men, because the evidence for it comes from anal sex, where drug levels build faster. It is not suitable for anyone with hepatitis B, since stopping and starting tenofovir can trigger a hepatitis flare.
| Approach | Who it suits | How to take it | When protection builds |
|---|---|---|---|
| Daily PrEP | Anyone at ongoing HIV risk | One tablet every day, at roughly the same time | About 7 days for receptive anal sex; about 21 days for vaginal or frontal sex and injecting |
| Event-driven 2-1-1 | Cis men who have sex with men, without hepatitis B | Two tablets 2 to 24 hours before sex, one 24 hours after the double dose, one more 24 hours later | From 2 hours after the double dose; keep one tablet daily while sex continues, then take the final two |
| Stopping | Everyone | Discuss with us first | Usually continue for 7 days after the last sex, or 2 days for cis men who have sex with men |
Tests before you start, and every three months
The starting visit includes an HIV test, ideally a fourth-generation lab test, to confirm you are HIV-negative. If you have had a possible exposure in the last 72 hours, we start PEP first and move you onto PrEP when the 28 days are complete, with no gap. If you have fever, rash or sore throat after a recent risk, we check for very early infection before prescribing. We also test kidney function with a creatinine blood test, because tenofovir is cleared by the kidneys, and check hepatitis B surface antigen and immunity; if you are not immune, vaccination is advised. A screen for syphilis, chlamydia and gonorrhoea is sensible at the same time, and a pregnancy test where relevant.
Once you are on PrEP, the rhythm is an HIV test every three months, usually with an STI screen, and kidney function every six to twelve months, more often if you are older or have other kidney risks. Our HIV test in Phuket page explains which test is used at each stage, and STD testing in Phuket covers the wider panel.
Side effects and safety
Most people have no side effects. A minority notice nausea, bloating, loose stools or headache in the first few weeks, which usually settle without stopping. Tenofovir disoproxil can cause small, usually reversible changes in kidney function and bone density, which is why monitoring matters. Tell us about regular painkillers: frequent ibuprofen or similar anti-inflammatory drugs for a sprained ankle or back pain can add strain to the kidneys. PrEP can be used during pregnancy and breastfeeding. Alcohol and recreational drugs do not stop PrEP working, but they are the most common reason for missed doses.
Staying on PrEP while travelling in Phuket
Crossing time zones is the first challenge. Pick a daily anchor, such as breakfast, and move it gradually to local time; a few hours either way does not matter. If you miss a daily dose, take it when you remember, but never two on the same day. Heat is the second: keep tablets below 30°C in their original pack, and never in a scooter seat compartment, a beach bag in the sun or a parked car, where temperatures climb fast. Carry a supply in hand luggage with a copy of your prescription.
If you run out, come in before the gap grows. If you have missed more than about a week and had condomless sex during the break, we test before restarting, and if the last risk was under 72 hours ago, PEP may be the safer first step. Bring your home clinic’s letter or last test results, which often speeds things up, and ask on WhatsApp whether the medicine is in stock today.
When to see a doctor
Come in promptly if you develop symptoms that could be early HIV, if you have missed doses and then had condomless sex, or if you notice passing much less urine, new swelling of the ankles or unusual tiredness. People with hepatitis B who stop PrEP need monitoring for a flare, with yellowing skin or eyes, dark urine or abdominal pain as warning signs.
Prevention and early detection
PrEP is one part of a prevention toolkit. Condoms add protection against gonorrhoea, chlamydia and syphilis, which PrEP does not cover. Hepatitis B vaccination is important for everyone on PrEP, and hepatitis A and HPV vaccination are often recommended for gay and bisexual men. Some guidelines now also offer doxycycline after sex to reduce bacterial STIs for certain gay and bisexual men and trans women; ask us whether that applies to you. Three-monthly screening is itself a form of early detection: it catches infections before symptoms and before they are passed on.
Starting or restarting PrEP with us
There is no booking system to navigate: walk in at any hour to the Bangtao (Cherngtalay) clinic in Cherngtalay, the Kata-Karon clinic or the clinic in Patong. Before you travel over, you can message us on WhatsApp to check stock and bring the right paperwork, or ring +66 81 718 9080. Our walk-in doctor in Phuket sees most people within minutes, and most walk-in visits are finished within half an hour.
A doctor hotel visit in Phuket is an option if you would rather have the consultation and baseline blood samples taken in private. We confirm the price on WhatsApp before your visit. Travel insurance often treats PrEP as preventive care and excludes it, so check your policy; we provide receipts and itemised invoices for any claim or reimbursement at home.
Related services and treatments
If an exposure has already happened, PEP treatment in Phuket is the urgent option, and we move people from PEP straight onto PrEP when that makes sense. The kidney and hepatitis B checks are part of our wider blood tests in Phuket. Because PrEP does not prevent bacterial or viral STIs, you may also need chlamydia treatment after a positive screen, herpes treatment for genital sores, or cold sore treatment for HSV-1 on the lips, which can spread through oral sex. Women on PrEP with a change in discharge may have bacterial vaginosis, covered on our BV treatment page. See all our medical services for anything else.
Summary
PrEP is a highly effective way to prevent HIV when taken consistently. Daily dosing suits everyone, while 2-1-1 is only for cis men who have sex with men without hepatitis B. Start with a same-day HIV test, kidney function and hepatitis B check, then test for HIV every three months. On holiday, protect your tablets from heat, keep to a daily anchor, and come in early if you run out or miss doses.
“PrEP works extremely well when it is taken as prescribed. Set a daily phone reminder and keep your three-monthly HIV test even while you are travelling.”
Dr. Ponlawat Pitsuwan, Physician, Takecare Clinic Phuket
Frequently asked questions
I’ve run out of PrEP on holiday. Can I restart straight away?
Often, yes. If your last dose was recent and you have had no condomless sex since, we can usually restart after a same-day HIV test. If the gap is longer than about a week and there was a risk during it, we test more carefully first, and if the risk was under 72 hours ago, PEP may be the right first step before PrEP.
How quickly can I get a PrEP prescription?
Usually at the same visit. A rapid HIV test gives a result in about 20 minutes, and the doctor can prescribe once it is negative, with kidney and hepatitis B results following from our on-site laboratory. If those later results raise a concern, we contact you and adjust the plan. Ask on WhatsApp whether the medicine is in stock today.
Do I need an appointment to start PrEP?
No appointment is needed. Walk in to any of our three clinics at any time of day or night. Bringing your last HIV test result, kidney results or a letter from your home clinic helps if you are already on PrEP, but it is not essential, because we can repeat the baseline tests here.
Can a doctor start PrEP at my hotel or villa?
A doctor can visit hotels and villas anywhere in Phuket around the clock, carry out the consultation, do a rapid HIV test and take blood for kidney function and hepatitis B. Message us on WhatsApp first so we can confirm whether the medicine can be brought to you on that visit.
Will travel insurance pay for PrEP?
Most travel policies treat PrEP as preventive medication, which is commonly excluded, though some international health plans do cover it. We confirm the price on WhatsApp before your visit and provide receipts, medical reports and itemised invoices, so you can claim from your insurer or health service at home if your plan allows it.
Is 2-1-1 dosing right for me?
Event-driven 2-1-1 dosing is supported by evidence only for cis men who have sex with men, and it is not suitable if you have hepatitis B. Women, trans and non-binary people, and anyone at risk through vaginal or frontal sex or injecting, should take PrEP daily. The doctor can help you choose based on your pattern of sex and your test results.
Sources
The CDC explains who PrEP is for and how well it works on its PrEP guidance page. The NHS describes PrEP alongside other options in its guide to preventing HIV. The World Health Organization HIV fact sheet sets out global prevention recommendations.
PrEP, pre-exposure prophylaxis, tenofovir disoproxil, emtricitabine, daily PrEP, event-driven 2-1-1 PrEP, HIV prevention, fourth-generation HIV test, creatinine, kidney function, hepatitis B surface antigen, PEP, doxycycline post-exposure prophylaxis, CDC, WHO, NHS, Bangtao, Cherngtalay, Kata, Karon, Patong, Phuket, Takecare Clinic Phuket, Dr. Ponlawat Pitsuwan
This page is general health information and not a substitute for a medical consultation.