PrEP is a prophylaxis to protect against HIV infection with drugs that were originally developed for HIV therapy. The application is now approved in Switzerland and the costs are reimbursed by the compulsory health insurance if the indication is correct. To avoid side effects and the development of resistant HI viruses, it is important that the medication is taken under medical supervision.
Thanks to today’s treatment options, HIV infection in Switzerland has changed from a fatal to a chronic, easily controllable disease since its discovery in the 1980s. However, this requires the daily, possibly lifelong, intake of medication. Instead of increasingly rare opportunistic infections, which used to characterize the picture of the disease, the focus is now on an increased risk of heart attack or dementia and the control of drug side effects. Thanks to the preventive measures introduced early on in Switzerland, the epidemic was quickly controlled in this country. Unfortunately, around 300 new HIV infections continue to be diagnosed in Switzerland every year. Half of them are men who have sex with men. Other infectious diseases such as gonococci (gonorrhea) or syphilis have even been on the rise again in recent years. Alternative prevention measures such as pre-exposure prophylaxis with medication (PrEP) or treatment as prevention (TasP) are therefore being discussed for homosexual and bisexual men.
PrEP is a drug-based prophylaxis with medication that was originally developed for HIV therapy. The efficacy of the combination of the two active substances tenofovir and emtricitabine (TDF/FTC) as PrEP has been demonstrated in several large studies. In Switzerland, TDF/FTC is approved for use as PrEP and has been reimbursed by health insurance since July 1, 2024 if indicated. To avoid drug-related side effects and the development of resistant HI viruses, it is strongly recommended that the medication is taken under medical supervision.
The effectiveness depends heavily on taking the medication correctly. If these are taken daily, the protection is probably comparable to condoms. The effectiveness is reduced if the medication is only taken irregularly. Individual cases of HIV infection have also been reported worldwide despite correct use of PrEP.
The two drugs tenofovir and emtricitabine have been used in HIV therapy for years. This combination can very rarely lead to kidney, liver and bone damage. They must therefore not be taken in the case of a serious pre-existing disease of these organs. It also requires regular blood tests in order to detect any damage to the organs in good time. If PrEP is taken even though a person is infected with HIV, the virus may develop resistance, as TDF/FTC is not a complete HIV therapy. PrEP must also not be taken in the case of an acute hepatitis B infection, as this can lead to an exacerbation of the liver inflammation after discontinuation of PrEP. PrEP also only protects against HIV and not against other sexually transmitted diseases and is therefore recommended in combination with condoms. If condoms are not used consistently, other sexually transmitted diseases should be ruled out on a regular basis.
Since July 1, 2024, HIV-PreP has been reimbursed by the compulsory health insurance if indicated. As with any treatment, the deductible and excess remain in place and must be paid by the user. The cost of HIV-PreP includes the drug tenofovir/emtricitabine and the medical consultation and laboratory tests. Tenofovir/emtricitabine is available as a generic in Switzerland and costs around CHF 65 per pack of 30 tablets.
PrEP is aimed at people who have an increased risk of HIV infection and do not consistently protect themselves with condoms. In Switzerland, these are primarily homosexual and bisexual men who have changing sexual partners and problems using condoms
The Infectious Diseases Department at the University Hospital Zurich has many years of experience in the treatment of HIV infection. We now offer advice and support for people who decide to take PrEP in our prevention consultation hours.
Opening hours
8.00 a.m. to 5.00 p.m.
Consultation hours take place from Monday to Friday between 08.00 and 17.00. Pre-registration is essential.
University Hospital Zurich
Department of Infectious Diseases and Hospital Epidemiology
Rämistrasse 100
8091 Zurich
Opening hours
8.00 a.m. to 5.00 p.m.
Consultation hours take place from Monday to Friday between 08.00 and 17.00.
