If I'm only a top, should I still take PrEP?

That's an excellent question. The short answer is: the risk is lower, but it is far from zero. The decision to take PrEP, therefore, depends on your overall situation and your personal comfort with that risk.

Let's break that down together.


Understanding the risk for the "top" partner

It is scientifically proven that the risk of acquiring HIV is significantly lower for the insertive partner ("top") than for the receptive partner ("bottom") during condomless anal sex.

However, a low risk is not a zero risk. Transmission is possible, although rare, through the opening of the urethra on the penis, especially if small cuts or another sexually transmitted infection (STI) are present, which could create an entry point for the virus.

The decision is yours and depends on several factors

The choice to take PrEP is not based solely on a sexual role, but on an overall assessment of your situation. Here are some questions to ask yourself:

  • Do you have multiple partners or partners whose HIV status you don't know?
  • Do your partners have other partners?
  • Are you always exclusively a "top," or could that change?

Some people choose to take PrEP even if they are exclusively tops for complete peace of mind.

The benefits of the "PrEP program" beyond the pill

It's also helpful to see PrEP not just as a medication, but as access to a comprehensive sexual health program. The regular follow-up that comes with PrEP (HIV and STI screenings every 3 months) is one of the best ways to proactively take charge of your sexual health, regardless of your specific HIV risk level.

The best approach: an informed discussion

The final decision is yours. The most important thing is to have a frank and non-judgmental discussion with one of our pharmacists. Together, we can analyze your personal situation to help you make the most informed decision for your health and your peace of mind.