Post Exposure Prophylaxis (PEP)

If you or your partner have been exposed to HIV, post-exposure
prophylaxis (PEP) is medication which may prevent a person from becoming
HIV positive. HIV takes a few days to become established in the body.
PEP helps the body’s immune system to stop the virus from replicating in
infected cells. These originally infected cells then die without
producing new copies of the virus.

PEP must be taken as soon as possible and definitely no later than 72
hours after exposure to HIV. The sooner treatment is started, the more
likely it is to work. PEP is a month long course of HIV medication. They
need to be taken strictly according to their dosing schedules.
Sometimes drugs used for PEP have unpleasant side-effects including
nausea, diarrhoea, but these are temporary.

What is PEP

Post-exposure prophylaxis (PEP) is a treatment that may prevent
human immunodeficiency virus (HIV) infection and is available to anyone
likely to have been exposed to HIV within the previous 72 hours. It is a
combination of anti-HIV drugs that must be taken exactly as prescribed
at very specific times over a four-week period.

When to use PEP

It is extremely important that a person who may have been exposed to
HIV through contact with blood or body fluids from an HIV positive
person seeks medical advice as soon as possible.
PEP may prevent
infection in anybody who has engaged in unprotected anal or vaginal
intercourse (including condom breakage) with a partner who is HIV
positive, or shared injecting equipment such as needles or syringes with
a person who is HIV positive. PEP is most effective when taken
immediately after exposure to HIV, preferably within two hours - but it
may still be effective if taken within 72 hours (3 days) from the time
of exposure.

Where to get PEP

PEP must be prescribed by a doctor and is available from the clinics
listed below. The standard prescription drug co-payment will be charged
by the pharmacy dispensing the drugs.

Anyone wishing to access PEP should telephone one of the services below
for opening hours, make an appointment if necessary and then advise them
that PEP may be required. Don't feel anxious about discussing PEP with
the trained clinical staff members of these services.

Even if the risk seems minimal or there is doubt about the need for PEP,
discuss the matter with a doctor, either in a hospital emergency
department, sexual health clinic or a GP. In addition, staff members
from HIV services listed below are able to listen, and provide
information about PEP.

A follow-up appointment with the doctor who prescribed PEP is
essential after finishing the course of drugs so people can be tested
for HIV.

It is recommended to take written information (i.e. a brochure
or similar) about PEP when presenting to the Emergency Department, and
inform the staff that that this is a ‘medical emergency’.

When asking for PEP, the doctor or nurse will ask what happened to
make you think it’s needed. They’re not being judgemental they simply
need to know what happened so they can determine how likely it is that
HIV exposure has happened.

How does PEP work

PEP will reduce the risk of HIV infection following an exposure to
infected blood or bodily fluids. In the case of occupational exposure
in a workplace (eg. needlestick injury in a clinic), PEP has been used
for a number of years and has been effective in most cases. Studies have
also shown the use of PEP to be effective in cases of non-occupational
exposures (eg. sex or sharing injecting equipment) in people who
completed the full course of PEP.

PEP consists of powerful drugs that can cause side effects such as
abdominal pain, diarrhoea or headaches throughout the four week course
of medication. Sticking to the strict medication routine is essential to
give the treatments a chance to work effectively.

What PEP is not

PEP is not a guarantee that HIV infection will be prevented, but will decrease the chances of becoming infected.

PEP will not make people immune to future HIV exposures. People still
need to practise safe sex and in the case of people who inject drugs,
safer injecting practices as these remain the best ways to prevent HIV
infection. This involves using condoms with water-based lubricant and
the use of clean, sterile injecting equipment at all times.

If you are exposed to HIV again in the future you should seek urgent
medical advice. Everyone has an equal responsibility in protecting
themselves and their partners from contracting HIV.