Post Exposure Prophylaxis for HIV

Many of us wonder, after a risky sexual exposure with a new partner when the condom breaks or after a night out you wake up in the morning with a new partner and cannot remember if you used condoms during intercourse on what to do next.

As physicians, our main concern is HIV, as we know most of HIV infected people do not know they have HIV until it’s too late. Fortunately there is a chance to protect ourselves with post exposure therapy.

Post exposure therapy or commonly known as PEP, is a month course of HIV medications taken as soon as possible after a risky encounter or possible exposure to HIV to prevent the virus from spreading within our immune system. PEP works best if it is started within 3 days or 72 hours after an exposure to HIV. If the window period exceeds 72 hours then the effectiveness reduces tremendously, and may not be effective. So every hour counts!

An important point to note is PEP should only be used in emergency situations; it should not be a practice to take PEP regularly.

Is PEP Required For You?

PEP may be suitable for you once you are HIV negative or unsure of your HIV status, and there is a high risk exposure with a partner with unknown HIV status. These few scenarios below can help in opting for PEP.

Scenario 1

During intercourse there was a sudden pop sound resulting in condom break with a new partner of unknown HIV status, or a HIV positive partner with unknown viral load status. PEP is advised as soon as possible.

Scenario 2

In the event where sharing needles, syringes or other medical equipment’s that are used to inject drugs.

Scenario 3

Male with male partners, especially receptive anal intercourse are at a higher risk of HIV. Anyone who has undergone a traumatic experience such as sexual assault should take PEP as soon as possible after exposure.

Scenario 4

If you are a healthcare worker who is exposed to high risk patients such as HIV positive patient, in the event of needle stick injury, you should seek for PEP as soon as possible to prevent infection of HIV.

How Long Do I Need To Take PEP For?

When PEP is initiated, you will need to complete the course of treatment for 28 days. All PEP medications may have side effects such as nausea and vomiting, however this occurs only for a minority of our patients and the symptoms subside with time. If you are unable to consume the medications, your physician may add some nausea and vomiting medications to help relieve the side effects. Usually after completion a HIV test will be done and repeated for the last time after 2 months of completion of PEP.

Does PEP Really Work?

One of the most common questions asked by most of my patients. PEP is very effective in preventing HIV when it’s taken correctly and consistently, however there is no treatment that is 100% effective. An initial baseline test that confirms that you are HIV Negative increases the effectiveness of PEP. After a risky exposure, the sooner you start the PEP the better your chances are at not contracting HIV.

While on PEP, its best to use other HIV preventive methods such as condoms the correct way every time you have sex.

What Are The Common Side Effects of PEP?

PEP is very save, however as true for any medications there may be some side effects. The most common side effects of PEP are nausea, and rarely vomiting in some people. All of these side effects are self-limiting and will subside with time. If the side effects bothers you or does not subside, inform your physician as supportive medications can be given to relieve your symptoms.

PEP medicines may also interact with other medicines that a person is taking (called a drug interaction). For this reason, it’s important to tell your health care provider about any other medicines that you take.

How Often Can You Take PEP?

PEP should not be taken routinely and should only be used in emergency situations. It’s not intended to replace regular use of other HIV prevention method such as condoms. If you feel that your risk of exposure is higher, then Pre exposure therapy may be suitable for you for long term prevention.

Visit our doctors at DTAP Clinics for further information and initiation of treatment.

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