PEP (article-exposure prophylaxis for HIV)

PEP (sometimes called PEPSE) is a combination of HIV drugs that can stop the virus taking hold. It can be used after the event if you’ve put yourself a risk of HIV transmission. To work, PEP must be taken within  hours (three days), and ideally should be taken within hours. PEP is not a ‘morning after pill’ for HIV, and it’s not guaranteed to work. It’s meant as an emergency measure to be used as a last resort, such as if a condom fails during sex. Taking PEP will not protect you from other sexually transmitted infections or unwanted pregnancy. Where to get PEP Text
PEP is available on the NHS for free, but is only given to people who meet guidelines about its use. The best place to get PEP is a sexual health or HIV clinic. If you need PEP over the weekend or outside of office hours, when clinics will often be closed, the best place to go is an Accident and Emergency department.

PEP is not normally available from GPs. Find out your nearest clinic. As PEP is a powerful course of drugs, and is expensive to prescribe, you might be asked about: the person you had sex with (and the chances that they had HIV) what sort of sex you had (vaginal, oral or anal) if the other person had HIV, what their viral load is. If the person you had sex with is living with HIV post exposure prophylaxis and has an undetectable viral load, you will not need PEP as it won’t be possible for the virus to have been transmitted. Once a doctor decides that it’s appropriate for you to have PEP, you will be asked to take an HIV test. This is to make sure you don’t already have HIV. If HIV is detected by a test, other forms of treatment will be recommended to you.

How to take PEP Text PEP must be taken exactly as instructed and for days. Do not skip a dose or fail to complete the full month as this makes it less likely to work. Do not double a dose if you miss one. If you do miss a dose and you remember in less than hours, take the next one as soon as you remember. If you miss more than 48 hours of PEP it will be discontinued. The medication now used for PEP is a single tablet called Truvada and two tablets of raltegravir. Side effects from PEP are likely to be mild ones in the first few days, such as nausea, headaches or tiredness.

Do not take recreational drugs while on PEP as there can be dangerous interactions. PEP refers to the use of antiretroviral drugs for people who are HIV-negative after a single high-risk exposure to stop HIV infection. PEP must be started as soon as possible to be effective – always within hours of a possible exposure – and continued for 4 weeksFor patients with HIV, sharing information about PrEP and PEP for their sex and drug injection partners without HIV can help prevent transmission. Health care providers can also offer to facilitate the conversations or identify providers who may be able to offer PrEP and PEP to partners. “What do you do when a condom breaks?” “What do you find works or doesn’t work when you talk with partners about HIV prevention medicines, like PrEP, they could take?” “When you party, are you injecting drugs? If so, are you sharing needles or drug preparation equipment with anyone?” PrEP vs. PEP – Injection Drug Use Transmission
There are insufficient data about PEP’s effectiveness to prevent HIV infections from nonsterile injection drug use. For persons who inject drugs and experience many exposures, PrEP is likely to be a better prevention strategy than PEP. Reorganization of the previous 4 guidelines into 1 document: This PEP guideline addresses management of 4 types of exposure to HIV: occupational, non-occupational (consensual sexual exposure, exposure through needle-sharing), sexual assault, and exposures in children. Icons throughout signal content specific to one exposure type (see the icon key above).

The edition reflects a unified approach to the recommendations for all exposure types, with differences between exposure scenarios highlighted throughout. This guideline was developed by the New York State Department of Health (NYSDOH) AIDS Institute (AI) for healthcare practitioners in any medical setting (e.g., emergency department, sexual health clinic, urgent care clinic, inpatient unit primary care practice) who manage the care of individuals who request post-exposure prophylaxis (PEP) after a possible exposure to HIV. Despite the availability of prevention measures, exposures occur that pose the risk of transmission. Fortunately, with rapid initiation of PEP, infection can be blocked. Preventing new HIV infections is crucial to the success of New York State’s Ending the Epidemic Initiative.

HIV transmission can be prevented through use of barrier protection during sex (e.g., latex condoms), safer drug injection techniques, and adherence to universal precautions in the healthcare setting. HIV infection can also be prevented with use of antiretroviral (ARV) medications taken as pre-exposure prophylaxis (PrEP). After an exposure has occurred, HIV infection can be prevented with rapid administration of ARV medications as PEP. The first dose of PEP should be administered within hours of an exposure (ideal) and no later than 72 hours after an exposure.

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