HIV Post-Exposure Prophylaxis (PEP)

HIV PEP is a course of pills that should be started as soon as possible after exposure to HIV to reduce the chance of infection. PEP should be started within 72 hours (or 3 days) after exposure to HIV, otherwise, the pills are useless. The sooner you start taking medications, the more effective they are – every hour counts.

PEP should be taken 1-2 times daily for at least 28 days. The drugs used as PEP are called antiretroviral drugs (ARVs). These medications prevent HIV from multiplying in the body.

Who can use HIV PEP?

PEP is for people who may have been exposed to HIV in the previous 3 days. You may want to start taking PEP if:

  • you have had sex with someone who is infected with HIV and did not use a condom or the condom broke;
  • you have been sexually assaulted;
  • you have shared needles or other injecting equipment (cotton, spoon, water) with someone who may be infected with HIV.

If you have been exposed to HIV in the previous 3 days and want to get PEP, see your local infectious disease doctor or AIDS center. Time is of the essence. The sooner you start taking PEP, the more effective it will be.

Post-exposure prophylaxis is an emergency way to prevent infection. It should not replace proven, consistent HIV prevention methods such as using condoms, taking PrEP (a daily pill that reduces the risk of acquiring HIV), and avoiding sharing needles and other injecting equipment. If you know you may have had frequent exposure to HIV (for example, if your sexual partner or partners have HIV), discuss the appropriateness of PrEP with your doctor.

Below you can see an HIV risk chart:

hiv risk chart

How do I get PEP?

Unfortunately, only medical staff who had a risk of infection in the course of their work have the right to receive PEP free of charge.

However, these drugs can be purchased with a prescription after consulting a doctor.

PEP can only be started within 72 hours (3 days) of exposure to HIV. But don’t wait – you need to start taking PEP as soon as possible. Therefore, if you cannot see a doctor right away, go to the emergency room as soon as possible. Every hour counts.

Before taking PEP, your doctor will talk with you about what happened to decide if you should take PEP. You will have a blood test for HIV (if your body already has the virus, you cannot take PEP). You will also be tested for hepatitis B. And if you have been in contact with HIV during intercourse, you need to be tested for other STDs such as gonorrhea, chlamydia and syphilis.

How do I take medication?

PEP is not just one pill, but a whole course of drugs that must be taken over several weeks. If your doctor prescribes PEP for you, you need to take your medication 1-2 times a day for at least 28 days (4 weeks). Each tablet must be taken strictly according to the instructions and not skipped, otherwise, the effectiveness of the PEP will decrease.

Postexposure prophylaxis does not prevent 100% infection and does not prevent future infection, unlike PrEP. Therefore, while taking PEP, you still need to protect yourself and others from HIV infection. Use a condom every time you have sex. If you inject drugs, do not share needles and injecting equipment. This will help protect you from exposure to HIV. It will also reduce the chances of transmitting HIV to others if you are infected.

If you experience symptoms such as a fever or rash while taking PEP, see your doctor. These symptoms can be signs of an early stage of HIV.

What are the side effects of HIV PEP?

PEP can have side effects such as abdominal pain and fatigue. But the side effects of PEP are not dangerous and can be managed. If you are really concerned about side effects, see your doctor.

If PEP does not work, you may have symptoms of the first stage of HIV infection, such as a fever or a rash. If you develop these symptoms while taking PEP or within a month after stopping PEP, contact your doctor.

What happens when HIV PEP is over?

As soon as you finish the course of medication, you need to go to the doctor and take a control test. Blood tests for HIV will need to be tested again 4–6 weeks and 3 months after initial exposure to HIV. Depending on the situation, your doctor may recommend a second HIV test after 6 months.

It is necessary to pass these retests to make sure that the PEP is effective. In the meantime, you must continue to protect yourself and others from HIV by using condoms during intercourse and by avoiding shared needles and other injecting equipment.

Preferred HIV PEP

The preferred regimen is the administration of tenofovir with emtricitabine or lamivudine, also with raltegravir or dolutegravir. However, in a situation where it is not possible to purchase drugs from the class of integrase inhibitors, any other representative of the class of protease inhibitors or NNRTIs is quite suitable.

It is important to remember that any medication should be taken only after consulting a doctor.