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HIV Postexposure Prophylaxis (HIV PEP)

Postexposure prophylaxis is a concern for many people: healthcare providers, partners in a discordant couple, people who have a real or possible risk of HIV transmission. Postexposure prophylaxis has not been sufficiently studied in terms of effectiveness, but it is used for healthcare providers who have a risk of HIV transmission. This article discusses the advantages and disadvantages of such prevention.

Prevention means preventing the risk of HIV transmission. Postexposure prophylaxis is used when there was a risk of HIV transmission, it involves the use of antiretroviral drugs used to treat HIV infection, which should be taken as soon as possible after the risk of HIV transmission so that this risky situation does not lead to the transmission of the virus. These drugs are only available by prescription. Postexposure prophylaxis should be taken within the first 24-36 hours after the risk, but no later than 72 hours. Antiretroviral drugs should be taken within 4 weeks if there is no difficulty.

Since 1996, postexposure prophylaxis has been a standard procedure for healthcare providers who have a professional risk of HIV transmission. Health workers take antiretroviral drugs, usually in the first hours after the risk of HIV transmission. Usually, postexposure prophylaxis is prescribed for an accidental injection with a needle containing blood with HIV. Postexposure prophylaxis in case of occupational risk reduces risk by 79%. However, some healthcare providers, even those taking postexposure prophylaxis, still got HIV.

In 2005, the United States Centers for Disease Control and Prevention (CDC) reviewed postexposure prophylaxis. According to the CDC, postexposure prophylaxis should be available for other risky cases not related to occupational exposure. People may be at risk of HIV transmission through unprotected sex, or when a condom breaks, or when using common injection needles to inject drugs. HIV can be transmitted to infants through breastfeeding from an HIV-positive mother. One postexposure study indicates that out of 400 cases of a possible risk of sexually transmitted HIV, no one has been transmitted.

The occupational risk of HIV transmission is usually an isolated case. However, other cases of risky behavior can occur quite often. According to some people, post-exposure prophylaxis may encourage people to have unsafe sexual behavior, suggesting that post-exposure prophylaxis is an “easy” way to avoid HIV transmission.

There are a number of reasons that explain why postexposure prophylaxis can be ineffective in risky cases not related to professional activities: there is no evidence that postexposure prophylaxis is effective in cases of unprofessional risk. There is also no information on how soon therapy should be taken after the risk of HIV transmission. Postexposure prophylaxis is not the same as the next morning emergency contraceptive pill, as it represents a regimen of taking drugs several times a day for at least 30 days.

For the best results, you should take postexposure prophylaxis without omissions. Skipping a single dose can lead to the development of HIV. It can also lead to the development of virus resistance to the drug. If this happens, the drugs will not affect the body. Drugs can give some side effects. About 40% of medical workers stopped taking postexposure prophylaxis due to side effects. But, despite all these shortcomings, there is a growing interest in the application of postexposure prophylaxis in cases of unprofessional risk.

Postexposure prophylaxis should be started as soon as possible after the risk of HIV transmission. The combination of drugs used as post-exposure prophylaxis depends on the degree of risk. Significant risks of HIV transmission in health care providers include the following: contact with large amounts of blood; blood entering the open wound when cut; visible blood on a needle that has already been used; contact with the blood of an HIV-positive person who has a high viral load (high level of virus concentration in the blood).

When the risk is significant, the United States Health Service recommends a combination of three approved antiretroviral drugs for four weeks. When the risk is less significant, according to the instructions, a four-week course is recommended using two antiretroviral drugs: AZT and 3TC. The most common side effects are nausea and general malaise. Other side effects may include headaches, tiredness, vomiting, and diarrhea. For more information, we recommend reading the reference material on antiretroviral drugs.

Postexposure prophylaxis is the prescription of antiretroviral drugs that should be taken as soon as possible after the risk of HIV transmission.

Postexposure prophylaxis among healthcare providers can reduce risk by 79%. The benefits of postexposure prophylaxis for unprofessional risk have not been confirmed. The use of postexposure prophylaxis is a controversial issue, as it can stimulate unsafe sexual behavior. Postexposure prophylaxis is the administration of two or three drugs several times a day for 4 weeks. The drugs may have side effects, which complicates the full course of postexposure prophylaxis. Postexposure prophylaxis is not 100% effective and cannot guarantee that risky contact will not lead to HIV transmission.