A GHN and HSE initiative
If your partner is exposed to HIV through unprotected sex or if a condom tears or slips off, there is a treatment option available that may prevent infection.
PEP = a course of medication consisting of at least two anti-HIV drugs which is prescribed to someone who has been accidentally exposed to HIV.
Post
= after
Exposure
= a situation where HIV has a chance to get into someone’s bloodstream
Prophylaxis
= a treatment to stop an infection happening
PEP involves taking a combination of at least two anti-HIV drugs for four weeks and aims to prevent HIV replicating itself in the body. PEP must be taken within 72 hours (3 days) of exposure to HIV, but the earlier the treatment starts the better.
PEP is not a cure for HIV and is not a morning-after pill. At the moment there is no cure for HIV. Some treatments are highly effective at slowing down the development of HIV-related infections but that is not the same thing as a cure. PEP can have considerable side effects. PEP is actually the same as the treatments offered to people who are HIV positive, except it is for a shorter period (one month). People taking PEP may experience the same side effects that people taking long-term treatments can have.
In Ireland PEP is only available by prescription from some sexual health and STI clinics or Hospital Accident and Emergency Departments. It is not available at your GP or in pharmacies. You need to get to your nearest clinic or to an A&E as soon as possible if there is no clinic open.
If you are prescribed PEP at a GUM/STI clinic or an A&E department, it is free of charge
PEP is not a cure for HIV and is not a morning-after pill. At the moment there is no cure for HIV. Some treatments are highly effective at slowing down the development of HIV-related infections but that is not the same thing as a cure. PEP can have considerable side effects. PEP is actually the same as the treatments offered to people who are HIV positive, except it is for a shorter period (one month). People taking PEP may experience the same side effects that people taking long-term treatments can have.
What to do if exposed to HIV?
If you and/or your partner find that you may have been at risk of or exposed to HIV, seek medical advice as soon as possible. Attend any available provider for PEP that you can access immediately. Don’t wait for the clinic you prefer to be open. Understandably you might be upset and confused about what to do or even about the situation where the exposure took place but in this case the sooner you act the more likely it is that the PEP will be effective.
For PEP to be effective it has to be taken within 72 hours (3 days) after the exposure to HIV. The sooner it is prescribed, the greater chance it has of working. Ideally it should be taken within a few hours of exposure. If you can’t get to a provider within 72 hours you will not be offered PEP. You will be advised to test for HIV and then test monthly for three months.
How many times can you get PEP?
The doctors decide who gets PEP and they’re unlikely to give these expensive and powerful drugs to the same person time after time. So someone who keeps having unprotected sex will usually be offered counselling about having safer sex and won’t be given PEP. The side effects often put people off wanting to take PEP more than once.
Not everyone will be prescribed PEP. There are guidelines for prescribing and each person is assessed based on the information provided in relation to the potential risk of exposure to HIV.
If the exposure or risk was within 72 hours then it is worth requesting that you be assessed for PEP.
The doctor will want to know the following information:
Some doctors may want to know if you are in a stable relationship or not and may want to assess your ability to negotiate safer sex. You will be tested for HIV at the start of the programme and there will be three follow-up HIV tests to assess if the programme has been successful. You will also be tested for Hepatitis A, B, C and Syphilis.
If your sexual exposure contact is known to be HIV+, it is essential that he comes along with you to provide as much information as possible to the doctor as regards his HIV and any medications he might be taking, etc. If your contact does not want to attend, please try to have a contact telephone number so the doctor can call him. This is important to giving YOU the correct PEP. Contact tracing is very controlled and confidential and is done with the permission of the contact. The doctor will only want to know about his HIV status and medication.
PEP is effective but is not a cure for HIV. It is not guaranteed to work, but the sooner you start taking PEP after a potential exposure to HIV, the better chance it has of working.
There is a real concern that using other drugs, especially if they are not prescribed, could interfere with PEP, making it less effective. Using non-prescribed drugs could also make you less likely to remember to take your medication at the proper times (PEP medication needs to be taken at approximately the same times each day) and could put pressure on your liver, kidneys and other organs.
You are not immune to HIV infection while taking PEP. It is vitally important that you do not put yourself at risk while on the programme. Unprotected sex while taking PEP puts you at risk of contracting HIV. Also finishing a course of PEP does not prevent you getting HIV in future. This means if you take certain risks, you can become infected just like any other HIV negative person.
You can still have and enjoy sex while taking PEP. Condoms are a more effective and pleasant way of preventing HIV than PEP
Safer sex practices and safer injecting methods remain the best way to prevent transmission of HIV.
