Health In Sex

PEP (post exposure prophylaxis) is a 4-week course of anti-HIV drugs which may prevent HIV infection if you've been exposed to the virus.

If you believe you've been exposed to HIV, you need to act quickly. To be effective, PEP must commence as soon as possible after an exposure, preferably within a few hours. PEP is unlikely to work if you start taking it more than 72 hours (3 days) after exposure to HIV.

Any action that allows potentially HIV-infected body fluids, such as blood or semen, to enter into your bloodstream means you may have been exposed to HIV. Exposure can occur if:

• you have anal sex without a condom and your partner is HIV+ or his status is unknown; or
• a condom breaks or slips off during anal sex and your partner is HIV+ or his status is unknown; or
• you share injecting equipment with a person who has HIV.

It is believed that there's a very low risk of HIV transmission through oral sex. Therefore, PEP is usually not considered in this situation, unless your partner is HIV+.

Taking PEP will normally involve a 4-week course of generally 2 or sometimes 3 different anti-HIV drugs. For PEP to work, you need to start taking them within 3 days (72 hours) after an exposure (the sooner the better), and continue to take them for the entire 28 days. You will also have blood taken to check for blood borne viruses (eg. HIV, Hepatitis B & C) and measure any effects from taking PEP. You will be asked to return in 4 weeks, 3 months and 6 months to repeat these tests. You will also be offered the option of free and confidential counselling.

From evidence gained in studies of exposed health care workers and in mother-to-baby transmission, it is believed that taking PEP can prevent HIV, but this is not yet proven in the case of sexual or injecting exposures. Taking PEP is not a guarantee that you won't contract HIV. A small number of people who have taken PEP have contracted HIV. It's offered as a last resort. Safe sex and safe injecting are still the best way to avoid HIV.

You can be assessed for PEP at sexual health clinics (see the list at the bottom of this page) and hospital emergency departments (open 24 hours). If possible, seek PEP from sexual health clinics, as there will be less of a wait. You should phone the clinic beforehand, to arrange for immediate consultation.

As with any prescription drugs, there is usually a dispensing fee involved. For a 4-week supply of one drug this will normally be $22.90 (or $4.60 if you have a Health Care Card). Keep in mind that your doctor is likely to prescribe at least two different drugs.

In taking PEP you must strictly follow the guidelines provided by your doctor. Missing doses or not completing the full course will reduce the chances of PEP working.

While some people don't experience any side effects, most people will have mild to moderate side effects. This may include nausea, rash, headaches and fatigue. Serious side effects are rare, and may include liver problems, pancreatitis, kidney stones and severe allergy. Your doctor will provide information on side effects and you should also read the information provided with the drugs.

If you're taking PEP, monitor the side effects and seek medical assistance if you feel unwell.

Until you have your final result at the end of your follow-up, to show that you're HIV negative, you should practice safe sex and safe injecting, and not donate blood or semen.

There is no evidence that you will be protected if you have another exposure to HIV whilst taking PEP. Safe sex and safe injecting are still the best methods to protect you from HIV.

Once you've finished the 4-week course of PEP, it's important to return to your doctor for follow-up testing to check the impact of PEP and your HIV status. After a course of PEP it may take longer for blood tests to show whether you have become infected with HIV. This is why your doctor may want to see you at the end of the first month, third month and sixth month.

Remember, PEP is not fully guaranteed to work, so follow-up testing is essential.

A state information service can be contacted if you wish to find out more.

Or you can speak to someone at the Hunter Sexual Health Service (Newcastle).