pep_smWhat is PEP – PEP is when a short course of HIV antiretrovirals are given to someone following a possible exposure to HIV in order to decrease the risk of HIV infection. PEP consists of 3 or more ARV’s and is taken for 28 days. It is best to begin treatment as soon as possible after exposure, before the virus has time to replicate in the body. PEP must be started within 72 hours of exposure. Although PEP is not 100% affective, it dramatically reduces the chance of infection.

When to use PEP – PEP is intended for singular cases of possible HIV exposure. PEP can be used after:

  • An episode of unprotected sex with a person known or thought to be HIV positive.
  • If a condom breaks or comes off while having sex with someone who may be HIV positive.
  • An incident of sexual assault.
  • The use of shared injection drug equipment with a person who may be HIV positive.
  • An occupational exposure (called oPEP) occurring in a healthcare worker.

NOTE: PEP recommendations differ from country to country and sometimes by state/providence. Some recommendations have concluded that PEP is not necessary if possible exposure occurred with a person known to be HIV positive with an undetectable viral load.

PEP is not a substitute for other methods of HIV prevention such as condoms/safe sex practices and sterile injection drug equipment.

Where to get PEP – PEP can be obtained by visiting a doctor, an HIV clinic, an urgent care clinic or the emergency room.

What drugs are used for PEP – PEP consists of a combination of HIV antiretrovirals; the same medications people living with HIV take to control HIV. A doctor will prescribe a drug regimen consisting of 3 or more medications that are best suited for each patient. As discussed below, side effects can be a big deterrent to the successful completion of PEP. As such, a discussion of the side effects and toxicities related to choices of PEP regimens should be thoroughly discussed with the doctor to conclude which regimen would work best for each individual. Doctors should be informed of all other medications being taken, including herbs and supplements, as interactions may exist.

Side Effects – There may be serious side effects associated with PEP, depending on how a person’s body reacts to each medication. It is vital that all prescribed doses are taken despite side effects. This may not be easy. A study of health-care workers on PEP reported that 40% did not complete the regimen due to side effects. Keep in mind that missed doses or taking an incomplete regimen can lead to HIV infection which will require years or life time use of the same drugs used for PEP.

Side effects include but are not limited to:

  • Diarrhea
  • Dizziness
  • Rash
  • Headache
  • Fatigue
  • Nausea
  • Muscle ache
Written by Jeannie Wraight

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