Q: I may have been exposed to HIV, should I take PEP?

What should I know
about PEP?

A:

What PEP is:

Post-Exposure Prophylaxis (PEP) is a 28-day course of HIV medications for persons seeking care within 72 hours after an exposure to HIV. This exposure must represent a substantial risk for HIV transmission from blood, semen, vaginal secretions, or other potentially infectious body fluids of a person know to be HIV positive or at high risk of being HIV positive. PEP should be administered as soon after exposure as possible and typically includes counseling and STD screening.

PEP was initially used among healthcare workers who experienced accidental needlestick injuries. Researchers found that PEP reduced the rate of infection by 79%, but some who took PEP still became infected. PEP is also available to people who have had a "non-occupational" exposure - such as unprotected anal intercourse. PEP often has side effects, which you should discuss with your healthcare provider, and is not to be used as a recurring form of HIV prevention or to give people "peace of mind." PEP is not a cure for HIV, nor is it guaranteed to prevent HIV from taking hold once the virus has entered the body. Condoms and lube for sex remain the most effective and efficient way of staying safe from HIV.

How PEP works:

PEP works by preventing HIV from reproducing before the infection can be established in a person’s body. PEP drugs given within the first few days after an exposure may help the body's immune system stop the virus from replicating (multiplying) in the infected cells of the body. The cells originally infected would then die naturally within a short period of time without producing more copies of the HIV virus.

As with other medications, it is important you take the pills as stated to maintain the right amount of the medication in your bloodstream at all times. This will mean that the medication will be as effective as possible. PEP works best when taken at the right dose, at the right time, without missing doses. PEP is not a ‘morning after’ pill that’s taken just once – it is one month of drugs.

How I get PEP:

PEP is available from a limited number of places in Chicago and requires a discussion with a medical provider to determine if PEP is advisable in your situation. Furthermore, insurance coverage for PEP should be discussed with your healthcare provider.

Organizations that provide PEP in Chicago are:

Ruth M. Rothstein CORE Center

Howard Brown Health Center

Your healthcare provider is also able to prescribe PEP.

Finally, the Center for Disease Control and Prevention (CDC) provides this advice about Antriretroviral therapy for prevention of HIV infection:

"The most effective methods for preventing human immunodeficiency virus (HIV) infection are those that protect against exposure to HIV. Antiretroviral therapy cannot replace behaviors that help avoid HIV exposure (e.g., sexual abstinence, sex only in a mutually monogamous relationship with a noninfected partner, consistent and correct condom use, abstinence from injection-drug use, and consistent use of sterile equipment by those unable to cease injection-drug use). Medical treatment after sexual, injection-drug--use, or other nonoccupational HIV exposure* is less effective than preventing HIV infection by avoiding exposure."

Answer provided by Howard Brown Health Center, with thanks to Terrence Higgins Trust, TheBody.com, and getpep.info.