Post-exposure prophylaxis (PEP) is an emergency medication taken after potential contact with HIV to reduce the risk of infection. It must be started within 72 hours of exposure to be effective.
What is post-exposure prophylaxis (PEP)?
This medical intervention uses antiretroviral drugs to stop HIV from replicating and establishing itself in the body. It is intended for emergency situations, such as:
- Sexual contact where HIV exposure is suspected.
- Victims of sexual assault.
- People who shared needles or drug equipment.
- Healthcare professionals exposed to the virus during their work.
It is not recommended for those who already have HIV or for people exposed to fluids that rarely transmit the virus, such as sweat, tears, saliva, or urine.
How to get and use the medication
If you believe you were exposed, seek immediate help from an urgent care center, emergency room, sexual health clinic, or primary doctor. For those seeking care after sexual assault, a sexual assault nurse examiner can provide follow-up care and collect evidence.
The treatment involves a combination of three drugs taken once or twice daily for 28 days. For adults, the regimen typically includes tenofovir and emtricitabine (combined in one pill) plus either dolutegravir or raltegravir. Raltegravir is preferred for those in early pregnancy or those who could become pregnant during treatment due to risks of birth defects. Children aged 2 and older may receive the same drugs in different doses.
Effectiveness and side effects
When taken consistently for the full 28 days, this treatment may lower the risk of HIV infection by over 80%. Effectiveness increases when the medication is started as soon as possible after exposure.
Common side effects include:
- Headache
- Fatigue
- Insomnia
- Diarrhea and vomiting
In rare cases, the drugs can lead to serious liver issues.
Post exposure prophylaxis cost and payment
Without insurance, a full course of treatment can cost between $600 and $1,000, excluding other emergency room fees. To manage the post exposure prophylaxis cost with insurance or other means, patients can use:
- Workers’ compensation or health insurance for job-related exposure.
- The federal Office for Victims of Crime for assault-related care.
- Copayment assistance programs (CAPs) to cover deductibles.
- Patient assistance programs (PAPs) from drug companies for low-cost or free medication.
FAQ
How does post exposure prophylaxis (PEP) work?
It uses antiretrovirals to block the virus from copying itself and settling into the body’s systems.
Can I take PEP every time I have unprotected sex?
No. This is an emergency medicine, not a substitute for condoms or sterile needles. People with frequent exposure risks should discuss pre-exposure prophylaxis (PrEP), a daily preventative medication, with a provider.
Can I have sex while taking the medication?
It is best to wait until the 28-day course is finished and a negative HIV test is confirmed. If you cannot wait, you must use condoms correctly.
Is it safe during pregnancy?
Yes, the medication can be used during pregnancy and breastfeeding, though the specific drug plan should be discussed with a doctor.
When to see a doctor
Seek medical attention immediately if you have experienced a potential HIV exposure. Warning signs that require urgent care include:
- Unprotected sexual contact with a partner of unknown or positive HIV status.
- Accidental needle sticks or sharing of injection equipment.
- Sexual assault.
Disclaimer: This information is for educational purposes and does not constitute medical advice. Consult a healthcare provider for diagnosis and treatment.
Related articles
- What to Do After a Positive HIV Test
- Recognizing Early AIDS Symptoms and Warning Signs
- Preventing Human Immunodeficiency Virus with Medication
- Vitamin D Needs for Children Living with HIV
- More about HIV & AIDS
Photo: Birch Landing Home, CC0 1.0, via stocksnap.io
approved by: Medica Health team