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·> What is PEP?
PEP: POST-EXPOSURE PROPHYLAXIS
WHAT IS IT?
Prophylaxis means guarding from or preventing disease, in this case HIV/AIDS. Post-exposure prophylaxis or PEP is a regimen of taking antiviral medications as soon as possible after exposure to HIV to lower the chances of HIV infection. These medications are only available by prescription. PEP also includes complete screening for other sexually transmitted diseases (STDs) like syphilis, gonorrhea and chlamydia. Treating these infections can help prevent the transmission of HIV.
Prophylaxis means guarding from or preventing disease, in this case HIV/AIDS. Post-exposure prophylaxis or PEP is a regimen of taking antiviral medications as soon as possible after exposure to HIV to lower the chances of HIV infection. These medications are only available by prescription. PEP also includes complete screening for other sexually transmitted diseases (STDs) like syphilis, gonorrhea and chlamydia. Treating these infections can help prevent the transmission of HIV.
WHO SHOULD USE PEP?
- Workplace exposure
Since 1996, PEP has been the standard procedure for healthcare workers exposed to HIV, usually after they have been accidentally jabbed with a needle containing infected blood. PEP in these situations has been proven to reduce the rate of HIV infection by approximately 79%. - Sexual and other types of exposure
There have been no formal recommendations from the Centers for Disease Control (CDC) to prescribe PEP if you engage in risky sexual behaviors, if a condom breaks during anal sex, or if you share needles for injecting drugs. However there has been research done on PEP used in these types of situations. In one study of PEP used in 400 cases of possible sexual exposure, no one became infected with HIV. It must be noted, though, that the majority of people with a suspected exposure to HIV would not develop an HIV infection whether or not they take PEP.
In some cities, after having a known exposure to HIV—for instance, if the condom breaks when you're being topped by an HIV+ guy—you will most likely be offered PEP if you see a doctor soon afterwards. These medications have to be started quickly, ideally within four hours after exposure, and up to 72 hours afterwards.
PEP is not usually provided to people who may have been exposed to HIV via oral sex or to persons exposed during heterosexual sex unless the partner is known to be HIV-infected or at very high risk. Oral sex is considered a very low risk sexual activity in terms of HIV transmission. One recent study has shown the risk to be near zero, but there are case reports of men who have gotten HIV from participating in oral sex but not other risky behaviors.
HOW WILL I DECIDE?
Most clinics have counseling sessions built-in to the process to help you determine your actual risk of contracting HIV. Before a doctor will prescribe PEP, he or she will talk to you about your possible exposure and let you know about the side effects of the drugs, the difficulty of sticking to the somewhat complicated regimen of pill-taking for 28 days, and the expense. One other negative to taking PEP is that it's possible people who take the regimen may later develop drug-resistant strains of HIV. Because of these downsides to the drugs, PEP is not considered the "morning-after" pill for HIV.
Most clinics have counseling sessions built-in to the process to help you determine your actual risk of contracting HIV. Before a doctor will prescribe PEP, he or she will talk to you about your possible exposure and let you know about the side effects of the drugs, the difficulty of sticking to the somewhat complicated regimen of pill-taking for 28 days, and the expense. One other negative to taking PEP is that it's possible people who take the regimen may later develop drug-resistant strains of HIV. Because of these downsides to the drugs, PEP is not considered the "morning-after" pill for HIV.
HOW MUCH DOES IT COST?
A typical dosage for four weeks can cost $600-1,000 including the medicine, blood tests and clinic visits. You need to check with your insurance company regarding coverage for these costs. Some clinics also offer a sliding scale fee for PEP services.
A typical dosage for four weeks can cost $600-1,000 including the medicine, blood tests and clinic visits. You need to check with your insurance company regarding coverage for these costs. Some clinics also offer a sliding scale fee for PEP services.
HOW IS PEP TAKEN?
The medications used in PEP depend on the type of exposure to HIV. Most forms of PEP involve several antiviral drugs. The drugs need to be continued for a four-week period several times a day.
The medications used in PEP depend on the type of exposure to HIV. Most forms of PEP involve several antiviral drugs. The drugs need to be continued for a four-week period several times a day.
WHAT ARE THE SIDE EFFECTS?
Being exposed to HIV is stressful and produces anxiety. About 1/3 of people who take PEP will have no other side effects. Those who do may experience nausea, stomach pain, headaches, fatigue, sleep disturbances and diarrhea. Serious side effects are rare, and may include liver problems, pancreatitis, kidney stones and severe allergy.
Being exposed to HIV is stressful and produces anxiety. About 1/3 of people who take PEP will have no other side effects. Those who do may experience nausea, stomach pain, headaches, fatigue, sleep disturbances and diarrhea. Serious side effects are rare, and may include liver problems, pancreatitis, kidney stones and severe allergy.
THE BOTTOM LINE
The most effective way to prevent HIV infection is to change your sexual risk-taking behaviors, practice safer sex more often, use clean works and stop sharing needles. If you do find yourself in a situation, though, where you may have been exposed to HIV, it is best to get yourself to a knowledgeable doctor or healthcare provider who can help you decide whether PEP is right for you at this time.
The most effective way to prevent HIV infection is to change your sexual risk-taking behaviors, practice safer sex more often, use clean works and stop sharing needles. If you do find yourself in a situation, though, where you may have been exposed to HIV, it is best to get yourself to a knowledgeable doctor or healthcare provider who can help you decide whether PEP is right for you at this time.
