Wednesday, September 23, 2015

Post-Exposure Prophylaxis (PEP)


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Post-Exposure Prophylaxis (PEP)

PEP 1, 2, 3 PEP involves taking anti-HIV drugs as soon as possible after having been exposed. To be effective, PEP must begin within 72 hours of exposure, before the virus has time to rapidly replicate in your body. PEP consists of 2-3 antiretroviral medication taken for 28 days. You can get PEP from your doctor's office, emergency rooms, urgent care clinics, or a local HIV clinic. The medications have serious side effects that can make it difficult to finish the program. PEP is not 100 percent effective, it does guarantee someone exposed to HIV will not become infected with HIV.

Can I prevent HIV After I've Been Exposed?

Yes. Post-exposure prophylaxis (PEP) involves taking anti-HIV medications as soon as possible (within 3 days) after you may have been exposed to HIV to try to reduce the chance of becoming HIV positive. PEP is a month-long course of emergency medication taken to try to keep HIV from making copies of itself and spreading through your body. PEP is used by health care workers who have been exposed to HIV-infected fluids on the job or anyone who may have been exposed through unprotected sex, needle-sharing injection drug use, or sexual assault. If you think you were exposed to HIV, go immediately to a clinic or emergency room and ask for PEP.
PEP must begin within 72 hours of exposure, before the virus has time to make too many copies of itself in your body. PEP consists of 2-3 antiretroviral medications and must be taken for 28 days. Your doctor will determine what treatment is right for you based on how you were exposed to HIV. You will be asked to return for follow-up appointments and additional HIV testing. (Talk to your healthcare provider about the recommended follow-up schedule for you.)
PEP is safe but may cause side effects like nausea in some people. These side effects can be treated and are not life threatening. PEP is not 100% effective; it does not guarantee that someone exposed to HIV will not become infected with HIV.

WHO NEEDS PEP?

PEP is used for anyone who may have been exposed to HIV during a single high-risk event.
Healthcare workers are evaluated for PEP if they are exposed after:
  • Getting cut or stuck with a needle that was used to draw blood from a person who may have HIV infection
  • Getting blood or other body fluids that may have lots of HIV in their eyes or mouth
  • Getting blood or other body fluids that may have lots of HIV on their skin when it is chapped, scraped, or affected by certain rashes
The risk of getting HIV infection in these ways is extremely low—fewer than 1 in 100 for all exposures.
PEP can also be used to treat people who may have been exposed to HIV during a single high-risk event unrelated to work (e.g., during episodes of unprotected sex, needle-sharing injection drug use, or sexual assault).
Keep in mind that PEP should only be used in uncommon situations right after a potential HIV exposure. PEP is not intended for long-term use. It is not a substitute for regular use of other proven HIV prevention methods, such as pre-exposure prophylaxis (PrEP), correct and consistent condom use or use of sterile injection equipment.
Because PEP is not 100% effective, you should continue to use condoms with sex partners while taking PEP and should not share injection equipment with others. This will help avoid spreading the virus to others if you become infected. If you have repeated exposures to HIV, you should consider PrEP.

Where Can I Get PEP?

You can request PEP at many places, including your doctor’s office, emergency rooms, urgent care clinics, or a local HIV clinic. If your provider has questions about PEP, they can contact the CDC-supported Clinical Consultation Center at (888) 448-4911 (the service is available seven days per week from 9 a.m. – 2 a.m. EST). The CCC’s PEP Quick Guide and other resources are available online.

Who Pays for PEP?

Antiretroviral medications are expensive, and many people cannot pay for them out of pocket. If you are a healthcare worker who was exposed to HIV on the job, your workplace health insurance or workers’ compensation will usually pay for oPEP. If you are prescribed nPEP after sexual assault, you may qualify for partial or total reimbursement for medications and clinical care costs through the Office for Victims of Crime funded by the U.S. Department of Justice (see the contact information for each state). If you are prescribed nPEP for another reason, and you cannot get insurance coverage (private, employer-based, Medicaid, or Medicare), your healthcare provider can help you apply for free antiretroviral medications through the patient assistance programs of the drug manufacturers. Online applications can be faxed to the company, or some companies have special phone lines. These can be handled urgently in many cases to avoid delay in getting medicine. Learn more about patient assistance programs and co-pay programs for PEP.

Additional Resources

Last revised: 09/21/2015

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