PEP
PEP (Post-exposure prophylaxis) is a 4-week course of anti-HIV medication that is shown to be effective in preventing HIV infection if started within 72 hours of exposure.
The key to PEP is accessing it as soon as possible after you think you may have been exposed to HIV. PEP is most effective within up to 24 hours of exposure and unlikely to work if not taken within 72 hours (three days) of the suspected exposure to HIV.
If you believe you have been exposed to HIV, you can be assessed for PEP from your local sexual health clinic or hospital emergency department.
For more information, go to www. get pep info or call the NSW PEP Hotline 1800 737 669.
PrEP
PrEP (pre-exposure prophylaxis) is medication taken daily by HIV-negative people to protect them from acquiring HIV.
PrEP guidelines involve either daily or on-demand dosing, with a doctor’s prescription and regular check-ups every three months. Daily PrEP is recommended for most people, while on-demand (2-1-1) dosing is an alternative for cis-gender men who have sex with men. On-demand requires taking two pills before sex, followed by one pill each on the next two days, and continuing daily if sex resumes.
When the PrEP drug is sufficiently present in the bloodstream and vaginal and/or rectal tissues when someone is exposed to HIV, the virus is unable to establish itself and pass on to that person.
You will be protected after taking PrEP every day for 7 days. If you are a woman, you will need to take it every day for 20 days before peak drug concentrations happen in the vagina.
Your doctor can give you more information.
PrEP should be considered if you plan to have a baby with an HIV positive partner.
PrEP is recommended for people who are at high risk of getting HIV.
You are at high risk if you:
- are having sex with a HIV-positive partner, and your partner does not have an undetectable HIV viral load
- are a man having anal sex with other men of unknown HIV status and do not always use a condom
To get PrEP you need to see a doctor to find out if PrEP is right for you. The doctor will ask you questions about your sex life to see if you are at high risk of getting HIV. The doctor will keep your personal information private and confidential.
If you are at high risk, the doctor will do:
- A HIV test. If this shows that you already have HIV, you should not take PrEP.
- A hepatitis B test. If you have chronic hepatitis B you may need to see another specialist doctor before you know if you can take PrEP.
- Kidney tests (blood tests), as these can be affected by the PrEP medication.
- Tests for other infections you can get from having sex.
If PrEP is right for you, the doctor will give you a prescription and explain the different ways that you can get PrEP.
Most people who take PrEP do not have any serious problems.
However, taking PrEP for a long time can affect your kidneys, so it’s important that these are checked. Your doctor will do a blood test every three months while you are taking PrEP to check this.
Daily PrEP
- Method: Take one tablet every day at a consistent time.
- Pre-exposure protection: For some groups, like cis-gender men who have sex with men, taking two tablets 2-24 hours before sex, and then one tablet per day, can be a way to initiate. For others, protection may take seven days to be fully achieved.
- Monitoring: You'll need to see your doctor every three months for a check-up and to get a new prescription.
On-demand PrEP
- Method:
Only recommended for cis-gender men who have sex with men and who do not have chronic hepatitis B.
- Dosing:
Take two tablets 2-24 hours before sex, one tablet 24 hours later, and another tablet 48 hours after the first dose.
- Continued protection:
If you have sex again, take one tablet daily until 48 hours after your last sexual activity.
- When to use:
You should only use this method if your HIV risk is from anal sex, not from injecting drugs.
Before starting PrEP
- See a doctor: Your doctor will check for HIV, other STIs, and hepatitis A, B, and C.
- Other checks: They will also check your kidney and bone health and may suggest vaccinations for hepatitis A and B.
- After starting: You'll need to visit your doctor every three months for a check-up to monitor for side effects, check for HIV and STIs, and get a new prescription.
The NSW Sexual Health Info Link 1800 451 624 is a phone service that can:
• Give you more information about PrEP
• Help you understand if PrEP is right for you
• Help you find a doctor who is experienced in HIV and who knows about PrEP