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HEALTH – PEP & PrEP explained

PEP is intended for emergency situations. It is not meant for regular use by people who may be exposed to HIV frequently. Another HIV prevention method, called pre-exposure prophylaxis or PrEP, is when people at high risk for HIV take an ARV medicine daily to prevent getting HIV

 

Post-Exposure Prophylaxis (PEP)

(Last updated 8/30/2016; last reviewed 8/30/2016)

Key Points

  • Post-exposure prophylaxis (PEP) involves taking antiretroviral (ARV) medicines very soon after a possible exposure to HIV to prevent becoming infected with HIV.
  • PEP should be started as soon as possible to be effective and always within 72 hours (3 days) after a possible exposure to HIV.
  • If your health care provider thinks PEP is right for you, you’ll take 3 or more ARV medicines each day for 28 days.

What is PEP?

PEP stands for “post-exposure prophylaxis.” The word “prophylaxis” means to prevent or protect from an infection or disease. PEP involves taking antiretroviral (ARV) medicines very soon after a possible exposure to HIV to prevent becoming infected with HIV.

There are 2 types of PEP: oPEP and nPEP. oPEP stands for “occupational post-exposure prophylaxis.” It’s when a health care worker takes PEP because of a possible on-the-job exposure to HIV, such as during a needlestick injury.

The other type of PEP is called nPEP, and it stands for “non-occupational post-exposure prophylaxis.” It’s when someone takes PEP because of a possible HIV exposure that happened outside of the person’s work, such as during sex or injection drug use.

Who should consider taking PEP?

PEP might be prescribed for you if you are HIV negative or don’t know your HIV status, and in the last 72 hours you:

  • Think you were exposed to HIV during your work, for example from a needlestick injury
  • Think you were exposed to HIV during sex
  • Shared needles or drug preparation equipment (“works”)
  • Were sexually assaulted

Your health care provider will help to determine whether you should receive PEP.

PEP is intended for emergency situations. It is not meant for regular use by people who may be exposed to HIV frequently. Another HIV prevention method, called pre-exposure prophylaxis or PrEP, is when people at high risk for HIV take an ARV medicine daily to prevent getting HIV. For more information on PrEP, see the AIDSinfo fact sheet on Pre-Exposure Prophylaxis (PrEP).

What should I do if I think I was recently exposed to HIV?

If you think you were exposed to HIV, immediately contact your health care provider or go to an emergency room, urgent care clinic, or local HIV clinic right away. You will have an HIV test and other tests done. Your health care provider or emergency room doctor will help to decide whether you should receive PEP.

When should PEP be taken?

PEP should be started as soon as possible to be effective and always within 72 hours (3 days) after a possible exposure to HIV. Research has shown that PEP has little or no effect in preventing HIV infection if it’s started later than 72 hours after an exposure to HIV.

How long is PEP taken for?

PEP involves taking 3 or more ARV medicines each day for 28 days. You will need to return to your health care provider at certain times while taking PEP and after you finish taking PEP for HIV testing and other tests.

What HIV medicines are used for PEP?

The Centers for Disease Control and Prevention (CDC) provides information on recommended ARV medicines for PEP. CDC also provides PEP recommendations for specific groups of people, including children, pregnant women, and people with kidney problems. The most recent PEP recommendations can be found on CDC’s PEP Guidelines webpage. Your health care provider or emergency room doctor will determine which medicines you should take as part of PEP.

Does PEP work?

PEP is effective in preventing HIV infection when it’s taken correctly, but it’s not 100% effective. The sooner you start PEP after a possible HIV exposure, the better. While taking PEP, it’s important to keep using condoms with sex partners and to continue safe drug injection practices. Read this fact sheet from CDC for information on how to use condoms correctly.

Does PEP cause side effects?

The ARV medicines in PEP may cause side effects. The side effects can be treated and aren’t life threatening. Talk to your health care provider if you have any side effect that bothers you or that does not go away.

PEP medicines may also interact with other medicines that people are taking (known as a drug interaction). Because of potential drug interactions, it’s important to tell your health care provider about any other medicines that you take.

 

Pre-Exposure Prophylaxis (PrEP)

(Last updated 6/9/2016; last reviewed 6/9/2016)

Key Points

  • Pre-exposure prophylaxis (PrEP) can help prevent HIV infection in people who don’t have HIV but who are at high risk of becoming infected with HIV.
  • PrEP involves taking a specific HIV medicine every day. PrEP is most effective when taken consistently each day.
  • According to the Centers for Disease Control and Prevention (CDC), by taking PrEP every day, a person can lower their risk of getting HIV from sex by more than 90% and from injection drug use by more than 70%.

What is PrEP?

PrEP stands for “pre-exposure prophylaxis.” The word “prophylaxis” means to prevent or protect from an infection or disease.

PrEP can help prevent HIV infection in people who don’t have HIV but who are at high risk of becoming infected with HIV. PrEP involves taking a specific HIV medicine every day. If a person is exposed to HIV, having the HIV PrEP medicine in the person’s bloodstream can help stop HIV from setting up a permanent infection in the body.

What HIV medicine is used for PrEP?

The HIV medicine currently prescribed for PrEP is a combination pill called Truvada. Truvada is made up of two HIV medicines: tenofovir disoproxil fumarate (brand name: Viread) and emtricitabine (brand name: Emtriva). Truvada was approved by the U.S. Food and Drug Administration (FDA) to treat HIV in 2004, and it was approved by FDA for use as PrEP in July 2012.

Other medicines are being studied for possible use as PrEP. These medicines are called investigational drugs, and none of them have been approved by FDA yet. To find out more about investigational HIV drugs, read the AIDSinfo What is an Investigational HIV Drug? fact sheet.

Who should consider taking PrEP?

PrEP is for people who don’t have HIV but who are at high risk of becoming infected with HIV through sex or injection drug use.

You may want to consider PrEP if you are HIV negative and:

  • you are in an ongoing sexual relationship with an HIV-positive partner; or
  • you are a gay or bisexual man who is not in a monogamous relationship with a recently tested, HIV-negative partner, and you have either 1) had anal sex without a condom in the past 6 months, or 2) been diagnosed with a sexually transmitted disease (STD) in the past 6 months; or
  • you are a heterosexual man or woman who is not in a monogamous relationship with a recently tested, HIV-negative partner, and you do not always use condoms during sex with partners whose HIV status is unknown and who are at high risk of HIV infection (for example, people who inject drugs or have bisexual male partners); or
  • you have injected drugs in the past 6 months, and you have either 1) shared needles or injection equipment in the past 6 months, or 2) been in a drug treatment program in the past 6 months.

The above are some examples of people who may benefit from PrEP. If you think PrEP may be right for you, talk to your health care provider.

Does PrEP work?

PrEP is most effective when taken consistently each day. According to CDC, by using PrEP every day, you can lower your risk of getting HIV from sex by more than 90% and from injection drug use by more than 70%. Adding other strategies, such as condom use, along with PrEP can reduce a person’s risk even further.

Does PrEP cause side effects?

Most people taking PrEP do not have any serious side effects from the medicine. Some people taking PrEP may have nausea, but this usually goes away over time. Talk to your health care provider if you have any side effect that bothers you or that does not go away.

What should I do if I think PrEP could help me?

If you think you may be at high risk for HIV and that you might benefit from PrEP, talk to your health care provider. If you and your health care provider agree that PrEP might reduce your risk of getting HIV, the next step is a physical examination, an HIV test, and other blood tests. If the tests show that PrEP is likely to be safe for you and that you might benefit from PrEP, your health care provider can give you a prescription.

Many health insurance plans cover the cost of PrEP. For people with limited income and no insurance, a commercial medication assistance program provides free PrEP.

What happens once I start PrEP?

Once you start PrEP, you will need to take PrEP every day. If you don’t take PrEP every day, there may not be enough medicine in your bloodstream to block HIV. Studies have shown that PrEP is much less effective if people do not take it every day.

You should keep using condoms while taking PrEP. When PrEP is taken daily, it offers a lot of protection against HIV infection, but not 100%, so condom use is still important. PrEP also does not reduce the risk of getting any other STDs. Read this fact sheet from CDC for information on how to use condoms correctly.

If you are having trouble taking PrEP every day or if you want to stop taking PrEP, talk to your health care provider.

Source:

https://aidsinfo.nih.gov/education-materials/fact-sheets/20/85/pre-exposure-prophylaxis–prep-

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