An introduction to...
PEP
Post Exposure Prophylaxis
What is PEP?
There are many ways to prevent HIV infection. Two of the most common are the use of condoms or dental dams, and not sharing needles when injecting drugs.
Unfortunately, things don't always work out as planned. Accidents happen. Sometimes having unprotected sex wasn't a decision we made, but happened as a result of sexual assault. Other times we decide to have unprotected sex and then worry about it afterwards. For these events, there is an option called PEP (Post Exposure Prophylaxis). PEP is the use of medications to reduce the chances of HIV infection after a person may have been exposed to the virus. A high-risk exposure includes unprotected anal or vaginal sex or needle exposure with someone who is HIV infected or someone of unknown status. Unprotected oral sex is lower risk for HIV infection. PEP is usually not given to people who had unprotected oral sex but you can talk to you doctor about whether it is right for you.
This therapy should NEVER be routine. It is a complicated medical therapy that should be attempted only in urgent situations.
The History of PEP
In 1994, the first study of PEP was done with health care workers who were exposed to HIV through events at work, such as needle sticks. The study was not 100% successful. But it did show that the use of AZT (zidovudine) decreased the risk for HIV infection in some people.
Studies have also shown that giving AZT to an HIV-infected pregnant women and her baby can decrease the chance that the baby will become HIV-infected.
Until recently, PEP was used only for health care workers and pregnant women. But the use of PEP not includes "non-occupational exposures." Non-occupational exposure typically occurs though unprotected sex or sharing needles with HIV-infected persons.
With the introduction of more effective antiretroviral medications, it may be possible to reduce the risk of HIV infection if someone has a non-occupational exposure.
Should I Take PEP?
If you are considering PEP, realize that potential benefits have to be weighed against the significant costs and health risks. You might be anxious about the experience that put you at risk for HIV. While some researchers believe PEP may help prevent HIV infection, this has not been proven and its use is currently being evaluated.
Side Effects
These medications can have severe side effects such as nausea, headaches, weight loss, dehydration and vomiting. Current recommendations for PEP treatments include a combination of a 2-3 antiretroviral therapy for a period of 28 days. The program requires a commitment to taking medications daily. The therapy may not be effective for everyone. If a person becomes infected with HIV, there is a risk that the virus will be difficult to treat because it may develop resistance to the PEP medications.
Cost
The 4 week course of these medications will likely cost between $600 to $1000. In some cases, the cost of these medications will not be covered by insurance. Talk to your medical provider about the availability of other programs that may assist you with the cost.
How do I get PEP?
If you have had a high-risk exposure within the past 72 hours, call your medical provider and ask to speak to a doctor about PEP.
Please note that medication is best started as soon as possible, and no later than 72 hours after an exposure from unprotected anal or vaginal sex or from sharing needles.
For more information on PEP, safer sex and risk reduction...contact i3 at 651-9175.
This information was obtained from the New York State Department of Health...March 21st, 2007.