Prophylaxis means the treatment preventing the occurrence of diseases. In HIV infection there are two preventive treatments called before exposure and after exposure. In this section, we’ll explain the after exposure treatment.
After exposure treatment (hereinafter referred to as PEP) is a 28-day treatment in which HIV treatment medication combinations preventing the virus from clinging to body are started to be used within 72 hours after a suspicious encounter. While PEP is known not to prevent HIV transmission 100%, very few HIV transmissions have been reported after using PEP.
It’s not a regular method used to prevent HIV transmission, but an emergency precaution.
PEP has long been used by health care employees after a risky occupational exposure to HIV, and has also been started to be recommended for victims of sexual violence and people who experienced a high risk sexual encounter.
To start PEP, your risk factors must be reviewed by an infectious disease specialist, kidney and liver function tests must be performed. A combination of more than one medication is used in PEP. The combination to be used can only be determined by a specialist doctor. You can start PEP only within 72 hours after encounter. PEP is not recommended for cases over 72 hours.
Your doctor will review your risk factors before starting PEP.
-If you are a passive partner in anal sex: PEP is recommended if you had a sexual intercourse with someone who is under more risk of HIV, if you had a sexual intercourse with a man who has sex with men, if you had a sexual intercourse with citizens of the countries where HIV prevalence is high, or if you had a sexual intercourse with someone living with HIV who’s not taking the treatment. PEP is not recommended if you had a sexual intercourse with someone living with HIV who’s taking the treatment but whose viral load is undetectable.
-If you’re an active partner in anal sex: PEP is recommended if you had a sexual intercourse with someone living with HIV whose viral load is not undetectable.
-Vaginal Sex: PEP is recommended for sexual intercourses with people living with HIV whose viral load is not undetectable.
-Use of unsterilized needle/syringe: PEP is recommended if you used needles/syringes of people living with HIV.
-If you’re a receiver in oral sex: PEP can be considered if you have wounds in your mouth and sperm of someone living with HIV whose viral load is too high touched your mouth.
PEP is not recommended if you performed an oral sex on female genitalia, if sperm splattered on your dermis or skin, if you’ve been bitten, if you experienced a pinprick in public.
If PEP was recommended as a result of the risk evaluation by your doctor, please note that medications to be used in the treatment are not covered by your health insurance even if they were prescribed by your doctor. You can buy the prescribed medication from the pharmacy by paying its fee. After using PEP, you should see your doctor again to have HIV tests, sexually transmitted infections tests, liver and kidney function tests.
*Information in this section is compiled from Disease Control and Prevention Center, and NAM Publications.
https://stacks.cdc.gov/view/cdc/38856 / http://www.aidsmap.com/Post-exposure-prophylaxis-PEP/page/1044883/