Article sponsored by DTAP Clinic.
If you have had a high-risk exposure to HIV in the last 72 hours read on.
HIV PEP & HIV PrEP are available in DTAP clinics.
You are a potential candidate for Post Exposure Prophylaxis (PEP) or Emergency HIV Treatment if:
- You have been exposed to potentially HIV infected body fluids
- Your exposure was less than 72 hours ago
Factors that can increase the risk of HIV infection include:
- Condom Break
- Presence of Blood (e.g. Menses)
- Presence of cuts
- Presence of Ulcers
- You are not circumcised
International PEP Guidelines
According to the WHO Guidelines on PEP, the following criteria apply: Individuals are eligible for HIV PEP if:
- exposure occurred within the past 72 hours; and
- the potentially exposed individual is not infected or not known to be infected with HIV; and
- mucous membrane or non-intact skin was significantly exposed to a potentially infectious body fluid; and
- the source is HIV-infected or the HIV status is unknown.
According to the NYHD HIV PEP Guidelines, HIV PEP treatment should be recommended in the following exposures:
- Receptive and insertive vaginal or anal intercourse
- Needle sharing
- Injuries with exposure to blood or other potentially infected fluids from a source known to be HIV-infected or HIV status is unknown (including needlesticks with a hollow-bore needle, human bites, accidents)
According to the same NYHD HIV PEP Guidelines, HIV PEP treatment should be evaluated on a case-by-case basis in the following exposure scenarios:
- Oral-vaginal contact (receptive and insertive)
- Oral-anal contact (receptive and insertive)
- Receptive penile-oral contact with or without ejaculation
- Insertive penile-oral contact with or without ejaculation
Factors that increase risk:
- Source person is known to be HIV-infected with high viral load
- An oral mucosa that is not intact (eg, oral lesions, gingivitis, wounds)
- Blood exposure — it is important to note that blood exposure can be minimal and therefore not recognized by the exposed person.
If the exposed person reports frank blood exposure, PEP would be indicated These are just guidelines. The ultimate decision on whether to start PEP or not requires a detailed analysis of the risk-benefit ratio. You must have this discussion with your doctor in a formal medical consultation.
What HIV PEP drugs do we use?
We use first-line PEP Medicines as recommended by the US CDC with fewer side effects and better HIV prevention. This is in accordance with International Standards.
We use a variety of different Anti-Retro Viral medications in various combinations based on a patient’s specific circumstances.
We do not believe in a ‘on-size-fits-all’ approach.
Although different medicines are used, they all have to be taken for 1 month.
What are the HIV PEP side effects?
With the new PEP Drugs we use, side effects are very rare. Fewer than 1 in 100 of our patients actually develop any side effects.
Common (< 1%) side effects include nausea, diarrhoea and feeling very tired.
Rash and fever are uncommon (< 0.1%) side effects.
There is a theory that these drugs can affect the liver and kidneys temporarily so these have to be monitored.
We routinely monitor all patients who take PEP but have never come across anyone develop kidney or liver problems with the medicines.
The new HIV PEP Drugs that we use are much more less side effects than the old medicines. Make sure you know what drugs you are taking before you start on the PEP.
So what now?
If you think you are at risk of being infected with HIV, come down to see us as soon as possible.
We will have an in-depth discussion with you on your risks and whether or not it is recommended that you take PEP.
We are a walk-in clinic, you do not need an appointment.