PEP (post-exposure prophylaxis)

PEP is treatment you can take if you have been exposed to HIV. It may prevent you from becoming HIV positive. HIV takes a few days to become established in the body. PEP helps your body’s immune system to stop the virus from replicating in infected cells. These originally infected cells then die without producing new copies of the virus.

PEP treatment must be started as soon as possible, and definitely no later than 72 hours (3 days) after exposure to HIV. The sooner treatment is started, the more likely it is to work. PEP is a month-long course of drugs. The drugs are the same drugs that are used by people with HIV. They need to be taken strictly according to their dosing schedules. Sometimes drugs used for PEP have unpleasant side-effects (e.g. nausea, diarrhoea) but these are temporary and manageable.

PEP is available from some hospitals and clinics. To find out where PEP is available call your local AIDS Council (pages Support & Services) or a sexual health clinic.

When you ask for PEP, the doctor or nurse will ask you what happened to make you think you need it: they’re not judging you, they simply need to know what happened so they can determine how likely it is that you have actually been exposed to HIV.

PEP is different from pre-exposure prophylaxis (PrEP), which is when HIV-negative people take HIV treatments on an ongoing basis to reduce the risk of acquiring HIV.

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PrEP (pre-exposure prophylaxis)

Pre-exposure prophylaxis (PrEP) is the term used to refer to HIV-negative people taking HIV treatments on an ongoing basis to reduce the risk of acquiring HIV. PrEP is different from PEP (post-exposure prophylaxis), which is a 28-day course of anti-HIV drugs taken after an exposure incident to prevent infection (see PEP).

Large clinical trials have found that PrEP reduced infection among gay men, heterosexual women and men, and people who inject drugs. In these trials, people who were taking PrEP were much less likely to get HIV than those who were taking the placebo.

In 2015, two studies designed to test the real world effectiveness of PrEP among gay men offered it further support. One of these studies used an intermittent dosing schedule, which may be helpful to some users who have sex less frequently and also know ahead of time when they are likely to have sex.

Drugs for PrEP have not yet been approved by the regulatory authority in Australia, and neither are the drugs subsidised for this purpose through the Pharmaceutical Benefits Scheme (PBS).

From mid-2014, PrEP became available in Australia in a limited way through research projects in some states. These projects are investigating the acceptability of PrEP, as well as the feasibility and impact of providing anti-HIV drugs for prevention on an ongoing basis.

Most gay men use condoms with partners whose status they don’t know, so are not at high risk of acquiring HIV. However, there are some men who might benefit from PrEP, either for a limited time or on an ongoing basis. These men include those who have HIV-positive partners (especially if the positive partner is not on anti-HIV drugs and/or has a detectable viral load) and men who have receptive anal sex without condoms with partners whose status they don’t know.