PEP

PEP (Post-exposure prophylaxis) refers to taking anti-HIV medicine after any high-risk exposure to HIV virus in order to reduce the risk of HIV infection.

PEP must be started within 72 hours after a possible exposure. The sooner you start PEP and follow the instructions to complete the whole course of treatment, the better. Research has shown that PEP has little or no effect in preventing HIV infection if it is started 72 hours after being exposed to HIV.

PEP must be taken at the same time every day for a consecutive of 28 days. It is effective in preventing HIV when administered correctly, but not 100%.

While taking PEP, it is important to keep using other HIV prevention methods, such as using condoms with sex partners and avoiding needle sharing.

• it is within 72 hours of a potential exposure to HIV;
• one is not living with HIV;
• a mucous membrane (including: eyes, mouth, vagina, rectum) has had direct contact with someone's body fluid that might be infectious, e.g. semen, vaginal discharge, blood or plasma;
• an open wound which has had direct contact with someone's body fluid that might be infectious;
• the source of exposure is infected with HIV or their HIV status is unknown.

Important: PEP is not recommended after all types of exposure except those with a substantial risk for HIV transmission. Individualized risk assessment by medical practitioner prior to prescription is required.

Generally speaking, anti-HIV medications for PEP are available at the Accident and Emergency Departments of public hospitals and at certain private clinics or hospitals.

Following a potential exposure to HIV, one should seek medical practitioner for initial assessment without delay and if PEP is indicated. If PEP is started by your doctor, continued follow up is important. The Therapeutic Prevention Clinic of the Department of Health provides follow up after initiation of PEP. The Hospital Authority also follows up its health care staff exposed in the health care setting.

• Timing and nature of the exposure;
• HIV status of the exposed person;
• HIV status of the source. If known to be HIV positive, whether or not the source is on antiretroviral therapy and the last HIV viral load if available;
• Any additional risk factors

Some people may experience side-effects such as nausea, headache and increase in bowel motions, though some people will experience no side-effects at all. PEP may also interact with other medicines that people are taking (known as a drug interaction). Because of potential drug-drug interactions, it's important to tell your health care provider about any other medicines that you are taking.

• PEP recipients should be followed up by designated clinics as indicated, where they will be reviewed for drug tolerance and adherence. The treatment should be continued for a total of 28 days, with adjustments only as indicated;
• Follow-up HIV testing at 12 weeks post-exposure;
• Counselling and education on risk-reduction behaviours will be offered during follow up;
• Prevention of further HIV transmission is necessary throughout the follow-up period. The following should be practised until the HIV status of the exposed person is ascertained:
• Use of condoms to prevent potential sexual transmission
• Avoidance of pregnancy and breastfeeding
• Avoidance of needle-sharing
• Abstain from donating blood, plasma, organs, tissue or semen

PEP is only for emergency situation; for people with ongoing risk of exposure to HIV, please discuss with your healthcare providers for other appropriate prevention methods.