Non-Occupational Post-Exposure HIV Prophylaxis

Introduction to PEP

Post-Exposure Prophylaxis (PEP) is any prophylactic (preventive) treatment started immediately after exposure to be pathogen (such as a virus) with the aim to prevent infection.


What is PEP?

PEP is the use of Antiretroviral Therapy (ART), often becoming the standard of care for healthcare workers, who hold on to the risk of occupational exposure to HIV. PEP should ideally be initiated within 72 hours of exposure, failing which is not advised.


Who needs PEP?

Anyone who have experienced condom failure or were involved in any form of unprotected anal or vaginal intercourse, receptive fellatio with ejaculation with:

  • A known HIV-infected partner and or
  • HIV at-risk groups (commercial sex workers, IV drug users, men who have sex with men – including bisexual men) and or
  • A person who was forced into any sexual act involuntarily (raped).

Before PEP Prescription

A detailed history of the exposure if crucial in evaluating a patient. An assessment will then be done by the doctor to determine the likelihood of HIV transmission. The level of risk can be estimated with the following table:

ExposureEstimated Risk
Needle stick injury0.33%
Receptive anal intercourse1%
Insertive anal intercourse0.04%
Receptive vaginal intercource0.1%
Insertive vaginal intercourse0.05%
Receptive fellatio with ejaculation (Oral Sex)0.04%
Sharing needles0.67%

The patient will then be advised on the risks, benefits and alternatives of PEP. Should the decision be made to proceed with treatment, it would be important to follow-up for: potential side effects of the medications, repeat HIV screenings as well as reinforcement of counselling messages.


Course of PEP

The full course for this PEP drug combination will be for a duration of 28 days. AfA Is working closing with DSC Clinic to bring you PEP at very affordable rates.


Adverse Effects of PEP

Any drugs prescribed have the potential possibility of side effects.

These symptoms includes nausea and diarrhoea.

It is advisable to check with your healthcare provider on what are the possible side effects on the medications being prescribed to you.


Do you think you need PEP?


Other Information

  • Exposure to saliva, urine, tears and sweat are not thought to be infectious
  • HIV transmission from splashes of contaminated fluids to mucosal surface (i.e. nostrils, mouth, lips, eyelids, ears, genital area and the anus) or non-intact skin is likely to be low, although it has not been accurately justified
  • PEP treatment is not 100% effective, best reports quote that PEP can potentially decrease the possibility of transmission by 81%
2 replies
  1. Simpleman
    Simpleman says:

    Hi,

    I had a unprotected sex. I went for a check and its negative. duration from unprotected is about 5 weeks after doing the check. ( not sure is 3rd or 4th gen kit). Will i need to do another check?

    Reply
    • afa_v2
      afa_v2 says:

      Hi Simpleman,

      Fourth-generation HIV tests can detect HIV infection in 50% of people by 18 days after infection; 95% of people by 34 days after infection; and 99% of people by one and a half months (6 weeks) after infection. You can make the decision if you are satisfied with this result, as there are many other factors to consider.

      In the future, if you believe that you have had been exposed to HIV, you should consider PEP or Post Exposure Prophylaxis. it is a month of HIV medication that can stop you from becoming HIV positive and it has an efficacy rate of up to 80%. You have to start this treatment within 72 hours of exposure. For more detailed information please visit – http://afa.org.sg/pep/

      Reply

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