PEP

What is PEPSE?
PEPSE stands for Post Exposure Prophylaxis after Sexual Exposure. It is administered to reduce the risk of contracting HIV infection after possible exposure to the virus.

When can I ask for it?
Initiation of PEPSE is recommended as soon as possible after exposure, preferably within 24 hours of exposure but can be offered up to 72 hours later. However, the sooner the better; the longer the delay, the less chance that PEP will work.

The decision to initiate PEP will be made on a case-to-case basis. Certain factors may increase the risk of HIV transmission and must be considered and discussed during a consultation. Blood, genital secretions and blood-stained body fluids increase the risk of transmission. PEP is recommended more readily in sexual assault cases, particularly if assailant is from a high prevalence group. Also, after a thorough evaluation, healthcare professionals are entitled to PEP in a needle-stick injury from a potential HIV source.

What does it involve?
This involves the use of drugs with potentially serious side-effects. Therefore, it is recommended that all individuals in need of PEP are strongly encouraged to meet with an appropriate healthcare professional specializing in sexual health to discuss risk reduction.

Before PEP is administered, an HIV test and STI testing are required. The HIV test will pick up the infection 4 weeks post exposure. This test is important because prior infection will determine what sort of treatment you require. Other regular tests are also recommended including pregnancy testing in women. Pregnancy should not alter the decision to start PEP but must be taken into consideration when choosing the appropriate drug. PEP are unlicensed in pregnancy and one should consider the risk and benefits of the treatment carefully.

An HIV test is then taken after 28 days on completion of treatment. Another HIV test and other STI screening tests will be also taken after 8 weeks to 12 weeks from your last sexual exposure, prior to starting the PEP.

PEPSE is an emergency method of HIV prevention and should not be considered or encouraged as first resort remedy. A 28 day course of treatment costs approximately €600, but can be more expensive in the case of brand name drugs.

It is suggested that individuals seeking PEPSE should attend for future regular sexual health check-ups.

What are the side-effects?
The major side-effects are gastro-intestinal symptoms (nausea, vomiting, abdominal pain and diahorrea), respiratory tract symptoms (cough, nasal symptoms, fever, cough and fatigue), headache and dizziness, among others.

Where can I go for PEP?
PEP can be prescribed at the GU clinic during working hours. Call GU clinic on 25457494/1 for advice and urgent appointment on weekdays. You can also access PEP at the Accident and Emergency (A&E) department during out of office hours. In this case, a prescription for the treatment and a referral ticket will be given for a GU clinic visit the next working day.