| Important
PEP is time-sensitive. A person who may have been exposed to HIV should seek urgent medical assessment as soon as possible. PEP may still be considered up to 72 hours after exposure. |
What is PEP?
PEP stands for Post-Exposure Prophylaxis. It is a short course of HIV medication that may be offered after a possible exposure to HIV. It aims to reduce the risk of HIV infection when started quickly and taken correctly.
PEP is not needed after every exposure. A healthcare professional will assess the type of exposure, the risk that the source has HIV, and any other factors that may affect the risk of transmission. The decision to initiate PEP will be made on a case-by-case basis.
When should I ask for PEP after a potential risk?
Ask for urgent advice if you think you may have been exposed to HIV through unprotected sex, sexual assault, sharing injecting equipment, or contact with blood or certain body fluids at work. PEP is considered after a clinical risk assessment. It is not automatically required in every situation.
Blood, genital secretions and blood-stained body fluids increase the risk of transmission. PEP is also recommended in sexual assault cases. Following a needle stick injury from a potential HIV source and after a thorough evaluation, healthcare professionals may require PEP.
How soon do I need to start PEP?
PEP should be started as soon as possible within 72 hours after exposure. The earlier, the better.
How long does PEP treatment last?
The standard course lasts 28 days. It is important to take PEP exactly as prescribed and to complete the full course unless a healthcare professional advises otherwise.
Who decides whether I need PEP?
A healthcare professional will decide after a clinical assessment of the situation. The assessment normally considers the type of exposure, whether the source person is known to have HIV or is likely to have it, and the source person’s HIV viral load if this is known.
Can I take PEP if I am pregnant?
Pregnancy does not rule out PEP, but it should be discussed during the assessment. It may affect the choice of medication and follow-up, so pregnancy or possible pregnancy should be discussed during the assessment.
What medicines are used for PEP?
The healthcare professional will choose the most suitable HIV medication in the specific situation. The choice can depend on medical history, kidney function, pregnancy, allergies and possible drug interactions.
Are there side effects?
PEP medicines can cause side effects, although many people complete the course without major problems. The healthcare professional should explain possible side effects and what to do if they occur. Anyone who develops concerning symptoms should seek medical advice.
What follow-up is needed after starting PEP?
Follow-up is important. Depending on the exposure and baseline results, this may include review by a GU or HIV clinician, STI testing, and repeat HIV and hepatitis testing. Further follow-up depends on hepatitis B vaccination status, test results and clinical circumstances.
What if I miss a dose?
| If you miss a dose | What to do |
| Within 18 hours of your usual time | Take the missed dose as soon as possible, then continue as normal. |
| More than 18 hours late | Skip the missed dose and take the next dose at the usual time. |
| If you miss doses often or around sex/risk | Speak to a healthcare professional, because adherence is important. |
Is PEP free?
PEP is free when clinically indicated following a risk assessment by the healthcare professional.
Where can I be assessed for indication of PEP?
- PEP can be prescribed at the GU Clinic during working hours. For advice, call 2545 7494 / 2545 7491.
- Outside working hours, PEP can be accessed from A&E.
- Female Sexual Assault – gynaecology.
- Male Sexual Assault – A&E department.
- Primary Health Care Centres are available 24 hours.
- If someone visits A&E or a Primary Health Care Centre, a prescription and referral ticket will be given for a GU Clinic visit on the next working day.
- Infection Control in case of occupational exposure.
- Treatment is currently dispensed from the Mater Dei Hospital Dispensary and the Gozo General Hospital Dispensary.
Can I use PEP instead of condoms or PrEP?
No. PEP is for emergency use after a possible exposure. It should not be used as a routine prevention strategy. A healthcare professional can advise on safer sex, condoms, regular testing and whether PrEP may be suitable for ongoing HIV prevention.
What should I do now if I think I need PEP?
Seek urgent medical advice immediately. Do not wait for symptoms because HIV infection may not cause symptoms at first and PEP is time-sensitive. If the exposure was sexual assault, attend emergency services (A&E Department, Mater Dei Hospital) immediately.
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