Let’s have a PEP talk – Dr. Nur Hidayati

This is not just any pep talk. For this year AIDS day, let’s talk about PEP.

What is PEP?

PEP stands for Post Exposure Prophylaxis and it means taking antiretroviral medications to  prevent yourself getting infected with HIV after exposure.

Exposure can be:-

  1. Occupational exposure – i.e. health care workers who were in direct mucosal contact to known HIV infected person’s bodily fluids
  2. Non-occupational exposure – i.e. unsafe needle sharing, sexual assault, unprotected sex or protected sex with condom failure (slippage or breakage) with a known HIV infected person (or status not known),

PEP is safe and effective. People who took PEP can reduce their risk of getting HIV infection by 90%.

Can it really protect you from getting HIV? Isn’t HIV really contagious?

Yes, if it is taken immediately or at least – less than 72 hours after exposure.

PEP is consisted of 2 or 3 antiretroviral drugs and needs to be taken for 28 days.

Does it protect you from other sexually transmitted infections (STI)?
No. The best way to protect you against STI is to abstain from all forms of sex or use condom during every sexual intercourse. You should also avoid having sex with multiple partners or if you are sexually active, be mutually monogamous (in other words – stay loyal to one partner only).

Can I take PEP every time I have a high risk unprotected sex?
No. PEP should only be used in an emergency situation. If you are a sexual partner of a person living with HIV – you should consider Pre Exposure Prophylaxis (PrEP) instead. Please contact your health care provider who can advice you further on PrEP.

When should I get PEP?

If you are HIV-negative (or do not know your status) and you have been exposed to HIV during sex, through sharing needles or if you’ve been sexually assaulted, talk to your health care provider regarding PEP as soon as possible.

If you had an occupational exposure with HIV (for example – needle stick injury with a HIV-infected person), you should report the incident immediately, follow you hospital’s Needle Stick Injury protocol and notify your hospital’s Infectious Disease team immediately.

Anyone who has had exposure with HIV should be counselled and screened for HIV right after exposure as well as during follow up at 4 weeks and 12 weeks after exposure. You also should be screened for other sexually transmitted infections and if you are female, you should be tested for pregnancy.

Where and how should I get PEP?

PEP should only be prescribed by doctors who are trained in managing HIV infection. Currently, PEP is available in selected MOH hospitals with infectious disease physicians, university hospitals (I.e. Universiti Malaya Medical Center), private clinics (example – Klinik Bangsar South – http://klinikbangsarsouth.com or The Red Clinic – http://theredclinic.com ) or you can contact Pink Triangle Foundation hotline at 03-4051 3611.

This article is written by a permanent columnist for the Malaysian Medical Gazette, Dr. Nur Hidayati. She specialises in internal medicine and is based at a hospital in Selangor. Find out more on The Team.

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