Post exposure - reducing your risks

If you have had unprotected sex, or a condom accident with someone who has (or might have) HIV, then you could take post exposure prophylaxis (PEPSE) to reduce the chance of getting HIV.

What is post exposure prophylaxis (PEPSE)?

PEPSE stands for ‘post-exposure prophylaxis after sexual exposure’. It is a four week course of HIV medication you can take after unprotected sex or a condom accident, to reduce the chance of becoming HIV positive.

The most common reason for being prescribed PEPSE is if you have had unprotected anal, or vaginal sex, with someone who has (or is at high risk of having) HIV. If you think you are at risk, you could take PEPSE to reduce the chance of getting HIV.

PEPSE works best the sooner it is taken after unprotected sex – and it must be within 72 hours.

I think I need PEPSE – what should I do?

If you think you might need PEPSE, you should attend a sexual health centre or go to your nearest Accident and Emergency department (open 24 hours a day). You will be seen by a doctor who will assess the risk of HIV transmission. Your doctor will decide whether to prescribe PEPSE.

If they do prescribe it, they will normally give you a starter pack which contains five to seven days worth of medication. They will also take a blood test to test for HIV (to make sure you aren’t already HIV-positive), and to test your blood count, and how liver and kidneys are working.

What happens after I start PEPSE?

You will normally have a follow-up appointment in the sexual health clinic about five days after starting PEPSE. This is to make sure things are going well, and to give you your blood results.

You will come back to the clinic after you have been taking the medication for two weeks, we will then repeat the blood tests to check your blood count, liver and kidneys. There is normally a follow-up visit or phone call at four weeks to make sure you have completed the course of medication.

The final HIV test will be three months after you have finished taking the PEPSE.

consultation

Does PEPSE work?

Research shows that PEPSE makes infection with HIV less likely. However, PEPSE doesn’t work every time – some people who take it still become HIV positive. It can fail because the anti-HIV drugs are not active against a particular strain, or it can fail because the drugs are not taken properly.

How do I take the medication?

This depends on what combination of medication is prescribed for you. Whatever the combination, you will have to take medication every day for 28 days. The PEPSE medication may not work if you miss pills.

Are there any side effects?

This depends on the combination of medication you are prescribed – the doctor will go through this with you.

The most common side effects include:
• headaches
• tiredness
• nausea
• stomach upset or diarrhoea

As well as being prescribed the anti-HIV medication, you will also get medication for nausea and diarrhoea which you can take as required. Most of the time, the side effects settle down after a week or so.