PEP (Post-Exposure Prophylaxis)

Post Exposure Prophylaxis (PEP) is a medication regimen that you can take if you believe you have just been exposed to HIV. If you take PEP as directed, it can prevent HIV from infecting your body. PEP must be taken within 72 hours of exposure, but should be taken as soon as possible to maximize the chance it will work.

PEP is most effective when taken immediately following an exposure to HIV. If you believe you have been exposed to HIV, you should seek PEP as immediately as possible.

If you answer yes to any of the following questions, you should seek PEP immediately:

• • Have you just experienced sexual assault?

• • Did you just have unprotected vaginal or anal sex with someone who you know is HIV-positive or whose status you do not know? (Unprotected means that a condom was not used, or that the condom broke or slipped off during sex).

• • Did you share needles (for drugs, hormones, or tattoos) or other drug injection equipment (works) with someone you either know is HIV-positive or whose HIV status you don’t know?

If you think that you were exposed to HIV at work, tell your supervisor immediately. (For example, if you were stuck by a needle in a healthcare set

Any healthcare provider can prescribe PEP at their discretion. However, it’s recommended that you see a provider with whom you feel comfortable discussing topics like sex, sexuality, drug use, needle sharing, and HIV. In Chicago, Howard Brown Health will help you see a provider same-day for PEP. If Howard Brown is closed and PEP is an immediate emergency need, you should visit the nearest emergency room. Remember that a hospital emergency room should always be a last resort.

A healthcare provider will want to discuss your exposure to HIV, including the date, time, and nature of the exposure. This is to evaluate whether PEP will be safe, effective, and necessary in your situation. You will be asked to test for HIV. A health care provider must verify that you are currently HIV-negative before prescribing PEP. If your test is positive (indicating an infection pre-dating your exposure), the provider will discuss making a treatment plan with you.

If you refuse HIV testing, you may be unable to receive PEP. You may be asked to contact the person who exposed you, if able. This person may be asked about their HIV status and how they are currently being treated for HIV. This information may affect the health care provider’s plan for your care. You may be offered additional testing for sexually transmitted infections (STIs) and/or Hepatitis C. You may be offered vaccines against other diseases, such as Hepatitis A and B. If you can become pregnant, you may be offered a pregnancy test. Your provider may discuss emergency contraception. Your provider will want to make a plan with you to reduce the risk of being exposed to HIV in the future. Your provider may want to discuss pre-exposure prophylaxis (PrEP), a daily medication like PEP that can reduce the chance of acquiring HIV if taken consistently and correctly. Unlike PEP, PrEP is taken before an exposure ever occurs, to introduce medications into your body that can prevent HIV from establishing an infection. Once finished with PEP, many patients choose to take PrEP to continue reducing their risk of acquiring HIV.

Once you have started PEP, your provider may wish to schedule a 1-month follow-up appointment to verify that PEP has successfully prevented HIV from infecting your body.

If the health care provider decides to prescribe PEP to you, the medication will be explained in detail at the time of your visit. You will be asked to fill the prescription and take the medication as directed. If PEP is obtained through an emergency room, you may be given the first dose along with a few days’ supply in order to give you time to fill the prescription for the rest.

Once you begin taking PEP, it is important to continue taking the medication as directed. Stopping or skipping doses may be dangerous. PEP is prescribed for 28 days, meaning you must take the medication each day for 28 days. Do not skip doses. PEP may not work correctly if taken in combination with certain medications. Before starting PEP, be certain to discuss any medications you’re taking with your health care provider and the pharmacist filling you prescription. Be sure to discuss any over-the-counter drugs, herbal medicines, and vitamins you’re taking.

You should only stop taking PEP if your healthcare provider instructs you to do so. You must complete the full course of medication to have the best chance of stopping HIV infection.

Side effects vary with the medications your provider chooses to prescribe as PEP. Many medications can be used for PEP, and your provider will choose the best ones. Common side effects for the medications used are typically mild, and may include upset stomach, headaches, diarrhea, and tiredness. Tell your provider right away if you experience side effects that make it difficult to take the medication. Do not stop taking PEP before talking to your provider; there may be ways to make you feel better, or alleviate side effects. Most patients have no or very few side effects with PEP. Most of those who do experience side effects decide to continue taking PEP because they want to do everything possible to avoid getting HIV. Many patients recognize that one month of PEP is easier than a lifetime of taking HIV medications.

Yes! Howard Brown offers PEP to patients on a walk-in basis. If you believe you have been exposed to HIV, you can come to Howard Brown during our regular hours of operation to receive treatment. Patients without insurance may qualify for low-cost services, and staff will be available to help you figure out how to pay for the medication.  Howard Brown Health always has a healthcare provider on call to help navigate you outside of regular business hours.

For additional information, call 773.388.8889 or walk in during our hours of operation.

If you are unable to come during regular hours of operation, seek PEP through the nearest emergency room.

PEP is covered by Medicaid and most private insurance plans. Co-pay assistance is available, and many patients with insurance pay nothing out of pocket. If you need help or do not have insurance, ask about patient assistance programs which may pay for the full cost of the medication.

If you are seeking PEP following an experience of sexual assault, you may visit any emergency room in Illinois to receive state mandated free care including PEP, emergency contraception, and STI testing.

The Illinois Rape Crisis Hotline can be reached at 888.293.2080.

Yes. If you are pregnant, you can still take PEP. Your provider will want discuss the benefits and risks to you and your baby. If you are nursing, you should stop breast feeding for three months following the exposure. HIV can be transmitted through breast milk, so your HIV status should be verified before you resume breast feeding. Ask your provider about pumping and discarding breast milk if you wish to go back to breastfeeding after the three month period.

Your provider will want to verify that PEP has successfully prevented an HIV infection. This means your provider may ask you to be tested one month and three months after completing PEP.

You may be offered additional services, such as HIV/STI prevention education, recovery services, needle exchange services, or counseling. If you need these services but they have not been offered, ask your provider for a referral.

If the exposure to HIV is ongoing (for example, an HIV positive regular partner) your provider may want to discuss PrEP with you in detail. PrEP is a daily pill that has been shown to protect people who are at ongoing risk for getting HIV. If you believe PrEP would be a good choice for you, ask your provider for more information.