PEP (Post-Exposure Prophylaxis) is an emergency HIV prevention method that involves taking antiretroviral medication within 72 hours of a possible exposure to HIV (such as unprotected sex or a needle-stick injury). The standard course lasts for 28 days, and it significantly reduces the risk of HIV infection when started promptly.

When Is PEP Recommended?

PEP is considered in situations involving high risk of HIV exposure, such as:

• Unprotected sexual intercourse (without a condom)
• Sexual assault (rape)
• Needle-stick injuries or contact with potentially infected blood
• Sharing needles or injection equipment

This explanation focuses specifically on sexual exposure to HIV.

Eligibility for PEP After Sexual Exposure

PEP is not prescribed to everyone. A medical assessment will determine the level of risk, HIV status of the source, and timing since exposure. Below are examples based on gender and exposure type.

For Men

🔴 High Risk (PEP Recommended)

• Unprotected anal sex (receptive or insertive) with an HIV-positive or high-risk male partner.
• Unprotected sex with a high-risk female (e.g. sex worker, person who injects drugs).
• Condom failure (e.g., breakage or slippage) with a high-risk partner.
• Exposure to semen or blood during sexual assault.
• Unprotected sex with partners from high HIV prevalence regions or high-risk populations.

🟠 Moderate Risk (Consider PEP)

• Unprotected sex with a partner whose HIV status is unknown and has no known risk factors.
• Condom failure with a low-risk partner.

🟢 Low Risk (PEP Not Recommended)

• More than 72 hours have passed since exposure.
• The partner is confirmed HIV-negative.
• Condom was used correctly and remained intact.
• Only oral sex occurred, with no ejaculation or bleeding.

For Women

🔴 High Risk (PEP Recommended)

• Unprotected vaginal or anal sex with an HIV-positive or high-risk male partner.
• Male partner is considered high risk (e.g., MSM, drug user), and a condom was not used.
• Condom breakage or slippage occurred.
• Exposure to blood/semen during sexual assault involving vaginal or anal penetration.
• Unprotected sex with someone from a high-prevalence region or high-risk group.

🟠 Moderate Risk (Consider PEP)

• Partner’s HIV status is unknown, but no specific risk factors are identified.
• Condom failure with a low-risk partner.

🟢 Low Risk (PEP Not Recommended)

• More than 72 hours have passed since exposure.
• Partner confirmed to be HIV-negative.
• Proper condom use with no issues.
• Only oral sex occurred, with no bleeding or ejaculation.

Standard PEP Treatment

Based on WHO and CDC guidelines:

First-line PEP regimen:

• Tenofovir disoproxil fumarate (TDF) + Emtricitabine (FTC)
  PLUS one of the following:
• Raltegravir (RAL) or
• Dolutegravir (DTG)

Treatment Duration: 28 days of daily dosing.

Pre-PEP Assessment & Follow-Up

Before starting PEP, the following evaluations are essential:

• Confirm that exposure occurred within 72 hours
• Baseline HIV antibody test
• Assess HIV status of the source person (if known)
• Test for kidney/liver function, hepatitis B/C, and other STIs
• Address emergency contraception or sexual assault support if applicable

Key Points

• PEP must be taken daily for 28 days, with good adherence.
• The sooner, the better – ideally within 2 hours of exposure.
• Side effects (e.g., nausea, fatigue) are usually mild and temporary.
• PEP is different from PrEP: PEP is for emergency use after exposure; PrEP is for ongoing prevention before exposure.

Our Clinic’s Services

We provide both PEP and PrEP treatment.
Our lead physician, Dr. Nagashima, is fully licensed to prescribe PEP, PrEP, and ART (antiretroviral therapy) for individuals living with HIV.

We are seeing more both men and women seeking care for HIV prevention. If you have concerns or think you may have been exposed to HIV, please feel free to contact our clinic for a confidential consultation.