PEP Q&A

PEP

Q&A about PEP

information provided by THT (May 2009)

Q Is PEP a cure for HIV?

A There is no cure for HIV. PEP can only stop an HIV infection if taken early on after HIV has entered the body, before the infection takes a hold - within 72 hours (3 days). Once HIV infection takes hold and the infection becomes permanent then anti-HIV drugs can't get rid of HIV from the body. This is because the virus is now in parts of the body that the drugs cannot reach. So, once HIV permanently infects someone the drugs can usually control the HIV in their body but never get rid of it completely.

Q But if HIV is in the body, isn't it too late and the person is now infected?

A No. After HIV gets in someone's bloodstream it takes time (hours or a few days) before it permanently infects them. If someone acts in that short time they stand a chance of stopping HIV before the infection takes hold.

Q How could the infection be stopped?

A Taking 2 or 3 anti-HIV drugs every day for 4 weeks might stop the HIV before it gets a permanent hold in the body. PEP is not a 'morning after' pill that's taken just once - it's one month of drugs.

Q So, on PEP someone won't become HIV positive?

A Research seems to show PEP makes infection with HIV a lot less likely. But PEP doesn't work every time - some people who take it still end up with HIV afterwards. It can fail because some anti-HIV drugs don't work against some strains of HIV. And it's more likely to fail if it is not taken properly or soon enough.

Q How soon?

A The quicker PEP is started, the better, certainly within hours. The longer the wait the more chance it won't work. After 72 hours (3 days) PEP usually isn't given because studies show it's unlikely to work by then.

Q Are the drugs the same as the ones taken by people with HIV?

A Yes, it's the same 'combination therapy' drugs that are taken by people who are HIV positive.

Q Does PEP have side effects?

A Yes, it can cause diarrhoea, headaches, feeling sick and vomiting. Because of the side effects many people taking PEP need time off from work or study. Some people have to stop taking PEP because of the side effects. Side effects go once someone stops taking the drugs. One Australian study showed among people taking PEP, side effects were mild to moderate for 2 out of 3 people and severe for 1 in 4.

Q Where does someone get PEP from?

A You may be able to get PEP from a sexual health clinic (GUM or 'clap clinic'), a hospital (usually A&E or 'Accident & Emergency' departments) or if you already have HIV, then try your HIV clinic if the PEP is for someone you've had sex with. Note: Not all of these places in every part of the country will have PEP or be able to give it. GP's usually won't be able to prescribe PEP.

Q "We had unsafe sex" or "The condom broke"... is it worth asking for PEP?

A To see if PEP might be given visit www.chapsonline.org.uk. This website will help work out how big the risk of getting HIV was and whether or not it's worth asking for PEP. There's a telephone number that offers the same service: 0845 12 21 200. It's operated by THT Direct and they can provide you with more information on PEP and where to get it.

Q What are the chances someone will get PEP?

A New guidelines have been given to Sexual Health Clinics and hospitals that help doctors decide if PEP should be given. A doctor will need to ask questions about what kind of sex happened, when and who with. It's worth thinking about PEP if you or someone you had anal sex with didn't use a condom or something went wrong with the condom and it's not later than 72 hours (3 days) since it happened. Doctors might sometimes give PEP after oral sex, depending on the circumstances.

Q What kind of questions are asked if someone wants PEP?

A Questions will be about: the person the unsafe sex was with (to judge the chances they had HIV or not), the sex involved, e.g. when it happened, was it oral or anal sex, who fucked who and did either or you come inside the other, having an HIV test. Before someone is given PEP they must have an HIV test to check that they don't already have HIV. They must also agree to be tested after taking PEP to see if it has worked. PEP won't be offered if someone refuses to be tested. Note: The kind of questions asked can be seen at www.chapsonline.org.uk.

Q What if someone can't get to a place that offers PEP within 72 hours?

A Once 72 hours are over PEP won't usually be offered. So, if it's not possible to get to a Sexual Health Clinic that's open it maybe worth trying a hospital Accident & Emergency department because they never close (although there is no guarantee they will give PEP). Check out www.chapsonline.org.uk for advice on finding a place that offers PEP.

Q How come we didn't know about PEP already?

A Before this recent PEP information campaign, about 1 in 4 gay men already knew about PEP. Over the last few years there have been articles in the press about PEP and it's been possible in some places to get PEP after sex. For a number of years people who have been sexually assaulted have often been offered PEP. For a long time doctors and nurses who have accidentally pricked themselves with a needle have been offered it.

Q If someone takes PEP can their body become resistant to anti-HIV drugs so that the drugs won't work if that person later gets HIV?

A No, it's the virus (HIV), not someone's body, that can become resistant to the drugs. If PEP works it gets rid of the virus and the virus can't become resistant because it's not there anymore. So, if someone were to get HIV later and needed drugs it wouldn't make any difference that they had taken PEP in the past. But, if PEP doesn't work and then a person end up infected, there may be problems with the HIV in their being resistant to some drugs, including ones used in PEP.

Q If someone's taking PEP, does that make them immune to HIV while they're on it or once they've stopped taking it?

A No. Unsafe sex while taking PEP could let more HIV into your body, making PEP much more likely to fail. If after taking PEP, someone had stayed HIV negative and then has unsafe sex again, they can become infected just like any other person who does not have HIV.

Q Now there's PEP, does it matter so much if people don't use condoms?

A Yes. Here is why PEP doesn't change the need for condoms: using a condom is more likely to stop HIV being passed on than PEP is, condoms don't make you ill with nasty side effects, you need a condom for as long as the sex lasts - but PEP has to be taken for 4 weeks, condoms are everywhere. PEP can be hard and sometimes impossible to get, and then to get in the required time, you control getting hold of condoms but doctors decide if you should get PEP and they may say no.

Q How many times can someone have PEP?

A Doctors decide who gets PEP and they are unlikely to give these expensive and powerful drugs to the same person time after time. So someone who keeps having unsafe sex will usually be offered help with having safer sex and will not be given PEP lots of times. Besides, the side effects often put people off wanting to take PEP more than once.

Q If one day I (or someone that I have had sex with) might have been at risk of getting HIV, what can I do?

A Check out the website www.chapsonline.org.uk or call THT Direct on 0845 12 21 200. Or call the clinic on 020 8725 3353.

THING TO REMEMBER ABOUT PEP:

PEP might stop a person getting infected with HIV
it must be started as soon as possible after unsafe sex or a condom not working - and definitely within 72 hours (3 days)
it means taking anti-HIV drugs for 4 weeks
side effects are common and can be very unpleasant
it's not guaranteed to work
not everyone wanting PEP will necessarily get it - doctors decide who gets it using the information given to them
PEP is not available at ALL clinics and hospitals