Sexual Health / HIV/HIV post-exposure prophylaxis

PEP / PEPSE

also: post-exposure prophylaxis · PEPSE

Overview

A 28-day antiretroviral course started AFTER a possible HIV exposure (sexual or occupational/needlestick) to prevent seroconversion. Time-critical.

Mechanism

A short triple-ART course (typically tenofovir/emtricitabine + raltegravir/dolutegravir) suppresses any virus before it establishes systemic infection — the window of opportunity is narrow.

Indications

Significant HIV exposure (condomless sex with high-risk source, needlestick from HIV+ source)

Adverse effects

GI upset, fatigue, headachecommon

As per the component antiretroviralscommon

Cautions & contraindications

Presentation >72 hours after exposureall

PEP is ineffective beyond 72 h — start ASAP, ideally within hours.

Interactions

As per ART components

Monitoring & kinetics

Baseline + follow-up HIV test (at 8–12 weeks after exposure),Hepatitis B/C, STI screen, renal function

Oral triple therapy for 28 days. Start within 72 h (sooner = better).

Choosing it

true

Source: BASHH — PEPSE guidelines · BNF — Post-exposure prophylaxis