What’s the story with PEP (Post-Exposure Prophylaxis)?

News from our Medical Director, Robert Winn, M.D.

In the realm of HIV prevention some things are as true now as they were at the beginning of the epidemic.  Condoms are an incredibly effective way to prevent the virus from passing from one person to another (you just have to wear them!)  

There are other ways to lower HIV transmission risk as well.  When a condom breaks or when risky unprotected sex has occurred, there is a medical intervention that lessens the chance that an HIV exposure becomes an HIV infection.  This is known as post-exposure prophylaxis (PEP).  If significant exposure risk has occurred, you should contact a medical professional as soon as possible to see if prophylaxis can help you.  Taking one full month of HIV medications, if started within 72 hours of an exposure, can significantly reduce transmission of HIV.  

Last month, data were released showing that certain men at high risk for HIV could successfully reduce transmission rates by taking a daily regimen of HIV medication BEFORE HAVING SEX.  (This is known as Pre-Exposure Prophylaxis, or PrEP).  The study suggested that some men may benefit from this method as long as they adhere to the regimen.  While still very controversial, we may have found yet another prevention strategy for our armory to curb the trend of increasing HIV rates among men who have sex with men.

Sex is a natural part of life and something that we should talk more about, particularly ways to make it safer to enjoy.  Knowing your partners’ status is important information whether you’ve just met on manhunt or have been together for many years.  We need to be better at talking about sex before we have sex and making informed choices before the moment of passion.  Condoms should always be considered.  Choosing lower risk sexual activities (like oral sex) is certainly a way to reduce risk.  However, when a risky act does occur or if you are always engaging in unprotected sex, talk to you doctor about prophylaxis and if it’s right for you. 

All this being said, one of the most effective prevention strategies is knowing your status.  It is estimated that approximately 70 percent of new HIV infections originated from individuals who did not know their status.  Too many people don’t get tested regularly or at all, and continue to have unprotected sex without full knowledge of their status.  Free and anonymous testing is available at our Washington West Project and throughout the city.  Getting an HIV test as part of a routine office visit is another alternative.

Having HIV is manageable, but most people with HIV wish that they were negative.  Until we find a cure, using prevention methods is the only way to stay negative.