HIV PREVENTION

Do you believe you may be at risk of an HIV infection? Was the incident less than  hours ago? If yes to both, then HIV Post Exposure Prophylaxis may be necessary.  For Pre Exposure Prophylaxis (PrEP) please scroll further down. Post exposure prophylaxis is an effective method of reducing HIV infections when used soon after a potential exposure. The medication must be started within  hours of a potential exposure to be effective. The standard regimen is known as ‘triple drug therapy’ because the medication uses three active ingredients to stop HIV at different points in its life/replication cycle. Our current best practice is to use the World Health Organisation and CDC recommendations. The PEP is used for  days, after which you test for HIV to ascertain your status. This is as recommended by the CDC.

What should you do if you have had a potentially risky exposure?

The first step would to visit us within  hours of this exposure. We can then discuss the situation to see if the risk is significant enough to warrant PEP medication. If your risk deems you suitable for PEP, we would require a few preliminary tests first. Blood tests are needed to ensure that kidney and liver function are not compromised allowing you to safely complete the  day course of the medication. A rapid HIV test is also needed to ensure that there is no post exposure prophylaxis pre-existing HIV already in your body. After, we can start you on the medication and review you during the course, with an HIV test at the end to ascertain your status. Any further issues can be discussed during the consultation. Please see below for a guide to risk based on sexual exposure. Remember, everything discussed in clinic is fully confidential – no details will be reported. HIV Pre-exposure prophylaxis (PrEP) is an effective method of HIV prevention designed to give you protection even before an exposure has taken place. The medication is similar to PEP but only one tablet per day is required. Patients wishing to start PrEP should attend clinic for a consultation on safety and suitability. If PrEP is deemed suitable for you we can start by performing simple kidney and liver tests as well as a preliminary HIV test (to ensure the medication is safe to commence).

PrEP is ‘loaded’ into your body for 1 week, requiring one tablet per day for one week. During this time you are not fully protected against HIV so avoidance of high risk situations is recommended. After one week you are given protection provided you continue the tablet once daily until you wish to stop. Once the medication is fully effective in your system you will be given significant protection against HIV even if you have multiple exposures.When to test for HIV?We recommend you do routine testing for HIV every three months and liver/kidneys blood testing twice yearly. It is important to note that even though PrEP is very effective, it is not . Therefore practicing safe sex while on PrEP is still paramount.
How does it work? Pre-exposure prophylaxis/PrEP works by interfering with two key areas of the HIV replication cycle. The single tablet of PEP actually contains two active ingredients and they work to halt HIV. Even if there was resistance to one active ingredient, there is the second to fall back onto.
Confidentiality

One last thing to remember is that taking PrEP from us is entirely confidential. Post-exposure prophylaxis, or PEP, is a method of preventing HIV infection. It involves using a four-week course of the drugs used to treat HIV, taken very soon after a person may have been exposed to the virus.It is an emergency measure, rather than one to be used as a regular method of preventing HIV transmission. PEP has been used for many years for healthcare workers who have had possible exposure to HIV; for example, after accidentally pricking themselves with needles previously used on people who were known to have HIV or considered at high risk of having HIV.In the UK, PEP has also been made available to people who may have been exposed to HIV in other ways, including during sex.”Guidelines have set out the range of activities where risk of HIV is great enough that PEP is recommended.”PEP is not a ‘cure’ for HIV. PEP may prevent HIV from entering cells in the body and so stop someone from getting HIV. PEP isn’t  effective. However, there have been very few reports of HIV infection after the use of PEP. To have the best chance of it being effective, you need to start taking PEP as soon as possible after the possible exposure to HIV.

It is best to start PEP within  hours, but certainly within  hours. Where to get PEP Go to a sexual health clinic. If they operate an appointments system and are fully booked, explain that it’s an emergency and that you need to be seen. If your local sexual health clinic is not open (for example, at the weekend), go to an accident and emergency (A&E) department at a hospital, where staff will contact an HIV specialist able to prescribe PEP. GPs (family doctors) cannot prescribe PEP.Guidelines for prescribing PEP

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