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PEP - Emergency HIV Prevention

Rongoa ī muri te huranga

So, you’re having sex and… the condom broke / you didn’t use one / you aren’t on PrEP / your partner doesn’t have an undetectable viral load – and you think there’s a chance you’ve been at risk of contracting HIV.

Take a deep breath and remember these three letters: P-E-P.

What is PEP?

PEP (post-exposure prophylaxis) means taking medicine to prevent HIV infection after a possible exposure. It needs to be taken within 72 hours of possible exposure, the sooner the better.

Unsure if you need PEP?

Use our tool to find if your at risk, it will recommend if PEP is a good option for you.

  

How to get access to PEP?

Head to your GP, your local after-hours clinic, or the emergency department at your local hospital as soon as you can – as the longer you leave it, the less chance it will be effective. 

Your GP or the clinical staff at the after-hours or the emergency department may need to ask you some pretty personal questions to assess your likelihood of exposure – this may feel a little awkward, but they’re just trying to make sure you get the care you need. So, it’s important to be honest. 

If you go to after-hours or the emergency department, the first people you encounter may not have heard of PEP but make sure you insist that you have potentially been exposed to HIV transmission and would like to see someone who knows about PEP so you can start within 72 hours of your exposure.  

Most A&E/Emergency departments should have a supply of PEP but may need a little time to get prescription approvals. 

Some pharmacies may also stock PEP. This site includes a list of all pharmacies that may stock PEP, however it's best to call in advance to ensure they actually have stock when you need it

Initiating PEP should be completely free for those eligible for publicly funded healthcare in New Zealand who meet one or more of the following PHARMAC criteria: 

  • You have had condomless anal intercourse or receptive vaginal sex with someone living with HIV with an unknown or detectable viral load. 
  • You have had condomless anal intercourse with someone from a high HIV prevalence country or high HIV risk group with an unknown HIV status. 
  • You have shared intravenous injecting equipment with someone living with HIV  
  • You have had non-consensual intercourse and your doctor thinks PEP would be suitable

Please note that in Aotearoa, HIV disproportionately affects gay, bisexual, and other men who have sex with men (GBM). They are 348 times more likely than heterosexual people in Aotearoa to be diagnosed with HIV. 

If you are part of this community and you have had condomless anal sex with someone who doesn’t know their HIV status or is HIV positive but with a detectable or unknown viral load, PEP might be right for you.  

If you don't meet the criteria for funded PEP, ask your doctor about self-funding - they can still write a prescription and you can pay for your own PEP pills at the pharmacy (approx $15 plus pharmacy mark-up). 

Once you have initiated PEP – make sure to follow the doctor’s instructions carefully and you will need to book follow-up HIV tests to see whether PEP has been successful. Your doctor will advise you on when is the best time to do this.

Prep

Struggle with consistent condom use?

You could consider taking PrEP to stay safe.

PrEP is a medication that prevents HIV negative people from acquiring HIV. 

 

Remember:

Condoms (and lube!), PrEP and U=U are the best ways to prevent HIV transmission – PEP is a bit of an emergency safeguard if something happens that you weren’t expecting, or didn’t have all the information about, during the encounter.

Basically, don’t think of PEP as part of your regular prevention toolbox – it’s more of the “break glass in case of emergency” box.

If you find that you’ve had to initiate PEP a couple of times now, it would be worth looking into whether PrEP is right for you.

 

What if…?

If PEP doesn’t work or isn’t made available to you – it’s important to remember that with modern treatments and scientific understanding, being diagnosed with HIV today is very different to how it used to be.

If you are diagnosed with HIV, you can be connected to treatment immediately, no matter your situation or immigration status and it is very likely you will reach what is called an undetectable viral load (UVL) within a few months or even less. Having UVL means you will get the most health benefits from being on treatment, including not being able to transmit HIV through sex.

While prevention is a very important part of stopping new HIV transmissions, if PEP fails – remember that your life is far from over. Head to the U=U page to learn more and reach out to NZAF’s counselling services if you would like to talk to someone.

 

Featured FAQs

What’s the difference between PrEP and PEP?

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PrEP and PEP are both HIV medications taken by people who do not have HIV. 

PrEP (Pre-Exposure Prophylaxis) is an HIV medication for people who are HIV negative - taken to significantly reduce the risk of acquiring HIV.

PEP (Post-Exposure Prophylaxis) is a medication given to people who may have been exposed to HIV. Although PEP is not foolproof, if taken within 72 hours of being exposed to HIV, it is likely to reduce the chances of contracting HIV. For PEP to be most effective, it needs to be taken as soon as possible after an episode of unprotected anal sex.

I had sex with a guy and I was the top. I came inside him and the condom broke. Should I get PEP? This was anonymous sex and I don't know this man. How much does PEP cost?

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If the condom broke then there is a risk of contracting HIV. While the risk is greatest for the bottom, it is still high-risk for the top because if the bottom has HIV it can be highly concentrated in the lining of his ass which can then enter the tip of your penis.

PEP is free under certain circumstances: 

  • If you know that the person you were having sex with is HIV positive and has an unknown or detectable viral load.  
  • If the person you were having sex with doesn’t know their status but is from a high HIV prevalence country or high HIV risk group 
  • If you have had non-consensual intercourse with someone and your doctor thinks PEP is suitable 

In other situations, you may have to pay. Ask your doctor about self-funding - they can still write a prescription and you can pay for your own PEP pills at the pharmacy (approx $15 plus pharmacy mark-up). 
 
We recommend visiting your local sexual health clinic, the emergency department of your nearest hospital, the local after-hours clinic, or even contacting your GP as soon as possible to find out your options. For PEP to be effective, it needs to be started as soon as possible and no later than 72 hours after exposure to HIV. 

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