PEP - Emergency HIV Prevention

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.

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. 

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.

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.