Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP)

PrEP” stands for Pre-Exposure Prophylaxis. The word “prophylaxis” means “to prevent or control the spread of an infection or disease.” PrEP is a way for people who don’t have HIV to prevent HIV infection by taking a pill every day. The pill contains two medicines that are also used to treat HIV. If you take PrEP and are exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from taking hold in your body. Along with other prevention methods like condoms, PrEP can offer good protection against HIV if taken every day.

PrEP is not for everyone. CDC recommends PrEP be considered for people who are HIV-negative and at substantial risk for HIV infection.

This includes anyone who:
Is in an ongoing relationship with an HIV-infected partner;
Is not in a mutually monogamous relationship with a partner who recently tested HIV-negative; and is a
gay or bisexual man who has had sex without a condom or been diagnosed with a sexually transmitted infection within the past six months;
heterosexual man or woman who does not regularly use condoms when having sex with partners known to be at risk for HIV (e.g., injecting drug users or bisexual male partners of unknown HIV status); or
Has, within the past six months, injected illicit drugs and shared equipment or been in a treatment program for injection drug use.

PrEP is a powerful HIV prevention tool. However, for sexually active people, no prevention strategy is 100% effective. Therefore, individuals who use PrEP should use it along with other effective HIV prevention strategies.

These include:
Using condoms consistently and correctly
Getting HIV testing with your partners
Getting STD testing with your partners
Choosing less risky sexual behaviors, such as oral sex.
If you inject drugs, participating in a drug treatment program or using sterile drug injection equipment.

Also, PrEP is only for people who are at ongoing substantial risk of HIV infection. For people who need to prevent HIV after a single high-risk event of potential HIV exposure—such as sex without a condom, needle-sharing injection drug use, or sexual assault—there is another option called postexposure prophylaxis, or PEP.

Post-Exposure Prophylaxis (PEP) involves taking anti-HIV medications as soon as possible after you may have been exposed to HIV to try to reduce the chance of becoming HIV positive. These medications keep HIV from making copies of itself and spreading through your body.

There are two types of PEP:
(1) occupational PEP (sometimes called "oPEP"), taken when someone working in a healthcare setting is potentially exposed to material infected with HIV, and
(2) non-occupational PEP (sometimes called “nPEP”), taken when someone is potentially exposed to HIV outside the workplace (e.g., from sexual assault, or during episodes of unprotected sex or needle-sharing injection drug use).

To be effective, PEP must begin within 72 hours of exposure, before the virus has time to make too many copies of itself in your body. PEP consists of 2-3 antiretroviral medications and should be taken for 28 days. Your doctor will determine what treatment is right for you based on how you were exposed to HIV. PEP is safe but may cause side effects like nausea in some people. These side effects can be treated and are not life threatening. PEP is not 100% effective; it does not guarantee that someone exposed to HIV will not become infected with HIV.

To be effective, PEP must begin as soon as possible, but always within 72 hours of exposure. Your healthcare provider will consider whether PEP is right for you based on how you might have been exposed and whether you know if the person whose fluids you were exposed to might be HIV-positive. You will be asked to return for more HIV testing at 4 to 6 weeks, 3 months, and 6 months after the potential exposure to HIV.

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