POST-EXPOSURE HIV PROPHYLAXIS (PEP)
Post-exposure prophylaxis (PEP) is a short course of antiretroviral treatment to reduce the chance of HIV virus being logded in the body after being exposed to it through sexual intercourse. However, take note that PEP does not guarantee someone exposed to HIV will not become infected with HIV. It is also not a substitute for other HIV prevention methods such as the correct use of condoms.
The estimated risk of HIV transmission per exposure from a known HIV-positive individual not on treatment is as follows:
|Receptive anal sex
||1 in 90|
|Insertive anal sex
||1 in 666|
|Receptive vaginal sex
||1 in 1000|
|Insertive vaginal sex
||1 in 1219|
|Performing oral sex
||< 1 in 10,000|
|Receiving oral sex
||< 1 in 10,000|
|Sharing drug injecting equipment
||1 in 149|
|Human bite / Semen splash to eye
||< 1 in 10,000|
* PEP is not recommended if the risk of exposure is < 1 in 10,000 or if the partner's HIV viral load is undetectable
Who should start PEP?
If you have had a high risk exposure within the last 72 hours (any unprotected anal or vaginal sex)
With a partner who is HIV positive
Is in a HIV-risk group e.g.
- Men who have sex with Men
- Bisexual men
- IV drug users
- Sex workers
- Victim of rape
How is PEP given?
The DSC Clinic offers a 28-day triple oral drug combination regimen of:
(Zidovudine 300mg/Lamivudine 150mg)
(Lopinavir 200mg/ Ritonavir 50mg)
(Emtricitabine 200mg, Tenofovir 300mg)
The cost of treatment at the DSC Clinic is up to $600 plus.
WHAT ARE THE COMMON SIDE EFFECTS ?
The common side effects are quite similar for all 3 drugs.
- Nausea or Vomiting
- Stomach upset
- Difficulty in sleeping
- Feeling tired or weak
BASELINE SCREENING AND FOLLOW UP
The following tests will be done at your first visit:
- HIV test
- Appropriate STI test as recommended by your doctor
Your doctor will advise you on the necessary follow up visits, but it is recommended that repeat HIV tests be done at 1 and 3 months
, in addition to completing all other appropriate STI tests.
Baseline tests will detect any pre-existing abnormality before treatment and can be repeated when necessary.
There is supportive evidence based on biologic possibility, animal & other studies that PEP can potentially decrease the risk of HIV acquisition if taken early enough. PEP is not given for exposures after 72 hours.
The treatment is not 100% effective and there have been cases of people who have still been infected with HIV despite receiving PEP.
PEP is not given to everyone because of the potential side-effects and also if the risk of the exposure is deemed to be extremely low (less than 1 in 10,000 chance) such that benefits of taking the medication outweigh the risks.
PEP is also not useful if you have had multiple high risk exposures over a prolonged period of time or continue to be at high risk for exposure. In such case, you may be more suitable for Pre-Exposure Prophylaxsis (PrEP), which is taken as a preventive daily medication. Please speak to your doctor to find out more.
SAFE SEX ADVICE
Safe sex is essential in preventing future exposures.
You can practice safer sex by:
- Having one partner at a time
- Using a condom for oral, vaginal or anal sex
- Going for regular STI & HIV screening
WHERE TO GET PEP
You can get PEP at the DSC Clinic during our operating hours.
Should you require PEP after our operating hours or over the weekends and the public holidays, you can head down to Tan Tock Seng Hospital A&E department.
Public Clinic (Level 1)*
|Monday to Friday|
8am – 11am
1pm – 4pm
|Women’s Clinic (Level 2)
||Tuesday to Friday |
1pm – 4pm
Evening Clinic (Level 1)
(mixed clinic for men & women)
|Monday & Friday|
4pm – 6.00pm
| Please note that DSC operates by appointments and patients are strongly encouraged to make an appointment with us. Walk-in patients are only seen under emergency situations.|
If you wish to make an appointment, please visit our Appointment Booking page.
We closed on Saturdays, Sundays and Public Holidays.
In case of emergencies outside of our operating hours, please visit the nearest A&E Department.
*The Public Clinic and the Evening Clinic accepts both male and female patients.
**All new cases and existing patients who have not seen a doctor for more than 2 years will be required to see a doctor for consultation