Post Exposure HIV Prophylaxis
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Patient Care

 Post Exposure HIV Prophylaxis

 Post Exposure HIV Prophylaxis

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: 

 
Type of Exposure
 
 Estimated risk of HIV transmission 
 
from a known HIV-positive individual 
 
not on ART
 

​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

Or
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?

DSC clinic offers a 30-day oral antiretroviral drug regimen of Truvada (Emtricitabine 200mg, Tenofovir 300mg) for post-exposure prophylaxis (PEP) in the management of Human Immunodeficiency Virus (HIV) infection.. Rilpivirine may sometimes be combined with Truvada for a triple oral drug combination regimen.
​Rilpivirine®  25mg Tab
Truvada®
(Emtricitabine 200mg, Tenofovir 300mg)

The approximate cost of PEP treatment at the DSC Clinic ranges from $400-$500.



WHAT ARE THE COMMON SIDE EFFECTS ?

      Side effects of Truvada:
·         Diarrhoea
·         Nausea or vomiting
·         Stomach upset
·         Headache
·         Difficulty in sleeping
·         Feeling tired or weak
Side effects of Rilpivirine:
·         Nausea or vomiting
·         Stomach upset
·         Headache
·         Difficulty in sleeping
·         Drowsiness
 
  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.

IMPORTANT NOTES

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.

S​AFE SEX ADVICE

Safe sex is essential in preventing future exposures.

You can practice safer sex by:

  1. Having one partner at a time
  2. Using a condom for oral, vaginal or anal sex
  3. 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.
 
 
DSC Clinic Registration Hours
Public Clinic (Level 1)*
 



Monday to Friday
Morning Session
8am – 11am
Afternoon Session
1pm – 4pm
Women’s Clinic (Level 2)

With effect from 3rd Jan 2020, the Women's Clinic registration hours will be as follow:

 

Tuesday, Wednesday & Thursday 

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
 
Last updated on 10 Dec 2019