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Post-Exposure Prophylaxis (PEP) for HIV in Malaysia: Immediate Care After Exposure

June 18, 2024

Have you ever had a high-risk sexual encounter?

Are you now concerned about contracting HIV?

Is there anything that can be done to save you from contracting HIV?

When you’re in a situation where you’ve had unprotected high-risk sexual contact with someone whose HIV status is unknown, these questions will race through your mind.

PEP – Post-Exposure Prophylaxis – is the solution.

If you think you’ve recently been exposed to HIV, talk to your health care provider, an emergency room doctor, or an urgent care provider about PEP as soon as possible (within 72 hours).

What is PEP?

PEP (post-exposure prophylaxis) means taking medicine to prevent HIV after a possible exposure. It must be started within 72 hours of possible HIV exposure.

PEP should be started as soon as possible. Every hour is crucial. If you’re given PEP, you’ll have to take it every day for at least 28 days.

They are given for emergency situations whereby a possible exposure towards HIV is suspected. For example:

your condom broke during sexual intercourse with a partner with unknown HIV status.
sharing needles, syringes or other equipment to inject drugs.
if you’ve been sexually assaulted.

HIV testing is a must before PEP can be prescribed to you and a retest is needed after completion of the 28-days treatment.

Your doctor will decide whether you are eligible for the prescription based on the risk of your sexual exposure. Please keep your composure and don’t let your fear get the best of you. There is no threat of HIV from sexual exposures such as deep throat kissing that do not involve any blood exchange. Again, oral sex with no blood exchange carries a minimal chance of HIV transmission.

What are the drugs included in PEP?

PEP comprises of antiviral medications such as:

Truvada
1. Emtricitabine
2. Tenofovir disoproxil fumarate
Isentress
1. Raltegravir

How effective is PEP?

After being exposed to HIV, it takes a few days for the virus to establish itself in the body. Once HIV is detected, you will be infected for the rest of your life. If you start PEP early enough, the anti-HIV medications can keep the HIV (which is already in your body) from reproducing, and it will die out before it can spread.

PEP is highly effective in preventing HIV if taken within 72 hours of potential exposure. PEP drugs given at this time may aid the immune system in preventing the virus from replicating (multiplying) in the body’s infected cells. The HIV-infected cells would then die naturally after a short period of time, without making any further copies of the virus.

However, you should take additional precautions to protect your partners whilst taking PEP. This involves using condoms for sexual activity at all times and not exchanging needles, syringes, or other injecting tools.

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Are there any side effects of taking PEP?

Nausea, diarrhoea, rash, and numbness are only a few of the unpleasant side effects. More serious side effects include kidney and liver toxicity.

You must balance the risks of taking these medications for 28 days against the potential benefits. If your chance of contracting HIV is still very low, the advantage of taking PEP is negligible. Together with the help of your doctor, you can objectively rationalise your options.

You might not need PEP if:

you are confident that your partner does not have HIV.
the partner is HIV positive but is on treatment and compliant to them.

Frequently Asked Questions (FAQs)

1. If the HIV virus is already in the body, isn’t it too late to prevent the infection?

You won’t be infected if you act fast. It takes time for HIV to permanently develop itself in the body after it enters the bloodstream. If a person who has been exposed to HIV gets PEP as soon as possible after being exposed to the virus (within 72 hours), they have a fair chance of preventing the virus from establishing itself in their body.

2. If I take PEP, I won’t become HIV positive?

According to research, taking PEP reduces the risk of HIV infection significantly. However, PEP does not always work; some people who take it develop HIV afterward. It has the potential to fail because:

the person is not compliant to the PEP as prescribed (every day for a month)
the anti-HIV medications do not work against some HIV strains (HIV drug resistant) but this is rare.
the initial viral load (the amount of HIV in the body) is too great for the drugs to be effective

Nevertheless, remember that the sooner PEP treatment is begun, the more likely it is to be effective.

3. How can I remember to take my PEP?

Here are a few tips that may help you on being compliant to your medication:

Set a daily reminder or alarm on your mobile device
Take your medications at the same time every day. For example, after breakfast or after dinner.
Store your PEP medications near something you use daily such as your watch or toothbrush as a reminder – each time you put on your watch or brush your teeth, you will notice them.
If you are planning for a night out, carry enough of your medications to take in case you couldn’t make it home.
Get someone trustworthy to remind you to take your medications.

4. I have completed my 28 days course of PEP, what should I do next?

If you’ve completed the PEP course, see your doctor and get tested again for HIV. The doctor will assess the risks and may advise you to begin taking PrEP. You should also get tested again for HIV 3 months after you’ve completed your PEP to confirm.

If you are not yet exposed to HIV, you may want to consider PRE EXPOSURE PROPHYLAXIS(PrEP)