What is PEP?
PEP is short for Post-Exposure Prophylaxis. It's a course of medication you take after being exposed to HIV (within 72 hours) to reduce the risk of becoming HIV-positive. A course of PEP lasts 28 days and includes Truvada (a medication used for PrEP, and also for treating HIV) along with another anti-HIV drug.
To get PEP, you should go to an emergency room within 72 hours of exposure, ideally as soon as possible. The clinician there will then make an assessment of your HIV risk, and will prescribe PEP if you meet the criteria.
How does PEP work?
PEP prevents HIV from spreading in your system by stopping it from replicating itself in your bloodstream. Taking PEP daily for the entire 28 days helps ensure the medication is effective at preventing HIV infection.
What is PEP-in-Pocket (PIP?)
PIP is Post-Exposure Prophylaxis (PEP) prescribed to you in advance so you have it on hand in the event of an unexpected high-risk HIV exposure.
Having PEP 'in pocket' allows you to start medication as soon as possible by removing the need to find a healthcare provider within the 72-hour window required to start PEP. PIP means less stress because the prescription is already in your hands.
How effective is PEP?
Taken consistently and for the full 28 days, PEP is very effective at preventing HIV. Studies have shown PEP can be more than 80% effective when taken correctly.
How do I get PIP with Freddie?
PIP is currently available to Freddie patients in Ontario only. If you are stopping PrEP or switching from daily PrEP to PrEP On-Demand (PrOD), book an appointment with your Freddie clinician. In this appointment you can talk about ongoing risk and prevention methods, and your clinician can provide a PIP prescription. Please note that Freddie provides PIP only, and does not offer PEP in response to an HIV exposure (i.e. within the 72 hour period). If you have had an HIV exposure and do not have a PIP prescription, please seek care at your nearest emergency room.
What follow-up do I need?
If you have used a PIP prescription from us, you will need to book a follow-up appointment with Freddie within one week of starting PEP. At this appointment, you will receive a lab requisition for baseline blood work to be done as soon as possible and then again at 12 weeks post-exposure. This blood work will help your healthcare provider confirm your HIV status.
What are the common side effects of PEP?
PEP is generally well tolerated with minimal side effects. Common side effects for persons who do experience them include nausea, diarrhea and fatigue.
What next?
Start your PEP as soon as possible if you think you have been exposed to HIV. Ideally, it is started less than 24 hours after the exposure, but it must be within 72 hours to be effective.
Book a follow-up appointment with Freddie as soon as possible but no later than 1 week after starting your PIP for blood work and ongoing follow-up.