HIV Post Exposure Prophylaxis (HIV PEP) for HIV Prevention

 

Have you been exposed to HIV within the last 72 hours? HIV can be prevented with HIV PEP treatment.

What is HIV PEP / HIV Prevention / HIV Post Exposure Prophylaxis ?

HIV POST-EXPOSURE PROPHYLAXIS (PEP) is short-term antiretroviral treatment and medication to reduce the chance of HIV infection after potential exposure, through sexual intercourse, sexual assault, injection-drug use and other potential exposures.

When started within 72 hours from exposure, HIV PEP treatment has been shown to decrease the odds of HIV transmission with an exposure by 81%.

 

HIV Post Exposure Prophylaxis (PEP) or HIV Prevention

Is the use of antiretroviral (ARV) medications to prevent or to stop the human immunodeficiency virus (HIV) from entering and infecting the body after exposure.

Antiretroviral (ARV) medications or antiretroviral therapy (ART) has become the standard of care for healthcare workers who have had accidental occupational exposure to HIV for e.g. needlestick injuries or contact of mucous membrane or exposed skin to potentially infectious material such as blood or bodily fluids.

Post Exposure Prophylaxis (PEP) has also been offered to people who have had non-occupational exposure to HIV such as sexual intercourse or injection drug use.

A non-occupational high-risk exposure refers to:

  • any unprotected anal or vaginal intercourse, receptive oral intercourse with ejaculation with a partner known to be HIV-infected, or in HIV risk group (commercial sex workers, IV drug users, men who have sex with men/ bisexual men) 
  • sharing of or exposure to contaminated needles
  • sexual assault (rape) victims
  • HIV PEP treatment has been shown to decrease the odds of HIV transmission with an exposure by 81%

 

When should HIV PEP / HIV Post Exposure Prophylaxis (PEP) be started?

HIV PEP should be started as soon as possible after exposure up to 72 hours. The ideal time period to start PEP is within 24 hours from exposure, although it has been shown to be effective up to 72 hours post-exposure. When HIV PEP has started early, it is effective in preventing HIV transmission and infection.

Exposure and Estimated Risks

  • Needle stick injury: 1/300
  • Receptive anal intercourse: 1/100
  • Receptive vaginal intercourse: 1/1000
  • Insertive vaginal intercourse: 1/2000
  • Insertive anal intercourse: 1/2500
  • Receptive fellatio with ejaculation: 1/2500
  • Sharing needles: 1/150

Generally, exposures to saliva, urine, tears and sweat are non-infectious, and the risk of HIV transmission from splashes of contaminated fluids to mucosal surface or non-intact skin has not been accurately quantified, although it is likely to below.

Are other forms of STD/STI testing required?

If you have had a high risk exposure, we would also recommend testing for other common STDs or STIs such as syphilis, gonorrhea and chlamydia. Our STD/HIV clinic provides a full range of STD and STI testing services which can be done at the same time as the HIV testing.  HIV and STD tests can be customised to suit your risk profile. The timing of testing should be discussed with our doctor but generally we recommend testing at 2 weeks, 1 month and 3 months.

HIV PEP Singapore Treatment

This is a typical HIV PEP treatment process at our clinic:

  • Consultation – To advise if you are a right candidate for HIV PEP treatment
  • Rapid HIV test – To ascertain that you are currently HIV negative
  • Baseline blood tests – To make sure that your vital organs are functioning normally. If you are generally healthy, taking HIV PEP treatment would not cause any problems to your health
  • Start PEP Treatment – Daily medication for a month (A combination of 2 – 3 antiretroviral drugs)
  • Follow-up blood and HIV tests – after 1 month and 3 months post-exposure

For a private consultation with our doctors on whether you are a suitable candidate for PEP treatment, please call us for an appointment. The full course of HIV PEP treatment costs are between $2000 – $2400.