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Condom broke, no worries, PULSE CLINIC is here to offer emergency prevention for you 7 days a week.
Written by Dr.Deyn Natthakhet Yaemim (Founding Director) on 6 June 2016, last updated 28 Fevruary 2021
If you have had a high risk exposure to HIV in the last 72 hours, PEP must be started within 72 hours after a possible exposure to HIV.
It is most effective when started within 24 hours, the sooner someone starts PEP the better prevention.
Factors that can increase the risk of HIV infection and you are a potential candidate for PEP due to:
However, if you are unable to access PEP within the 72 hours, even if it has been up to 5-7 days since the exposure occurred, it is still worth seeking medical advice to see what your options are. This may include commencing a 3-drug combination of antiretroviral medications as soon as possible just in case you have become HIV positive. In this case, you would be starting very early treatment and minimising the damage to your immune system.
PEP means Post-Exposure Prophylaxis. It refers to a management to prevent HIV infection for those who are HIV negative and potentially exposed to HIV, by taking PEP it means the person is taking AntiRetroviral medication to prevent/stop HIV from being established in the body of the person.
For more information about the medication and ordering process,
please email pulseliving@pulse-clinic.com or chat on your preferred platform.
+66-84-226-2569 @pulserx PulseClinic
It takes a few days for HIV to become established in the body following exposure. Once it is established you will have HIV for the rest of your life. However, if you begin taking PEP in time, the anti-HIV drugs will prevent the HIV (that's already in your body) from reproducing and it DIES out before it has a chance to multiply. PEP drugs given at this time may help the body’s immune system to stop the virus from replicating (multiplying) in the infected cells of the body. The cells originally infected would then die naturally within a short period of time without producing more copies of HIV.
The golden period for PEP medication is 72 hours after a potential exposure to HIV, and it is proven to be highly effective if it is started within this period. PEP can make sure that you won’t be infected with HIV, regardless of the means that you caught it. However, you must take it daily for at least 28 days, and on top of daily dosage, it must be at the same hour every day. This is because the PEP drug will show its full effectiveness if taken as mentioned.
PEP is the right tool for you to use to prevent yourself from getting HIV if
Not if you act quickly. After HIV gets in the bloodstream it takes some time before it permanently establishes itself in the body. If a person who has been exposed to HIV acts quickly to get PEP (within 72 hours) they stand a good chance of stopping the virus from establishing itself in their body.
Research indicates that taking PEP makes infection with HIV a lot less likely. But PEP doesn’t work every time – some people who take it still end up with HIV afterwards. It can fail because:
- the person doesn’t or isn’t able to take PEP as prescribed (every day for a month)
- some anti-HIV drugs don’t work against some strains of HIV (HIV drug resistant, although this is rare)*
- the initial viral load (the amount of HIV) in the body was too great for the drugs to be effective**
However, the sooner PEP treatment is begun after exposure to the virus, the more likely it is to work.
1. Consultation
2. Rapid screening for HIV, Hepatitis B virus with result in 15 minutes, accuracy 99.9%
3. Kidney function tests
4. PEP Medications
5. Test or treatment for possible sexually transmitted infections
We use the latest gold standard PEP medicines with fewer side effects and better HIV prevention which will be taken for 28 days.
For adults: Tenofovir combined with either Tenofovir (TDF) and emtricitabine (FTC) as preferred backbone drugs and these are also the preferred drugs for treating HIV.
The recommended third drug, which is also recommended by WHO and CDC as a preferred drug for HIV treatment, will be chosen by your doctor.
There are some of our clients who do not understand when our doctors try to explain about HIV drug resistant. If you are unlucky and being exposed to such HIV, the classic PEP medications are not able to help you. That's why American CDC suggested on their PEP treatment guidelines that we should use a higher class of drugs that is less likely to be resisted by the HIV drug resistant type. These higher class medications are available at our clinics and they are costly. Much more expensive than the classic PEP medications generally used in low income countries. When our doctors prescribe this higher class PEP medications it is because they evaluate that your risk is very high and they are trying to keep the standard as high as American Center of Disease Control Guidelines for PEP treatment.
At PULSE CLINICs, your doctor might advice that you get treatment as prevention for possible gonorrhoea, chlamydia, syphilis after unprotected sex or sexual accident. And they will suggest that you get tested to sreen for STIs/STDs such as ureaplasma parvum, ureaplasma urealyticum, mycoplasma hominis, mycoplasma genitalium, trichomonas vaginalis, LGV because up to 70% of people who are infected do not have any symptoms (asymptomatic infecitons) and pass on the infections to other people without knowing. Most of us think that STDs/STIs are transmitted through sexually contact only but in 2021 that's not true anymore because we know that there are numbers of STDs/STIs that spread via direct contact (skin-to-skin) such as touching.
- You are confident that your partner doesn't have HIV.
- The partner is HIV positive and on successful treatment (Known as ‘undetectable viral load')
- Human bites
- Another person's semen gets in your eye.
Trust PULSE CLINIC to take care of your health like other 45000 people from over 130 countries. We provide discreet professional service with high privacy. Here to help, not to judge.
The doctor will try to evaluate how likely it is you have actually been exposed to HIV before starting treatment.
Questions will include what happened to make you think you’ve been exposed to HIV, what sort of sexual or injecting activity or partner is likely to be HIV-positive. We will ask you things like if you know whether the person has HIV (and if they are HIV-positive, if you know if they have an undetectable viral load), and in the case of a possible exposure through a sexual encounter, we will ask about things like: the kind of sex you had (e.g., anal, vaginal or oral sex); if you fucked them or they fucked you; if either of you came inside the other; and if there is anything else you are worried about.
"It is important to be honest and accurate in providing this information – WE are there to help you, not to judge you."
and the information will help us to assess the seriousness of the situation.
The risk of getting HIV from oral sex is extremely low. PEP is not recommended after possible exposure to HIV through oral sex. The only exception would be following receptive oral sex from a partner known to have HIV and when the receptive partner has cuts or lesions such as ulcers in their mouth.
At PULSE CLINICS (every branches throughout Asia) we have seen this more than 5000 times before, you're not the first and not the last. The doctor won't judge, He/She will be very helpful and make you feel at ease. If you think you're at risk and need PEP, call us.
With the new PEP drugs we use, side effects are very rare. Fewer than 1 in 100 of our patients actually develop any side effects.
Common side effects (<1%) include nausea, diarrhoea and feeling tired. Rash and fever are uncommon (< 0.1%) side effects. So does PEP have any side effects? Some side effects like nausea, dizziness, may occurred but they usually subside in one week. These side effects aren’t life-threatening.
- PEP must be started within 72 hours after a recent possible exposure to HIV, but taking it as soon as possible is the best way to do.
- If you’re prescribed PEP, you’ll need to take it once or twice daily for 28 days.
- PEP is effective in preventing HIV when administered correctly, but not 100%
The PEP guidelines around the world stated that PEP should be taken 28 days to achieve a successful treatment. However, most drugs will contain 30 pills in a bottle, which leads to some healthcare provider to sell the whole 30 pills in a bottle instead of separate pills. Anyway, all you need is 28 days of treatment and then you're done. You don't need to take it for 30 days.
There have been small animal studies that have suggested 28 days is optimal and a case-control study of health care workers showed failure of PEP when the 28 days of treatment was not completed. Therefore, current guidelines recommend that 4 weeks of PEP should be used.
Here are a few tips that may help you remember to take PEP each day for the month:
- Set a daily alarm or reminder on your mobile phone to remind you to take your medications.
- Take your drugs at the same time each day (e.g., after breakfast, after dinner).
- Put your PEP drugs near something you use daily, as a reminder.
- Take your medications at the same time you brush your teeth – and place the medications near your toothbrush so you will notice them.
- Keep a post-it-note attached to your fridge or noticeboard with the letter ‘P’ on it; this will be a discreet reminder to you to take your drugs.
- If you are planning a big night out, carry enough of your PEP drugs to take in case you don’t make it home.
- Get someone you trust to remind you to take your medications.
You can check the PEP cost at your nearby healthcare provider as each place will have different pricing for this service. You can enquire about the payment options too, as some places will accept only in cash but not cards.
PULSE CLINICS accept payment with credit cards, debit card, cash and bank transfer.
Check with your insurance company if PEP is covered, we can issue a medical certificate together with receipt, many of our patients use that to be reimbursed form their insurance.
You may drink moderate amounts of alcohol (within normal recommended safe limits) while taking this medication.
PEP can interact with other drugs (including other prescription drugs, supplements and vitamins) and change the way the PEP drugs work. Taking recreational drugs while on PEP can be risky. Recreational drugs can have severe side-effects in combination with some of the PEP drugs. Talk to the doctor or nurse who prescribes you PEP about any other prescription or recreational drugs you may be taking or planning to take. If you wish to take recreational drugs while on PEP, talk to the doctor who prescribed you PEP. If you usually take multivitamins, calcium tablets or treatment for indigestion, please discuss this with the Doctor or Nurse as they may affect how well the Raltegravir is absorbed.
Once started, it is not recommended to stop even though you will get HIV PCR test and it may comes out negative. Stopping the PEP course before 28 days is highly dangerous as it may result in PEP failure, and failing treatment means a risk of getting HIV infection.
There’re possibilities that PEP can fail to prevent HIV infection. This is due to four possible reasons,
Once you've finished the course of PEP, see your provider or come back to us to get tested for HIV, the doctor will evaluate your risks and might recommend you to start taking PrEP. You should get tested again 1 and 3 months after you have finished the PEP to confirm your HIV status this is because PEP can delay HIV infection!
Well, practically yeah sure you can take PEP every time you have unprotected sex but it is not recommended because preventing the infection after the risks has happened is not better than preventing it BEFORE the risk will happen. There's a thing called PrEP which refers to Pre-Exposure Prophylaxis which means you take PrEP and you are protected even before you have sex. If you can anticipate any unprotected sex in the future you better take PrEP in-advance to protect yourself as it is cheaper than a course of PEP (and less terrifying), and PrEP can prevent you from HIV infection up to 99% if you take it daily. Want to know more about PrEP? Read here
For more information about the medication and ordering process,
please email pulseliving@pulse-clinic.com or chat on your preferred platform.
+66-84-226-2569 @pulserx PulseClinic
#BuyPrEPonline #iwantprepnow #PrEPatPULSE #PulseClinicBKK #PrEPinBangkok #prepinKL #prepinMalaysia #prepinPhuket #prepinHongKong #prepasian
Activity | Risk-per-exposure |
---|---|
Vaginal sex, female-to-male, studies in high-income countries | 0.04% (1:2380) |
Vaginal sex, male-to-female, studies in high-income countries | 0.08% (1:1234) |
Vaginal sex, female-to-male, studies in low-income countries | 0.38% (1:263) |
Vaginal sex, male-to-female, studies in low-income countries | 0.30% (1:333) |
Vaginal sex, source partner is asymptomatic | 0.07% (1:1428) |
Vaginal sex, source partner has late-stage disease | 0.55% (1:180) |
Receptive anal sex amongst gay men, partner unknown status | 0.27% (1:370) |
Receptive anal sex amongst gay men, partner HIV positive | 0.82% (1:123) |
Receptive anal sex with condom, gay men, partner unknown status | 0.18% (1:555) |
Insertive anal sex, gay men, partner unknown status | 0.06% (1:1666) |
Insertive anal sex with condom, gay men, partner unknown status | 0.04% (1:2500) |
Receptive fellatio | Estimates range from 0.00% to 0.04% (1:2500) |
Mother-to-child, mother takes at least two weeks antiretroviral therapy | 0.8% (1:125) |
Mother-to-child, mother takes combination therapy, viral load below 50 | 0.1% (1:1000) |
Injecting drug use | Estimates range from 0.63% (1:158) to 2.4% (1:41) |
Needlestick injury, no other risk factors | 0.13% (1:769) |
Blood transfusion with contaminated blood | 92.5% (9:10) |
Sources: vaginal sex;1 anal sex;2 fellatio;3 2 mother-to-child;4 other activities.5
References
1. Boily MC et al. Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies. Lancet Infect Dis 9(2): 118-129, 2009
2. Vittinghoff E et al. Per-contact risk of human immunodeficiency virus transmission between male sexual partners. American Journal of Epidemiology 150: 306-311, 1999
3. Del Romero J et al. Evaluating the risk of HIV transmission through unprotected orogenital sex. AIDS 16(9): 1296-1297, 2002
4. Townsend C et al. Low rates of mother-to-child transmission of HIV following effective pregnancy interventions in the United Kingdom and Ireland, 2000-2006. AIDS 22: 973-981, 2008
5. Baggaley RF et al. Risk of HIV-1 transmission for parenteral exposure and blood transfusion. AIDS 20: 805-812, 2006
updated on 28 February 2021.
Trust PULSE CLINIC to take care of your health like other 45000 people from over 130 countries. We provide discreet professional service with high privacy. Here to help, not to judge.