Positive Life NSW Blog

50% of HIV-negative guys don't know about PEP: What's going on?

Posted by on in Advocacy and Policy


PEP (post-exposure prophylaxis) is the technical jargon for treatment that can stop you getting infected with HIV after a risky exposure (i.e. “We didn’t use a condom when fucking and I’m worried about HIV”).

PEP has been around since the mid-1990s and is highly effective at stopping HIV infection before it becomes an infection. However, the effectiveness of treatment is time dependent. You’ve got a short window of opportunity to access treatment, and that window is up to 72 hours – preferably the soon the better. After that, PEP is less effective at knocking out the HIV virus, and the longer you leave it, the higher the chance that PEP won’t eliminate HIV and you’ll potentially become HIV-positive.

So, when I recently read that about half the HIV-negative men having sex with men in Sydney don’t know about PEP, I was shocked! And it seems that knowledge of PEP has been declining, according to John McAllister who runs the PEP Hotline Service at St. Vincent’s Hospital and research published in the Sydney Gay-Community Periodic Surveys.

You have to wonder, how many of the 356 newly diagnosed infections in 2013 could have been averted with PEP, particularly since between 70 percent to 85 percent of all those new infections were in men who have sex with men.

So what’s involved if you have had risky sex? Well, if you think you may have been exposed to HIV, call 1800 PEP NOW (1800 737 669). Risky sex would be getting fucked without a condom and not knowing the partner's HIV-status, or sharing needles or equipment with others of unknown status.

Last year, 721 people called the 1800 PEP NOW after-hours call service and about half (447) were referred for PEP. Not surprisingly, most calls to the PEP hotline were on Saturday and Sunday nights, with the elapsed time from exposure to triage by the St. Vincent’s team averaging 16 hours. Most partners were of unknown HIV status.

If PEP is prescribed, it’s usually a combination of three well-tolerated and highly effective antiretrovirals, taken daily for 28 days. Side-effects are minimal or mild and can be well managed by the clinical team at St. Vincent’s.

PEP is reported to be 80 percent effective, but efficacy improves the sooner you start treatment and is dependent on your adherence to the drugs for the 28 days.

I remember having a conversation with some guys who attended the Genesis workshop for newly-diagnosed gay men some years back. They could recall when they thought they were infected and regretted not taking PEP. They told me that they would have rather endured even severe side-effects for a brief period than end up with HIV for the rest of their life. Any inconvenience from PEP seemed a small price to pay, to get rid of HIV.

So, remember to call the 1800 PEP NOW number if you have engaged in risky sex. It’s better to take antiretrovirals for 28 days, instead of living with HIV for the rest of your life. There’s no shame in asking for help! Write it on a card and keep it handy in your wallet. If you or a mate has been exposed to HIV, take the initiative and look after one another by ringing 1800 PEP NOW.

And remember, we can all play an important role in ending HIV in NSW. We just need to be informed and to give a f**k!

Also published at GayNewsNetwork 15 April 2014

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