World Aids Day: PrEp and PEP and when to use it

Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) are treatment plans intended for people who run a high risk of HIV transmission but are currently HIV-negative.

HIV is transmitted through contact of bodily fluids, which can occur during sexual intercourse, shared needles, contact with blood, breast milk, or rectal, vaginal, or seminal fluids.

According to the prepdaily.org website, it is possible for someone to contract HIV if they have unprotected sex with a partner who has HIV or whose HIV-status is unknown. Someone who shared needles or drug preparation equipment with other people or someone who contracted an STD within the past six months might also be at risk.

The biggest difference between PrEP and PEP is timing because PrEP is a treatment plan to prevent HIV before a person is exposed while PEP is a treatment plan for after a person is exposed. The word prophylaxis means ‘treatment or actions taken to prevent a disease’.

“In order to qualify for PrEP, a person must be first tested for HIV and have a current undetectable viral load. PrEP can also only be given to a person who has not knowingly come into contact with possible HIV transmission. PEP is given to a person after possible transmission, while their viral load is still undetectable with a standard blood test. PEP is also given to people who think they may have been exposed to HIV through sexual contact, shared needles or someone who has been sexually assaulted. Also, if a healthcare worker is accidentally pricked by a used needle during work, they would likely be given PEP as a precautionary measure.”

Both treatments are free at public institutions or at a fee from private institutions.

According to the Desmond Tutu Health Foundation, you should take PrEP if you are:

• A sexual partner who is HIV positive and not on antiretroviral treatment or whose viral load is not yet suppressed.
• Sexually active in a high HIV prevalence population.
• Involved in vaginal or anal intercourse without condoms with more than one partner.
• A sexual partner with one or more HIV risk factors.
• Someone with a history of an STI by lab testing or self-report or syndromic STI treatment.
• Injecting shared needles.
• Breastfeeding from a HIV-positive person.