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A bit of PEP talk

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I have recently beenhearing a radio advert where a girl tells her friend that she had unprotectedsex and fears that she may have potentially been exposed to HIV. Her friendthen asks her if she has heard about PEP, to which the girl replies that shehadn’t. Just like the girl, I had also never heard about PEP and so thought I woulddo some research and post it in a blog in case there are other people who havenot heard of this relatively new regime!

PEP is short for PostExposure Prophylaxis. It was actually first used with health workers who hadbeen accidentally pricked with a needle used for someone thought to have hadHIV. Now, it can be used as a course of medication to prevent HIV developing inthe body if someone has been exposed to the virus, such as through unprotectedsex or exposure to blood/infected bodily fluids. PEP should be takeneveryday for four weeks and the medication is a series of anti-HIV drugs, thesame ones that HIV positive people take as their combination therapy (alsoknown as HAART).

Time is an essentialfactor here. PEP needs to be started within 72 hours of exposure to HIV, withthe sooner it being taken the better. It can take hours to a few days for HIVto permanently infect a person, and this is where PEP comes in. If drugs aretaken that can interfere with this early process, the HIV infection can then beprevented from becoming permanent. After 3 days, the virus would have spread toother parts of the body and so any drugs taken beyond this time would not havean effect on the virus. PEP is also not guaranteed to work; it may not betaken soon enough and/or some HIV drugs may not work against certain strains ofHIV. The HAART combination therapy is selected based on the individual patientsuch as their adherence, toxicity of drugs and cost.

The criteria thatdetermine who can get PEP is strict, so cannot be given to anyone and sideeffects such as diarrhoea, headaches and vomiting are common. The side effectsin itself may need medication to be controlled and can also cause people tostop their PEP treatment. It is therefore important to state that PEP is seenas another way to prevent HIV, and nota cure for it. Awareness of preventing the transmission of HIV is the overallkey treatment.

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