Post-Exposure Prophylaxis (PEP)

Post-Exposure Prophylaxis

Among the concerns a survivor may have following a sexual assault, the fear of HIV infection is one that many share. While this resource cannot serve as a substitute for sound medical advice, the following information is intended to answer common questions related to accessing and using post-exposure prophylaxis (PEP) and to connect survivors to available resources. While the risk of contracting HIV from a sexual assault is relatively low, there are still options to help reduce it.

WHAT IS PEP?

Post-exposure prophylaxis (PEP) is a series of pills a person can take after possible exposure to HIV. Exposure is defined as coming into contact with body fluids of someone with HIV, such as blood, semen, and vaginal fluids. When taken within 72 hours of possible exposure, PEP lowers a person’s chance of getting HIV.2 The medicines used in PEP are called antiretroviral medications (ART). These medicines work by stopping HIV from spreading through your body.

PEP is different from pre-exposure prophylaxis (PrEP). PrEP is a preventative medicine used by people who are at high risk for being exposed to HIV, to prevent exposure through sexual contact or intravenous drug use. Find more information about PrEP here.

HOW DO I TAKE PEP? HOW LONG WILL I BE ON IT?

You take PEP 1-2 times a day for at least 28 days (four weeks). When a healthcare provider prescribes PEP to you, instructions for taking the medication will be explained in detail. It is very important to follow all instructions and complete the full course of medication in order for PEP to be most effective. Be sure to discuss any other medications, herbal medicines, and vitamins you may be taking with your healthcare provider and pharmacist when receiving PEP.4

For additional instructions and recommendations for taking PEP, check out this PEP User Guide.

HOW DO I ACCESS PEP?

In New Jersey, there are a number of avenues to accessing PEP. For immediate access to PEP, you can seek services in emergency rooms across the state. For assistance with referrals and accessing services, state resources include:

For survivors of sexual assault seeking forensic exams at Sexual Assault Response Team (SART) hospitals, PEP services and/or referral services should be available at each hospital.

For additional information, survivors and their loved ones can access the free, compassionate  support of a Confidential Sexual Violence Advocate by calling the statewide 24-hour sexual assault hotline at 1-800-601-7200 or by finding a county-based sexual violence program here.

DO I NEED TO REPORT MY EXPERIENCE TO RECEIVE PEP? IS RECEIVING PEP CONFIDENTIAL?

Before you get PEP, the nurse or doctor will talk with you about your possible exposure to HIV to decide whether PEP is right for you. This means that a disclosure may be necessary to receive a prescription/be given PEP. This information will remain confidential between you and your prescriber and reporting to law enforcement is not required in order to access PEP. However, if you are seeking assistance with payment for PEP through the Victims of Crime Compensation Office in New Jersey (VCCO), additional reporting to law enforcement may be necessary in order to qualify for compensation.

HOW DO I PAY FOR PEP? WHAT CAN I DO IF I DON’T HAVE HEALTH INSURANCE? WHAT CAN I DO IF I DON’T WANT TO USE MY HEALTH INSURANCE?

PEP is covered by Medicaid and most private insurance plans.4 Co-pay assistance and cost sharing programs are available. In general, coverage of PEP varies by county.

Consult with your prescriber for more information about payment assistance. Your healthcare provider can apply for free PEP medicines through the medication assistance programs run by the manufacturers. Enrollment applications, such as Gilead’s Advancing Access form, can be filled out online, over the phone, or through fax.

If you are a survivor of sexual assault and receiving a forensic exam in New Jersey, coverage of the cost of PEP varies by county. You may qualify for partial or total reimbursement for medicines and clinical care costs through the Victims of Crime Compensation Office in New Jersey (VCCO). (Please note that to receive assistance through VCCO, a police report may be necessary). More information and the application for the claim are available here.

WHAT ARE THE SIDE EFFECTS?

According to the CDC, PEP could potentially cause nausea and headaches for some people. Side effects from PEP are not dangerous or life-threatening and can be treated.1

WHAT HAPPENS AFTER I TAKE PEP?

You need to visit your nurse or doctor for follow-up testing after you finish PEP. You’ll get another HIV test 4-6 weeks after you were first exposed to HIV, and then you’ll be tested again three months later. Your doctor may recommend another HIV test six months later.3

WHAT IF I AM PAST THE 3-DAY (72 HOUR) MARK OF POSSIBLE EXPOSURE?

If you are past the 72-hour mark of possible exposure, consult with your doctor or forensic nurse examiner about HIV & STD testing and other options for moving forward.

REFERENCES

  1. NSVRC. “Sexual Violence and HIV.” Sexual Violence and HIV A Technical Assistance Guide for Victim Service Providers. NSVRC, 2008. https://www.nsvrc.org/sites/default/files/Publications_NSVRC_Guides_Sexual-Violence-and-HIV_A-Technical-Assistance-Guide-for-Victim-Service-Providers.pdf.
  2. About Pep.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, April 21, 2021. https://www.cdc.gov/hiv/basics/pep/about-pep.html.
  3. Parenthood, Planned. “Pep and HIV.” Planned Parenthood. Accessed February 15, 2022. https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/hiv-aids/pep.
  4. “Post-Exposure Prophylaxis (PEP).” Howard Brown Health, August 30, 2019. https://howardbrown.org/service/post-exposure-prophylaxis-pep/.