If you think you need Post Exposure Prophylaxis (PEP), then you need to act quickly, ideally as soon as possible after possible infection with HIV. If you are unsure, call us on 020 7637 1600 and speak to one of our lovely receptionists who will help you.
PEP, short for Post-Exposure Prophylaxis, is an emergency HIV prevention treatment used after a potential exposure to HIV.
Unlike PrEP, which is taken before an exposure occurs, PEP is designed to reduce the risk of HIV infection after a potential exposure has already taken place. PEP represents one of the most important developments in modern HIV prevention and, when started appropriately and within the correct timeframe, can significantly reduce the risk of HIV becoming established within the body.
However, timing is critical. The single most important thing to understand about PEP is that it must be started as soon as possible following a potential HIV exposure.
PEP consists of a combination of antiretroviral medications taken for 28 days. The aim is to prevent HIV from establishing a permanent infection following a significant exposure.
The medications used for PEP are similar to those used in HIV treatment and work by interfering with the virus’s ability to replicate. If HIV replication can be suppressed during the earliest stages of infection, the body may eliminate the virus before permanent infection becomes established.
PEP has been used successfully worldwide for many years and is now an established component of HIV prevention programmes.
PEP is generally considered following exposures where there is a realistic risk of HIV transmission. Examples may include:
Not every exposure requires PEP. The decision depends upon several factors including:
For this reason, individual risk assessment remains crucial.
PEP should be started as soon as possible. The effectiveness of PEP decreases as time passes.
Current UK guidance recommends that PEP should only be prescribed if treatment can be commenced within 72 hours of the exposure. After 72 hours, PEP is generally no longer recommended because it is unlikely to provide meaningful benefit.
Importantly, patients should not wait for test results before seeking advice regarding PEP. If there is concern about a significant exposure, medical assessment should occur immediately. Every hour matters.
PEP typically consists of a three-drug antiretroviral regimen taken for 28 days. The exact regimen may vary slightly over time as HIV treatment evolves and guidelines are updated.
Current regimens are generally well tolerated and considerably easier to take than older HIV medications. Most patients are surprised by how straightforward modern PEP has become.
It is impossible to provide an exact percentage because effectiveness depends on multiple factors including:
However, extensive clinical experience strongly supports the effectiveness of PEP when prescribed appropriately and taken correctly. The earlier treatment is started, the more effective it is likely to be. Patients presenting within hours of an exposure are therefore in a much stronger position than those presenting towards the end of the 72-hour window.
Modern PEP is generally very well tolerated. Most patients complete treatment without significant difficulty.
Potential side effects may include:
When side effects do occur, they are usually mild and temporary. The potential inconvenience of treatment is generally outweighed by the potential benefit of preventing HIV infection.
Ideally, baseline HIV testing should be performed before treatment is started. However, testing should never delay access to PEP. The priority is starting treatment within the appropriate timeframe.
Baseline testing serves several purposes:
Further HIV testing is then performed following completion of PEP according to established protocols.
Completing PEP is not the end of the process. Follow-up HIV testing remains an important component of care. This allows clinicians to confirm that HIV infection has not occurred and to provide definitive reassurance.
Many patients experience significant anxiety whilst awaiting final testing. Understanding the testing process and expected timelines often provides considerable reassurance during this period.
A PEP consultation often provides an opportunity to discuss future HIV prevention. Many individuals who require PEP may benefit from considering PrEP if they feel there is a possibility of future HIV exposures.
This is not because they have done anything wrong, but because modern HIV prevention allows people to take proactive control of their sexual health. For some patients, a PEP consultation becomes the starting point for a broader discussion regarding sexual health, vaccination, STI screening and long-term HIV prevention strategies.
You should seek urgent medical advice immediately if:
It is always easier to assess someone promptly than attempt to address concerns after the 72-hour window has passed.
At The Wright Practice, we provide rapid PEP assessment and prescribing where appropriate. Our role is not simply to issue medication, but to carefully assess risk, explain the evidence, arrange appropriate testing and provide ongoing support throughout the process.
For many patients, understanding their true level of risk is just as important as the treatment itself.
Wow! Dr. Dan was extremely knowledgeable and attentive to my health and well being. I’m so glad to have found him!
I have been going to Dr Wright for a number of years now. He is highly knowledgeable, compassionate, open minded and efficient, I couldn’t recommend him highly enough
I have been a patient of Doctor Dan for some time and continue to consult with him despite having left the UK. Dan has the enthusiasm and energy of a young man, whilst taking the holistic “physician” approach of an old school family doctor, equipped with the most modern insights and technology.
Dr Jain was great. Expert knowledge with practical advice
Within 72 hours of the exposure, and the sooner the better. Effectiveness decreases as time passes, so don’t wait for symptoms, test results, or to decide whether you’re ‘sure’ you were at risk. Seek assessment immediately.
An NHS sexual health (GUM) clinic or A&E department, especially outside normal working hours. The Wright Practice can prescribe PEP, but it is a costly private prescription, so we usually recommend the NHS route first for speed.
PEP is a 28-day course of antiretroviral medication taken once or twice daily, depending on the specific regimen prescribed.
Most people tolerate modern PEP well. Mild, usually temporary side effects can include nausea, headache, fatigue, gastrointestinal upset or sleep disturbance.
No. The decision depends on the type of exposure, the HIV and treatment status of the source partner if known, and how much time has passed. This is why an individual risk assessment, rather than general statistics, is the right way to decide.
Ideally, yes, a baseline test helps establish your HIV status before treatment. However, this should never delay starting PEP within the 72-hour window; starting treatment takes priority over testing.
Follow-up HIV testing remains important to confirm your status, following an established testing schedule. We can talk through the right timeline for your specific situation.
PEP significantly reduces the risk of HIV infection following exposure, but like any preventative treatment it is not guaranteed to work in every case, which is why timing, adherence to the full 28-day course, and follow-up testing all matter.
If you feel there’s an ongoing or future risk of HIV exposure, this is worth discussing. PrEP is taken before potential exposure to provide ongoing protection, and a PEP consultation is often a natural point to bring this up.
PEP is unlikely to be effective after this window. Instead, the right next step is usually HIV testing at the appropriate time point; we can advise on which test and when, based on how long ago the exposure occurred.
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101 Harley Street, London, W1G 6AH
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