So you’ve had unprotected sex and think you now might have got HIV? That’s no big problem these days is it? You just go along to the clinic the next day,or the one after, ask for PEP and you are sorted. You stay negative. It’s like a morning-after pill but for gays. No, actually.
First of all, what are we talking about? PEP (Post-exposure prophylaxis) is essentially HIV meds taken for a month. The meds (usually one called Truvada) is a single pill with two classes of drugs in it. One of them blocks HIV from entering your cells; the other prevents HIV from replicating itself. This double whammy can be enough to stop the virus from taking hold.
HIV will take hold within 3 days of arriving in you. Because by then it’s spread practically everywhere and isn’t just sitting in your arse, where it arrived (or a vein if you’ve got infected by sharing needles). That means it is now impossible to get rid of. Despite the efforts of many and a shed load of money thrown at the problem there still isn’t a cure for HIV. Big deal you might say? That’s why there’s PEP.
This is why the answer is no. At best PEP is only 70% effective. So you are already taking a pretty big risk if you are relying on PEP to keep you HIV-negative. A 30% chance of PEP not working is a pretty high risk. Is it worth it?
Then there’s the 3 days – that’s the end of the ‘window period’ or your sexual health clinic (where you will have to wait a few more hours probably….)
There are some really nasty side effects that many people get – headaches, diarrhea, vomiting and general stomach upsets that can knock you for six. Weight loss is common. It is not unusual for people to have to take time off work or study because they feel so awful. The side effects do go once you stop taking the meds.
In short, don’t treat PEP as your main way of not getting HIV. Of course, it’s great it exists and it has prevented some people from becoming HIV+. Of course, it’s useful to know it’s an option in an extreme case. But don’t stop using condoms or negotiating the kind of sex you like. Because you might regret it.
The longer you leave it and the closer to the end of the window period you get to, the less likely PEP will work anyway, so the effectiveness is a lot less. And 72 hours is very short. You’ve shagged, slept, woken up, thought ‘fuck’, thought about doing something, had a coffee blah blah blah. Whatever it is. It’s not hard for 24 hours or more to have passed.
You can only get PEP at A&E or your sexual health clinic (where you will have to wait a few more hours probably….). They will certainly ask you some direct questions. You might be embarrassed by the situation but they won’t be: When? How? Who with? How often? With how many? Is this the first time? And there’s no guarantee they will give it to you anyway. It isn’t automatic. They may even say they haven’t got it anyway and you have to go somewhere else. And they might not give it to you either. If they think the risks you have taken are small ones they probably won’t. It doesn’t come cheap, although it is of course cheaper than a lifetime on meds.
You don’t know how much virus the guy you’ve been fucking has got. Just because he’s positive and on meds doesn’t mean to say his viral load is undetectable. He may have had a cold or the flu recently – which will temporarily put his viral load up. He might have other sexually transmitted infections that could also mean he isn’t presently undetectable.
There are some really nasty side effects that many people get – headaches, diarrhea, vomiting and general stomach upsets that can knock you for six. Weight loss is common. It is not unusual for people to have to take time off work or study because they feel so awful. The side- effects do go once you stop taking the meds.
In short, don’t treat PEP as your main way of not getting HIV. Of course, it’s great it exists and it has prevented some people from becoming HIV+. Of course, it’s useful to know it’s an option in an extreme case. But don’t stop using condoms or negotiating the kind of sex you like. Because you might regret it.
For more information, GMI trainers can talk to you about negotiating safer sex practices. Go to www.gmipartnership.org.uk.
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