Emergency Post-Exposure Prophylaxis (PEP)

• Know Your Risk. PEP can protect you if you had anal or vaginal sex without a condom with someone who has, or might have, HIV. PEP can also prevent HIV if you were exposed while injecting drugs.
• Act Fast. PEP works best if started right away. You should begin PEP within 36 hours but not beyond 72 hours after a potential exposure to HIV. Go to an emergency room, clinic or NYC Sexual Health Clinic and ask for emergency PEP to prevent HIV, or call the NYC PEP Hotline at (844) 3-PEPNYC (844-373-7692). The Hotline is available 24/7 and can help you get started on PEP right away.
• Take PEP for 28 Days. PEP is taken in pill form for 28 days. You need to take PEP each day to keep enough medicine in your body to stop HIV. If you want to stop taking PEP, talk to your doctor first.
• Know about Common Side Effects. PEP can have mild side effects, like stomach pain and headache.
• Be Ready to Follow-Up. After you finish taking PEP, your doctor will give you an HIV test to make sure PEP worked.
• Find Out about Paying for PEP. Many insurance plans including Medicaid cover PEP. Assistance may be available if you are uninsured.
• Consider PrEP: If you often worry about exposure to HIV, ask your doctor about PrEP - a daily pill that helps prevent HIV.

PEP contains some of the same medicines that people with HIV take to stay healthy. If you are exposed to HIV, it takes a few days for an HIV infection to take hold in your body. As soon as you start PEP, these medicines begin to stop the virus from multiplying. As you continue taking PEP for the full 28-days, cells with HIV die and the virus stops spreading to the rest of your body.

If you are HIV-negative, PEP can protect you if you had anal or vaginal sex without a condom (or your condom broke) with someone who has HIV or may have HIV. PEP can stop HIV if you were the victim of sexual assault. PEP can also stop HIV if you were exposed while injecting drugs.

You may be at higher risk of HIV infection if you were the receptive (or 'bottom') partner in anal or vaginal sex (if you had a partner's penis in your anus or vagina). Receptive partners have a greater chance of exposure to HIV through semen or blood.

PEP is NOT usually recommended after sex that has a lower risk of spreading HIV, like oral sex. If you are unsure whether you are at risk of HIV infection, ask a doctor.

PEP is only meant to be used for a one-time exposure to HIV. If you often worry about being exposed to HIV, ask your doctor about PrEP - a daily pill that helps prevent HIV.

PEP is prescribed by a doctor or nurse. You should take PEP exactly as prescribed.

You should begin PEP within 36 hours but not beyond 72 hours after a potential exposure to HIV.

When you start PEP, you may be given a 'starter pack' with a few days' supply of pills. You may have to fill a prescription for the rest of the 28 days. To avoid any interruption to PEP, fill your prescription as soon as possible and let the prescribing clinic know if you have trouble getting your pills for any reason.

PEP is much more effective at stopping HIV if you take all the pills for the full 28 days. It is very important never to skip a dose. It is best to take your pills at the same time every day. If you keep missing doses, ask your health care provider about ways to stay on track.

PEP involves several steps:

• Before you start PEP, you will be tested for HIV. Your healthcare provider will also check your kidney and liver function and your overall health.
• During a follow-up appointment or phone call, your provider will ask you about side effects and HIV risk, and make sure you are taking all the pills in PEP.
• When you finish PEP, you will be tested again to make sure you have not become infected with HIV.
• After you finish PEP, stay HIV-negative. Use condoms, and ask your doctor about PrEP. If you inject drugs, always use a clean syringe.

See A User's Guide to PEP for additional tips on how to take PEP.

PEP is safe. Emergency PEP has been used for many years to stop HIV in people who were accidentally exposed while at work.

PEP can cause mild side effects, including upset stomach and headaches, especially at the beginning of treatment. These symptoms often get better or go away after the first week of taking PEP.

If side effects are bothering you, tell your health care provider right away. There may be ways to help you feel better. Do not stop taking PEP before talking to your provider.

In one study of healthcare workers who were accidentally exposed to HIV, PEP reduced the rate of infection by 80%. However, PEP is not 100% effective, but if you take PEP immediately after an exposure and for the full 28 days, it often prevents HIV infection.

PEP does not provide full protection against HIV. Condoms give you and your partners additional protection, even while on PEP. Condoms also protect against other sexually transmitted infections (STIs) and unintended pregnancy.

PEP is for emergency situations. If you worry about regular exposure to HIV through sex or while injecting drugs, PrEP may be a ­­better option for you.

Clinics with experience providing PEP are all over New York City. You can find the locations of these clinics by visiting Where to get PrEP and PEP.

To get started on PEP right away, call the NYC PEP Hotline at (844) 3-PEPNYC (844-373-7692). The Hotline is available 24/7 and can connect you with a clinic that has expertise in providing PEP. If calling after-hours, the Hotline can help you get a PEP starter pack through a pharmacy and connect you with a clinic for the rest of PEP.

In New York State, PEP is covered by Medicaid and many private health insurance and prescription plans. Call 311 for help getting Medicaid or low-cost insurance.

If you have no health insurance, you may receive financial assistance for PEP through these clinics in New York City.

There are also patient assistance programs to help uninsured patients pay for PEP. Your medical provider can help you apply.

If you are the victim of sexual assault in New York State, financial support for PEP is available. Call (800) 247-8035.

• Use condoms as often as possible. Find the size and type of condom you like. Condoms are available for free in all five boroughs of New York City.
• Use Lube. Use water-based or silicone-based lubricant, especially during anal sex.
• Get Tested for HIV. It's the only way to know if you or a partner has HIV.
• Get Checked for Other Sexually Transmitted Infections (STIs) .STIs can make it easier to get or spread HIV.
• Talk to Your Partners About Testing . Ask your sex partners about the last time they had an HIV test. To be sure, get tested together.
• Support Your Partners Living With HIV . If your partner is living with HIV, encourage him or her to get HIV care and take his or her medications every day. This will help your partner stay healthy and reduce his or her chance of passing HIV to you.
• Avoid Alcohol and Drugs When You Have Sex . Drinking or getting high when you have sex can make it hard to remember to use condoms. For help to stop using, call NYC Well at (888) NYC-WELL (888-692-9355).
• Use Clean Syringes : If you inject drugs, and are not ready to stop, use a new, clean syringe every time. Clean syringes are available for free all over New York City.
• Consider PrEP : If you often worry about exposure to HIV, ask your doctor about PrEP - a daily pill that helps prevent HIV.

For PrEP and PEP resources for healthcare professionals in New York City, visit Information for Providers.