PEP

A friend (Guinnie, can I call you a friend?? After all, I have only laid eyes on you once, but you do know more about my thoughts & actions than is probably sensible considering.) has asked before for me to do an informative post on an important aspect of HIV Awareness:

What to do should you have been exposed to the HI virus.
Through sex, through accidental exposure to blood through care & treating.

I usually simply refer to this topic as PEP – Post Exposure Prophylaxis.
This is an emergency medical response for a person exposed to HIV. It consists of counselling, lab tests, and medication. It lasts for 4 weeks.

I only know this topic in theory, so maybe some people will comment about the practical reality of it all…

PEP Starter Packs are supposed to be available at all heath care services and some police stations (Phone 10111). Demand it if you have been raped or sexually assaulted. It is your legal right. You will need to start treatment as soon as 2 hours and as delayed as 72 hours after the incident. Obviously the sooner you start, the more chance you will have of not becoming infected with HIV.

At these places they will give you a STARTER PACK. This pack is designed to provide medication for only the first 3 days, because it is designed as an emergency measure. The course of medication, however, needs to last for 4 weeks. So you will need to visit a doctor or a clinic to obtain the follow-up medication.

In South Africa, rape survivors are provided with free ARV (antiretroviral) drugs at state hospitals & some clinics. Phone the AIDS Helpline (0800 012 322) should they not be available at the place you visit, to find out where they can be freely obtained. ART (ARV Treatment) is also available at chemists, but a prescription is needed and then they are not free.

A combination of AZT & 3TC is usually recommended for a period of 28 days. In higher risk situations (the other person is known to be HIV+ or where considerable trauma & bleeding is evident) the treatment may include more – a doctor would advise you on this. Should the exposure have been through sex, treatment should also include treatment against Sexually Transmitted Diseases (STDs) and the morning-after pill (medicine used to prevent pregnancy).

You should be counselled and tested for HIV before the treatment is started.
If you test positive immediately, you will not be given ART (ARV Treatment) as you were infected prior to the incident & so it will be ineffective. If you must wait for the test results of the HIV test, you should start being treated immediately, and continue until you know if you were positive or negative before the incident.

You must be counselled on the side effects of the treatment. I do know that one type of ARV used can cause diarrhoea, fever, inflammation of the liver, muscle pain, dizziness, headaches, loss of appetite, nausea, fatigue, insomnia and vomiting. Very rarely, more serious side effects can occur – just keep your doctor up-to-date on your situation. This drug’s combination with the Morning-After pill is likely to cause sever nausea.

There are (expensive) tests available through doctors that can tell your HIV status within days after infection.

After the 4 week course of treatment, you will need to go for HIV tests at 6 weeks, 3 months, and 6 months after the incident, and even at one year to be 100% certain of your HIV status. You must practice safe sex for 6 months after the incident.

You should visit a psychologist or a counsellor to address the psychological trauma you have suffered through the incident.
Please also report the rape or sexual assault to the police.

The sooner you start on this course, the better. The ARVs interfere with the replication mechanisms of HIV and prevents the virus from reproducing. Unfortunately ART (ARV Treatment) does not always succeed in preventing HIV from infecting a person. But it is your best hope at the moment.

Some international companies store their own PEP packs, readily available to their employees & dependants, who were exposed through rape, sexual assault, or accidents through work-related activities. You can discuss such a possibility with your employers, and instate it through your company’s HIV Workplace Policy.

Children who have been sexually assaulted or raped can take antiretroviral drugs – dosages will be adjusted to the child’s weight. Children older than 14 years do not need their parents’ or guardians’ permission to have an HIV test or to take ARV medication.

As for The Morning-After Pill – one tablet is taken within 72 hours of exposure, and a second tablet is taken 12 hours after the first tablet. This medication is likely to cause severe nausea.

PLEASE use this information sensibly. As seems to distressingly happen with the morning-after pill these days, some people think that these measures can be used as a substitute for contraception. PEP is to be used with care and should not be used routinely or frequently in place of general safer sex practices. Misuse of this treatment can make you resistant to future treatment.

Basically - Do not mess around with ARVs & PEP!

I hope that you never have to remember or use this information!

Now I have a hangover to nurse with food from the darling Sandwich Lady, and a friend to convince to go on a date I was party to establishing when we met an eligible bachelor as we got nicely sozzled over much white wine last night.