HIV PEP – What You Need to Know

During sex a condom tears or slips off, or maybe one wasn’t used. You might have been drunk or high and don’t know for sure. Whatever the reason, you or your partner may have been sexually exposed to HIV. But try not to panic, as there is a treatment option available called PEP, that may prevent the HIV virus from taking hold in your bloodstream. The important thing is to attend an STI/GUM clinic or Emergency Department and talk to a healthcare provider to see if you need to take it. Familiarising yourself with the information below might be helpful for yourself, a sexual partner or a friend in the future.

What You Need To Know

PEP can stop HIV replicating itself in the body after the virus has entered the body:

 

  1. PEP is an emergency measure if you have been exposed to HIV.
  2. The earlier PEP is taken the better. If you’ve had a high-risk sexual encounter within the last 72 hours (three days), it’s important to get help straight away (check the list of where to get PEP here). It is vital that this medication is given within 72 hours (three days) of the potential exposure to the virus, otherwise it will not work, so, ‘please don’t leave it until the 72 hours is up or nearly up’.
  3. PEP can only be prescribed by doctors and if certain criteria are met. http://www.hpsc.ie/a-z/EMIToolkit/appendices/app7.pdf
  4. Most STI or GUM clinics can provide PEP, as can Emergency Departments (ED) and sexual assault units (for sexual assault only).
  5. PEP is free of charge, however at Emergency Departments and if you have no referral letter, you may have to pay the €100 mandatary attendance fee for Emergency Departments (some Hospitals may charge more if you are a non-EU National).
  6. All public STI/GUM clinics listed below are free to attend.
What is PEP?

Post= after,

Exposure= a situation where HIV has a chance to get into someone’s blood stream.

Prophylaxis= a treatment to stop an infection happening.

 

PEP is a combination of anti-viral drugs. It involves a 28-day (4 week) course of tablets that is prescribed to someone who has been exposed to HIV.

 

To be effective, PEP must begin as soon as possible after the exposure and before 72 hours (3 days) is up. ‘So, the sooner you start after exposure, the better it works’.

 

You must remember to take the medication every day for the full 4 weeks. If you miss any doses or do not complete the course it greatly affects the chance that PEP will not work.

How do I get PEP?

PEP is available for free (€100 attendance fee may be imposed at Emergency Departments) but it is only given to people who meet national guidelines for its use http://www.hpsc.ie/a-z/EMIToolkit/appendices/app7.pdf

 

These national guidelines help doctors decide who might be offered PEP. Some of the questions asked are;

Do you know your own HIV status

  • The person you had sex with (and the chances that person had HIV).
  • What kind of sex happened (vaginal, oral or anal?).
  • If the other person definitely had HIV, what was their ‘viral load’ (if this is known)?

 

Once a doctor has considered your risk, a decision will be made about whether PEP is provided. At the same time, you will have a series of blood tests. This makes sure that you don’t already have HIV, depending on the result, you will continue PEP.

 

The best place to go for PEP is your nearest STI/GUM clinic, check the list. If you need PEP over the weekend, outside of STI/GUM clinic hours or during a public holiday, the best place to go is the nearest Emergency Department of a hospital. Most are open 24 hours with some community departments open till midnight (see list ‘Where to Get PEP’). PEP is not available from GPs (family doctors) or from pharmacies.

 

In Emergency Departments and some STI/GUM clinics you will be given a “PEP starter pack”. This means if the doctor decides to prescribe PEP to you after the assessment, you will be given a short course of PEP for four to six days. This is not the full course. If given a PEP starter pack, you will be referred to another clinic for further assessment based on your blood results and for continuation of treatment if recommended.

 

Sometimes people might face obstacles when asking for PEP. The medical staff or receptionists may not know about it or may give out incorrect information such as ‘PEP is not available to the general public’.

 

If this happens, ask to speak to the ‘doctor on duty’ who should know about the PEP guidelines. ‘Don’t panic’ check the list for nearby options also see the support section here for helplines that you can call for help and advice.

How do I take PEP?

In 2017 the combination medication used for HIV PEP is a tablet called Truvada® (which contains Tenofovir and Emtricitabine) and either two tablets called Isentress® (containing Raltegravir) or one table called Tivicay® (containing Dolutegravir). These antiretroviral drugs are commonly used to treat HIV.

 

 

For PEP to have the best chance of working it must be taken exactly as instructed by a doctor and for 28 days.

 

When you are prescribed PEP you should receive printed information of; the types of tablets, what to do if you miss a dose, the possible side effects, and what medicines or herbal treatments may affect you. There is an outline for this below;

 

Skipping doses, or not taking the pills for the full month, makes it likely that PEP will not work – if you miss more than 48 hours (two days) please tell your prescriber as they may advise that PEP be discontinued.

 

If you forget to take your PEP tablets, follow this procedure;

  1. If you remember within (12 hours for Truveda) or (six hours for Isentress) after you were due to take it, ‘take the missed dose and go back to the usual time for the next one’.
  2. If more than 12 hours or the six hours, after you were due to take the dose, ‘wait and take your dose at the usual time’. ‘Don’t take extra tablets to make up for the missed dose’.

 

As recreational drugs can have dangerous interactions with HIV medication, it’s advisable not to use them while taking PEP.

 

Tell the doctor assessing you about any prescribed drugs, recreational drugs, herbal treatments or over-the-counter medicines you’re taking.

 

If you do get side effects from PEP they are likely to be mild ones experienced in the first few days, such as nausea, headaches, dizziness or tiredness – they should pass after a day or two.

 

Once you’re finished taking PEP you will be tested for HIV again four weeks after finishing the course.

 

You may be advised to follow-up for other blood and STI tests three months after this.

Dublin

GMHS Clinic for MSM

(Walk-in clinic Tuesdays and Wednesdays 4.30 – 6:30pm -Full PEP Service During Clinic Hours), 

Baggot St. Hospital, Baggot St., Dublin 4.

Tel: 01-669 9553.

 

Dublin 4

Emergency Department,

(Open 24/7 -Starter PEP Pack),

St Vincent’s University Hospital, Elm Park, Merrion Rd, Dublin 4.

Tel: 01-221 4358

 

Dublin 7

Emergency Department,

(Open 24/7 -Starter Pack)

 Mater Hospital, Circular Rd., Dublin 7. 

Tel: 01 803 2000

 

Dublin 8

GUIDE (STI) Clinic,

(Full PEP service during Clinics),

St Jame’s Hospital, Dublin 8. 

Tel: 01-416 2315/6

 

Emergency Department.

(Open 24/7 -Starter PEP Pack),

St James’s Hospital, Dublin 8,

Tel: 01-410 3000/416 2774/5

 

Dublin 9

Emergency Department,

(Open 24/7-Starter PEP Pack),

Beaumont Hospital, Dublin 9.

Tel: 01-809 3000

 

Dublin 15

Emergency Department,

(Open 24/7 -Starter PEP Pack), 

Connolly Hospital,

Mill Road, Blanchardstown, Dublin 15.

Tel: 01-6465000 

 

Dublin 24

Emergency Department,

(Open 24/7 -Starter Pack),

Tallaght Hospital, Tallaght, Dublin 24.

Tel: 01-4143510 

 

(SEXUAL ASSAULT CASES ONLY, Starter PEP Pack Provided). 

Dublin: Rotunda Hospital,

Parnell Square, Dublin 1,

Tel: 01-817 1736 (out of hours 01-817 1700)

LEINSTER

Carlow

STI Clinic,

(no PEP Service -Telephone to make arrangements), 

District Hospital, Athy Rd, Carlow, Co Carlow.

Tel: 051 842 646

 

Kildare

Emergency Department.

(Open 24/7-Starter PEP Pack),

General Hospital, Naas, Co Kildare.

Tel: 045-849900/500

 

Kilkenny

Emergency Department.

(Open 24/7-Starter PEP Pack),

St Luke’s General Hospital, Kilkenny, Co Kilkenny.

Tel: 056-778 5000

 

Louth

Drogheda: Emergency Department.

 (Open 24/7-Starter PEP Pack), 

Our Lady of Lourdes Hospital,

Drogheda, Co Louth.

Tel: 041-983 7601

 

Dundalk: Injury & Medical Assessment Unit, 

(Open 7 Days, 9.00am to 8.00pm-Starter PEP Pack).

Louth County Hospital, Dublin Rd, Dundalk. Co Louth.

Tel:042-9334701

 

Meath

Emergency Department.  

(Open 24/7-Starter PEP Pack),

Our Lady’s Hospital, Navan, Co Meath. 

Tel: 046-907 8500

 

Offaly

Emergency Department.  

(Open 24/7-Starter PEP Pack),

Regional Hospital, Tullamore, Co Offaly.

Tel: 057-935 8024/ 932 1501

 

Westmeath

Emergency Department.  

(Open 24/7 Starter PEP Pack), 

Midland Regional Hospital,

Longford Rd., Mullingar.

Tel: 044 934 0221

 

Wexford

Emergency Department.  

(Open 24/7 Starter PEP Pack).

General Hospital, Newtown Rd, Wexford, Co Wexford.

Tel: 053-915 3313/14

 

(SEXUAL ASSAULT CASES ONLY, Starter PEP Pack Provided). 

Westmeath:  Midland Regional Hospital, 

Longford Rd., Mullingar, Co Westmeath.

Tel: 044-939 4239/086 040 9952 (out of hours 044-934 0221)

MUNSTER

Clare

STI Clinic,

(Mondays 9.00am-12.00am -Full PEP Service),

University Hospital Ennis, Co Clare. 

Tel: 061-482 382

 

Emergency Department

(7 Days 8.00am – 8.00pm-Starter PEP Pack),

Injury Unit & Medical Assessment Unit, University Hospital, Ennis, Co Clare.

Tel: 065 686 3121.  

 

Cork

STI Clinic,

(Mon-Thur. 9.00am-12.30pm and Wed 2.00pm-4.30pm -Starter PEP Pack),

University Hospital, Old Blackrock Rd., Cork. 

Tel: 021 496 6844 ()

 

Cork: Emergency Department,

(Open 24/7-Starter PEP Pack),

University Hospital, Old Blackrock Rd,

Tel: 021 4920200

 

Cork: Emergency Department,

(Open 24/7-Starter PEP Pack),

Mercy University Hospital, Grenvelle Place, Cork, Co Cork.

Tel: 021-493 5241

 

Bantry: Emergency Department

(7 Days, 8.00am to 8.00pm-Starter PEP Pack),

Injury & Medical Assessment Unit, General Hospital, Bantry, Co Cork.

Tel: 027-52929 

 

Kerry

Emergency Department

(Open 24/7-Starter Pack),

University Hospital, Tralee, Co Kerry.

Tel: 066-718 400

 

Limerick

STI Clinic, (Full Pep Service during clinics), University Hospital

Dooradoyle, Limerick, Co Limerick.

Tel: 061-482 382

 

Emergency Department.

(Open 24/7-Starter PEP Pack), 

University Hospital Dooradoyle, Limerick City.

Tel: 061-301 111

 

 

Tipperary

Emergency Department.  

(Open 24/7 Starter PEP Pack). 

General Hospital, Clonmel, Co Tipperary.

Tel: 052-617 7000

 

Waterford

STI Clinic,

(Must Telephone to make arrangement to be seen),

University Hospital, Dunmore Rd, Waterford, Co Waterford. 

Tel: 051-842 646

 

Emergency Department.

 (Open 24/7 Starter PEP Pack).

University Hospital, Dunmore Rd, Waterford, Co Waterford.

Tel: 051-848 000

 

(SEXUAL ASSAULT CASES ONLY, Starter PEP Pack Provided). 

Cork:

South Infirmary Victoria University Hospital,

Old Blackrock Road

Tel: 021 4926297 bleep 789.

 

Limerick:

University Hospital,

St Nessan’s Rd, Dooradoyle, Limerick Co Limerick

 

Waterford:

University Hospital, 

Dunmore Rd., Waterford, Co Waterford,

Tel: 051-842 157 (out of hours 051-848 000)

CONNAUGHT

Galway

Galway: STI Clinic,

(Clinics Mon-Fri -Full-PEP Service), 

University Hospital, Newcastle Rd., Galway. Co Galway.

Tel: 091-525 200

 

Galway: Emergency Department,  

(Open 24/7-Starter Pack) , 

University Hospital, Newcastle Rd., Galway. Co Galway.

Tel: 091-524 222

 

Ballinasloe: Emergency Department,

(Open 24/7-Starter Pack), 

Portiuncula Hospital, Ballinasloe, Co Galway.

Tel: 090-964 8200 

 

Mayo

Emergency Department.  

(Open 24/7-Starter PEP Pack), 

General Hospital

Westport Rd., Castlebar, Co Mayo.

Tel: 094-902 1733

 

Sligo

Emergency Department.  

(Open 24/7-Starter PEP Pack), 

General Hospital

The Mall, Sligo, Co Sligo.

Tel: 071 917 1111. Note. Contact STI Clinic based in Hospital for Referrals for PEP. Tel; 071-917 0473

 

(SEXUAL ASSAULT CASES ONLY, Starter PEP Pack Provided).

Galway:

Hazelwood House,

Parkmore Road, Galway, Co Galway.

Tel: 091-765 751/087 6338118 (out of hours 091-757631)

ULSTER

Antrim

GUM Clinic, 

(Full PEP Service during clinic hours),

Level 3, Outpatients Department, Royal Victoria Hospital,

Grosvenor Road, Belfast. BT12 6BA

Tel: 028-9063 4050 (048 from RoI)

 

Emergency Department,

(Open 24/7-Starter PEP Pack), 

Royal Victoria Hospital,

Grosvener Road, Belfast. BT12 6BA 

Tel: 028 9063 2250 (048 from ROI)

 

Emergency Department, 

(Open 24/7-Starter PEP Pack), 

Mater Hospital, 45-54 Crumlin Road, 

Belfast BT14 6AB, 

Tel: 028 9074 1211

 

Armagh

GUM Clinic,

(Full PEP Service during clinic hours), 

Health and Care Centre, Tavanagh Avenue,

Portadown, County Armagh. Tuesday 500pm-8.00pm.  

Tel: 028 3083 4215

 

Emergency Department,

(open 24/7 -Starter PEP Pack), 

Area Hospital,

68 Lurgan Road, Portadown, Co Armagh.

Tel: 028 3861 2006/2014 (048 from ROI)

 

Cavan

Emergency Department,

(Open 24/7-Starter PEP Pack),

General Hospital, Lisdaran,

Cavan, Co Cavan.

Tel: 049-437 6000

 

Derry

Derry: GUM Clinic

(Full Pep Service During Clinics),

Altnagelvin Area Hospital,  

Glenshane Road, Derry/Londonderry, 

Tel: 028-7161 1269 (048 from ROI)

 

Derry: Emergency Department. 

(Open 24/7 Starter PEP Pack),

Altnagelvin Area Hospital,

Derry 

Tel: (028-7134 5171).

 

Colraine: GUM Clinic, 

(walk-in clinic on Tuesdays and Fridays -Full PEP Service),

Causeway Hospital,

4 Newbridge Rd., Colraine,

Co Derry

Tel: 028-7034 6028 

 

Colraine: Emergency Department,

(Open 24/7 -Starter PEP Pack), 

Hospital, Coleraine, Co Derry. 

Telephone: 028-7032 7032 (048 from ROI)

 

Donegal

GUM/STI Clinic,

(Full PEP Service During Clinic),

General Hospital, Letterkenny,

Co Donegal. 

Tel: 074-912 3715

 

Emergency Department,

(Open 24/7 -Starter PEP Pack),

General Hospital, Letterkenny,

Co Donegal.

Tel: 074-912 5888

 

Down

Newry: Gum Clinic,

(Full PEP Service During Clinics),

John Mitchell PLace,

Hill Street, Newry,

County Down.

Tel: 028-3083 4215 (048 from ROI)

 

Newry: Emergency Department,

(Open 24/7 -Starter PEP Pack),

Daisy Hill Hospital,

5 Hospital Rd., Newry,

Co Down. 

Tel: 028-3083 5000 (048 from ROI)

 

Downpatrick: Sexual Health Clinic,

(Full PEP Service During Clinics), 

Hospital, 2 Struell Wells Rd.,

Downpatrick,

Co Down, 

Tel: 028-4483 8133 (048 from ROI)

 

Downpatrick: Emergency Department,

(Open 24/7 -Starter PEP Pack), 

Hospital, Downpatrick,

Co Down,

Tel: 028-4461 3311.

 

Fermanagh

Emergency Department.

(Open 24/7 -Starter Pack) 

South West Acute Hospital,

124 Irvinestown Rd., Enniskillen,

Co Fermanagh.

Tel: 028 6638 2000 (048 from ROI)

 

Monaghan

Emergency Department.

(Open 7 Days 8.00am to 5.00pm-Starter PEP Pack).

Minor Injury Unit and Medical Assessment Unit,

General Hospital, Monaghan,

Co Monaghan.

Tel: 046-907 8500

 

(SEXUAL ASSAULT CASES ONLY, Starter PEP Pack Provided). 

Donegal: 

Letterkenny General Hospital,

Co Donegal,

Tel:087 066 4593/087 068 1964

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