Preventing HIV with PEP

There may be instances when you’ve had a possible exposure to HIV. Some examples of exposures include:

  • Having condomless vaginal or anal sex with a partner living with HIV, or whose HIV status you don’t know
  • Having a condom break during sex
  • Sexual assault/abuse
  • Sharing needles with other people (to inject drugs, hormones, or for other reasons)
  • Exposure to someone else’s blood or other bodily fluids that can transmit HIV (semen (ejaculation) or pre-ejaculation, vaginal fluid, anal fluids, or breast milk, which might happen during sex, from an occupational needle stick, an accident or otherwise)

If you seek medical care right after a possible exposure, you may be able to take a course of medication that can help prevent you from contracting HIV. This medication is called HIV post-exposure prophylaxis or PEP.

When do I start PEP?

If you may have been exposed to HIV, it is important to seek care right away. PEP is time-sensitive and should be started within two hours of the exposure, and no later than 72 hours after exposure.

So don’t hesitate–call the New York City or New York State PEP Hotline. Both PEP hotlines run 24/7 and perform PEP assessments, provide PEP prescriptions, and then connect clients to medical appointments with local community providers.

  • New York City PEP Hotline: 844-3-PEPNYC
  • New York State PEP Hotline: 844-PEP-4NOW

What should I expect when I start PEP?

PEP is only effective if you are HIV-negative and begin taking the medication within 72 hours of exposure. Please note that:

  1. The sooner you start taking PEP medication, the better.
  2. It’s important to take your entire 28 days of PEP medication.
  3. You should attend medical visits and get HIV and sexually transmitted disease testing at the beginning and end of your course of PEP.
  4.  If you think you may have exposures in the future, ask your medical provider about pre-exposure prophylaxis (PrEP), a safe, effective pill or injection that lowers your risk of getting HIV from sex. 

Will I experience any side effects while on PEP?

Most side effects are mild or nonexistent. Some people may experience nausea, headaches, vomiting, and fatigue, but these reduce in severity in less than a week. If you experience these symptoms for longer than a few weeks, reach out to your health care provider to ensure it is not something else.

How will I pay for PEP? Will my health insurance cover PEP?

While most health insurance plans cover PEP, there are several assistance programs that can help cover the cost of PEP if you are uninsured or underinsured.

The Mount Sinai Institute for Advanced Medicine provides program assistance for uninsured New Yorkers. We take Medicaid insurance if you are located in or around New York City. We can also help you find a provider if you live elsewhere in New York State.

What should I do after I start PEP?

It is important to take your daily PEP medication and use condoms. After you’ve completed your 28-day course of medication, we will retest you for HIV. Other things to avoid include needle sharing, chestfeeding, donating blood, plasma, organs, tissue, or semen.

You will meet with your health care provider at the end of your course of PEP. At that appointment, you will discuss the use of other prevention options such as HIV pre-exposure prophylaxis or PrEP.