What Is Post Exposure Prophylaxis (PEP)?

Submitted on Jul 9, 2015 by  tj30trust

As a person living with HIV, I feel it is absolutely vital to my mental wellbeing to be around likeminded people who share with me the hurts and struggles due to fear and stigma attached to having a positive diagnosis. I attend a support group for people living with HIV and we have become a family who care about each other. On Wednesday, June 24th, I went to the group, For Life, and we had a speaker come in from Miami Dade who works with a pharmaceutical company. I sat and listened to her presentation about HIV and its replication within cells.

It was a very uneasy situation for me because instead of educating and informing, she was more so preaching. She continued to point out my boyfriend who at this time has not started an ART regimen after being diagnosed in 2008 and remains to this day a non-progressor with a viral load of 1600. She never discussed his decision to start the medication; she only came off as accusatory. As an advocate in the HIV/AIDS community, I promote treatment yet I respect people's decisions surrounding their health and healthcare. He made an informed decision concerning his healthcare at one point and changed his decision at a later point in his life. I, on the other hand, started ART as soon as I could. In this presentation, no one was allowed to mention the names of any medications they are currently taking. And then, the conversation began with a Q & A period.

There were questions about PrEP, such as the side effects, cost, ease of accessibility and the like. I have sat in on so many PrEP discussions and heard nothing on PEP, post exposure prophylaxis. I asked the question, "Why isn't PEP getting as much exposure as PrEP when PEP can be used in instances that can provide a safeguard after possible exposure? The conversations about medicine seem to only be about medicines that aid in prevention of possible transmission beforehand and medicines that lead to being undetectable after having been exposed to the virus. Please do not take what I am saying out of context. I understand the importance of PrEP and the ART medications. I get that these are controlled circumstances. But what about situations beyond one's control, such as sexual assault?"

I asked the question because not every rape or sexual assault is reported due to shame and embarrassment of the victim. I am someone who has been sexually assaulted and never reported the incident because I am a transgender woman and never felt protected when it came to the police. I didn't want to be made into a mockery. In retrospect, had I known that PEP is a common practice inside emergency rooms, I would have gone to seek help regardless of my trans identity.

I know someone right now who resides in Miami Dade, who was raped and now lives with HIV. She has yet to come forward and bring her attacker to justice. She also contracted HIV from her attacker and sees him almost daily in her neighborhood. I feel very strongly when I say not talking about PEP adds to the rise in new HIV diagnosis. My heart goes out to her because she has great difficulty in trying to swallow the medication post-diagnosis. She is a young, single mother of a very beautiful little girl and she worries that she won't live to see her daughter graduate.

My mind went to her as I sat in my support group and listened to the representative speak in what I perceived to be a very judgmental and accusatory tone. My question was not answered to my satisfaction. I was told PEP exists; it is common practice, so there is no need to advertise it. I thought to myself about all the commercials surrounding Bayer, Tylenol and Aleve. We know what these medicines are used for because we see it, experience it and know without a doubt they are accessible. Not so with PEP. I left not knowing the name of these medications. I can spout off the name of PrEP and some ART medications without blinking an eye. Where is the education about Post Exposure Prophylaxis?

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