HIV Post-Exposure Prophylaxis or HIV PEP

HIV stands for Human Immunodeficiency Virus. PEP stands for Post-Exposure Prophylaxis. HIV PEP is used when an HIV-negative person believes that they may have been exposed to HIV. HIV PEP consists of taking HIV medications once or twice a day for 28-days to prevent becoming infected after possible exposure.

HIV PEP medications must be started within 72-hours of possible exposure. If an HIV-negative person believes that they have been exposed to HIV, they need to talk to a medical provider as soon as possible.

Washington State Department of Health (DOH) does not have a program to assist with costs related with accessing HIV PEP. DOH does have contracted Prevention Navigators who are available around the state to provide guidance and support to individuals in need of access to HIV prevention and other supportive services. This includes supporting access to HIV PEP, HIV Pre-Exposure Prophylaxis (HIV PrEP), health insurance enrollment/utilization, HIV/STD testing, condoms and syringe exchange. If you have questions about accessing services in your area, contact a local Prevention Service Navigation Provider (PDF).

HIV rates in Washington have been gradually declining since 2014; when HIV PEP and HIV PrEP were added to the HIV prevention toolbox. Learn more about HIV, HIV statistics and research & HIV PrEP.

HIV PEP information, HIV PEP access, and who to contact for financial assistance

Who needs HIV PEP?

Anyone who thinks that they have been exposed to HIV. HIV PEP can reduce the chance of becoming HIV positive for individuals who may have been exposed to HIV through:

  • Sex
  • Sexual assault
  • Injection drug use
  • An occupational setting (i.e. in a medical setting, first responders, animal handlers/bite at work, etc.)
  • Being a victim of a crime
How does HIV PEP Work?

Timing is very important. Treatment must start within 72 hours of the exposure for it to be effective.

HIV PEP consists of taking HIV medications once or twice a day for 28-days to stop the virus from replicating. This reduces the likelihood of HIV establishing itself in the body. Once a person has completed their 28-day treatment, they should discuss HIV Pre-Exposure Prophylaxis (HIV PrEP) with their provider as a potential on-going HIV prevention strategy.

Additional information on HIV PEP is available at the HIV Clinical Guidelines Program and on the CDC website.

How to access HIV PEP

A health care provider must prescribe HIV PEP medications. Those who may have been exposed to HIV and need HIV PEP can go to their health care provider, an Urgent Care Clinic, Local Health Department* or Emergency Room.

Timing is very important, as treatment must start within 72 hours of exposure. The health care provider will decide which HIV PEP medications the individual should take.

If the potential exposure to HIV was through condomless sex or sexual assault, a person should also seek testing for sexually transmitted infections like syphilis, gonorrhea, and chlamydia. If the potential exposure is via shared injection equipment, the person should ask their medical provider about testing for hepatitis C virus (HCV).

HIV PEP is intended for emergency situations. Regardless of exposure, HIV PEP is not meant to replace the use of condoms, using HIV PrEP to prevent HIV infection, using sterile needles when injecting drugs, the use of personal protection equipment, or other harm reduction measures.

*Services may be limited at Local Health Departments, it is advised that individuals contact them before going in.

HIV PEP prescribing

Standard provider prescribing includes a 28-day regimen of Truvada® and Isentress® or Tivicay®.

Additional information on PEP is available at the HIV Clinical Guidelines Program and on the CDC website.

What are the side effects of HIV PEP?

HIV drugs used for PEP may cause mild to moderate side effects such as:

  • Nausea/Vomiting
  • Diarrhea
  • Fatigue
  • Rash
  • Appetite Changes
  • Sleep Changes

Adherence is important!
Adherence means sticking to a treatment plan that a health care provider has instructed and prescribed. Skipping doses or stopping treatment could mean HIV is able to replicate and the person could become HIV-positive. In addition, the body may become resistant to the drugs that were prescribed for HIV PEP. This may make it difficult or impossible to treat future HIV infection.

If the side effects are intolerable and make it difficult to adhere, an individual should contact their healthcare provider immediately.

What happens after a person takes HIV PEP?

A person who has completed the 28-days of HIV PEP should visit their doctor for follow-up testing. Another HIV test should be taken 4-6 weeks after the first exposure to HIV. Then another HIV test should be taken again 3 months later. Depending on the situation, the provider may recommend another HIV test 6 months later.

It's very important to get these follow-up tests to make sure HIV PEP worked.

Patient Financial Assistance for HIV PEP Services

This section outlines access to financial assistance based on how a person was exposed to HIV. Select an exposure below to see your options for assistance.

Exposure to HIV through Sex or Injection Drug Use

Information below is for assistance with paying for HIV PEP (i.e. condom broke, unaware of partner HIV status, needle sharing etc.). Click on the link below for quick access on how to find financial patient assistance programs for quick access to HIV PEP medications:

Post-Exposure Prophylaxis (PEP) Medication Assistance Programs

Additional Patient Assistance Programs

Programs listed below have specific eligibility criteria.
Each program is subject to funding availability and may or may not be accepting new or renewing enrollment.

My Good Days

Individuals with Medicare Part D or Military insurance coverage may apply for assistance with My Good Days at: https://www.mygooddays.org/patients/diseases-covered/hiv-aids-treatment-and-prevention.

Patient Advocate Foundation Co-Pay Relief Program

Individuals with any insurance coverage may apply for assistance with the Co-pay Relief Program at: https://copays.org/funds/hiv-aids-and-prevention/

Patient Access Network

Individuals with Medicare Part D coverage may apply for assistance with Patient Access Network at: https://www.panfoundation.org/disease-funds/hiv-treatment-and-prevention/

Other Medications Prescribed for HIV PEP

Some patients could be prescribed different medications for HIV PEP depending on their health evaluation with their healthcare provider. If prescribed different medications than the standard regimen (which is Truvada® and Isentress® or Tivicay®), work with a Prevention Navigator and/or Pharmacist to access patient assistance programs through the drug manufacturers.

Exposure to HIV through an Occupational Setting or as a Crime Victim

Washington State Department of Labor & Industries provides information about services offered by their programs on their website. They may pay for medically necessary HIV PEP services related to exposure to HIV in specific circumstances such as:

  • Individuals who have been exposed in a work setting (Occupational Exposure). Coverage is through the Workers' Compensation insurance coverage*
  • Individuals who have been exposed as a result of a crime (Crime Victim Exposure). Coverage is through the Crime Victims Program

For assistance with paying for medically necessary HIV PEP services due to an occupational or crime-related exposure, contact the Washington State Department of Labor & Industries based on the exposure below:

Occupational Exposure – 800-547-8367 or go online https://lni.wa.gov/patient-care/treating-patients/communicable-diseases/

Provider Only Hotline: 800-848-0811

Crime Victim Exposure - 800-762-3716 or go online https://lni.wa.gov/patient-care/treating-patients/treating-crime-victims

*Industrial insurance coverage in Washington State is limited in liability. Coverage or payment for these services is subject to laws and regulations governing workers' compensation insurance (Title 51 RCW.)