Keeping it in the room: health, happiness and living in Berlin
As part of my work on THT Direct, I’m often asked about what to do if someone’s either not used a condom, or it broke, and now they’re worried they might have caught something. Specifically HIV.
Actually, many other STIs are much easier to catch than HIV, but because they’re usually easily cured, HIV’s the one that most people are concerned about.
If you act fast, then you may be able to take a course of medication called PEP (Post Exposure Prophylaxis), which should prevent you from being infected.
It needs to be taken within 72 hours of the risk event – but the longer you leave it, the less effective it’s thought to be. You can get it from any sexual health clinic – check THT’s clinic finder to find one. All A&E departments in the UK also carry PEP and should be able to provide it to you, though I’ve heard of doctors not knowing that – or pretending they don’t know.
It’s not always a nice experience; for many people, side effects include nausea, diarrhoea or sleep disturbance. These effects might wear off after a while, or may continue for the whole 30 days. For this reason – and the fact that it costs hundreds of pounds – doctors try not to give it unless they think you really need it.
The important thing to be aware of is that it’s always up to the doctor in charge whether to give you anything. If they say no, then there’s not much you can do. They, in their infinite wisdom, don’t think that what happened is likely to have put you at serious risk.
They do have guidelines to follow, though, which have recently changed.
If the doctor decides to give you PEP, they’ll always want to test you for HIV. You might already have it without knowing. They’ll also want to book you in a test after 12 weeks to make sure you’ve definitely not caught it, and maybe again after 6 months. It’s just to be on the safe side.
The most important change in the new guidelines is that now, if you’re a man who fucked someone who knows he’s HIV+ but he’s on meds, and his viral load is undetectable (the majority of people on meds are in this position), then PEP isn’t necessary. That’s because there’s so little virus in their system, they’re unlikely to have infected you.
The new guidelines also say that if you stab yourself with a discarded needle, then, because HIV can’t live outside the human body for very long, you don’t need PEP.
Because it’s an emergency treatment, PEP is always free at the point of use – though if you’re not from the EU, they may want to send you a bill later.
You can find more information about the new guidelines at the excellent NAM site; i-base is a great resource, with both online forums and a free helpline; or if you want to talk to someone, you could always phone THT Direct free on 0808 802 1221.