PEP (POST-EXPOSURE PROPHYLAXIS), also called nPEP is an emergency medication taken by HIV negative people who have recently had a high risk exposure to the virus, to help prevent HIV infection. PEP can be thought of as the Plan B, or emergency contraception for HIV prevention.
If you’ve had a risky encounter, you should start taking PEP AS SOON AS POSSIBLE, ideally within 24 hours, but up to 72 hours after. A course of PEP involves taking antiretroviral medications for a period of 28 consecutive days. A high risk exposure includes: Unprotected anal sex A condom breaking during anal sex Sharing needles
If you’ve had a risky exposure, go to the closest hospital emergency room immediately. You can also go to specialized clinics if you’re in a metropolitan area. You can also ask your family doctor for an emergency appointment.
PEP is free if you are covered by OHIP+. You are eligible for OHIP+ if you have an Ontario health card, you’re under 25 and you don’t have private insurance (through either your employer, your parents or your school).
You may also be eligible for OHIP+ if you are 65 or older, if you are on the Ontario Disability Support Program (ODSP), or if you are on the Ontario Works program.
If you have private insurance, the coverage amount varies depending on your insurance company, and some may require you to pay the full cost upfront before being reimbursed. It is important to check with your insurance company to determine the extent of your coverage.
If you don’t have insurance or your insurance doesn’t cover PEP, the cost for a 28-day course of PEP typically ranges from $1,500 to $2,000, depending on the type of medication.
If you have low income (ie. you earn less than $50,000 per year), you could be eligible for Trillium, an Ontario program that help pay for the cost of medication. The deductible for Trillium is 4% of your annual household income. You can learn more about Trillium by checking out Ontario’s Trillium Drug Program, as well as their Guide to Understanding the Trillium Drug Program.
While PEP is not 100% effective in preventing HIV infections, it is highly effective when taken consistently for 28 days. The effectiveness of PEP increases the sooner it is started, ideally within 24 hours and up to a maximum of 72 hours.
To optimize the effectiveness of PEP, it is crucial to have it prescribed by a healthcare provider and to follow their instructions regarding daily consumption for the full 28 days. Additionally, other prevention strategies such as condom use and new needle use should be employed to avoid other potential exposures while taking PEP.
If you are at a higher risk of contracting HIV, it may be worth considering long-term protection through pre-exposure prophylaxis (PrEP). PrEP is a preventative medication that can be taken daily to significantly reduce the risk of HIV infection. For more information on PrEP, you can check out our guide to PrEP. Start your free online visit by clicking the button below.