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AZT Post Prophylactic
Mar 6, 2003

What do you know about using AZT as a post prophylactic in case a woman has had unprotected sex with a man who is HIV positive and she is negative? Do you know when it should be used and how long it should be used to try to keep her positive? Is there any evidence that this works at some percentage level?

Response from Dr. Remien

What you are asking about is "Post Exposure Prophylaxis" (PEP) also known as "Post Exposure Treatment" (PET). Here is a response to a question about PEP that was posted on the "Safe Sex, Prevention, and Transmission" Forum on this website:

PEP stands for post-exposure prophylaxis, the use of anitviral medications shortly after a high-risk exposure to PREVENT infection. PEP was initially used among healthcare workers who experienced accidental needlestick injuries. Researchers found that PEP reduced the rate of infection by 79%, but some who took PEP still became infected. Research on PEP for sexual exposures is currently being conducted to see if treatments for the general public are feasible and effective.

Post-exposure prophylaxis probably needs to be started within 24-36 hours of exposure. Since the procedure is still not widely practiced, is expensive (and not covered by health insurance), and can cause troubling side-effects for people, PEP is only recommended for individuals who have a significant exposure to HIV. Criteria vary, but PEP is only warranted when someone has unprotected vaginal or anal intercourse with an infected person or a person from a high-risk group (men who have sex with men, injection drug users, or people from an area of high HIV prevalence), or for a victim of sexual assault. Programs that provide PEP are developing (mostly in urban areas) and hospitals sometimes have protocols for administering non-occupational PEP.

Besides the cost, hassle and side-effects of the medications, taking PEP does not have any long-term health consequences. Remeber, it is only indicated for people who have a high-risk exposure.

Please read through the articles posted on the "Post-exposure Prevention for Sexual, Needle, or Non-occupational Exposures to HIV" page at The Body for more information.

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