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You never seem to recommend Post exposure Pro...Is it not worth the side effects?
Jun 4, 2006

Dr. Bob: I've been reading your forum for a while now and everytime someone tells you about a high risk encounter you tell them to get tested at the 3 month mark to see if they became infected. You never seem to recommend PEP. Do you think PEP is not worth the side effects? Do you think PEP is not really going to prevent infection to someone exposed to HIV from a non-occupational experience? Lastly?- I read somewhere that England recommends PEP to start b/f 48 hours of having unprotected sex with someone known to have the virus or even if the status of the person is unknown. Why is it different from the United states? Here they recommend PEP to start 72 hours before the the time of exposure only if the you are certain the person you were with is infected. Please correct me if I'm wrong? Thanks for your time and help, GV

Response from Dr. Frascino

Hi,

I recommend PEP when there has been an HIV exposure that represents a substantial risk for transmission.

New U.S. guidelines for PEP treatment of non-occupational exposures to HIV (n-PEP) were issued in January 2005. In addition, California also recently issued its own n-PEP guidelines. The full tests are available at:

1. http:www.cdc.gov/mmwr/mmwr_rr.html/ (for the US guidelines)

2. http:www.dhs.ca.gov/ps/ooa (for the California guidelines)

I suggest you read through these documents. They address all the issues raised in your post regarding the U.S. guidelines. If you still have questions after that, please don't hesitate to write back.

Dr. Bob



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