&lt;p style=&quot;text-indent: 0px; margin: 0px; text-align: left;&quot;&gt;&lt;strong&gt;&lt;a href=&quot;https://cms.pulse-clinic.com/pulseteam/2&quot;&gt;Dr.Deyn Natthakhet Yaemim (Founding Director)&lt;/a&gt;&lt;/strong&gt; &lt;span style=&quot;color: #999999;&quot;&gt;6 June 2016, last updated 24 August 2022&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;text-indent: 0px; margin: 0px; text-align: center;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;h1 style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;strong&gt;PEP (Emergency PEP)&lt;/strong&gt;&lt;/h1&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;table style=&quot;border-collapse: collapse; width: 100%;&quot; border=&quot;1&quot;&gt;
&lt;tbody&gt;
&lt;tr&gt;
&lt;td style=&quot;width: 100%;&quot;&gt;
&lt;p&gt;&lt;span style=&quot;text-decoration: underline;&quot;&gt;&lt;strong&gt;&lt;span style=&quot;color: #ff99cc; text-decoration: underline;&quot;&gt;Key Points&lt;/span&gt;&lt;/strong&gt;&lt;/span&gt;&lt;/p&gt;
&lt;ul&gt;
&lt;li&gt;PEP involves taking a 28-day course of anti-HIV drugs, after possible exposure to HIV.&lt;/li&gt;
&lt;li&gt;Doctors will assess your risk of HIV infection before prescribing PEP.&lt;/li&gt;
&lt;li&gt;We recommend the ned medication called KOCITAF&lt;/li&gt;
&lt;li&gt;PEP is available from sexual health clinics and accident &amp;amp; emergency departments.&lt;/li&gt;
&lt;/ul&gt;
&lt;/td&gt;
&lt;/tr&gt;
&lt;/tbody&gt;
&lt;/table&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;If you have had a high risk exposure to HIV in the last 72 hours,&amp;nbsp;&lt;a href=&quot;https://www.pulse-clinic.com.sg/hiv-pep&quot;&gt;HIV PEP&lt;/a&gt; must be started within 72 hours after a possible exposure to HIV.&lt;br /&gt;It is most effective when started within 24 hours, the sooner someone starts PEP the better prevention. Decades of knowledges and experience have shown that PEP can reduce HIV infection.&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;strong&gt;&lt;span style=&quot;text-decoration: underline;&quot;&gt;Factors that can increase the risk of HIV infection and you are a potential candidate for PEP due to:&lt;/span&gt;&lt;/strong&gt;&lt;/p&gt;
&lt;ul style=&quot;list-style-type: square;&quot;&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;The partner is known to be HIV positive AND is not on treatment.&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Anal sex with penetration without condom&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Vaginal sex without condom&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Condom break&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Presence of blood&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Presence of cuts or ulcers&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;You are not circumcised&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;You have been exposed to potentially HIV infected body fluids&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Your exposure was less then 72 hours ago&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Partner of unknown HIV status who belong to higher risk HIV group (e.g. MSM or from africa or S.E.Asia)&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;They penetrated you (Their penis, your arse) AND you don&#39;t know for sure whether they have HIV or not.&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;However, if you are unable to access &lt;a href=&quot;https://www.pulse-clinic.com.sg/hiv-pep&quot;&gt;HIV PEP&lt;/a&gt; within the 72 hours, even if it has been up to 5-7 days since the exposure occurred, it is still worth seeking medical advice to see what your options are. This may include commencing a 3-drug combination of antiretroviral medications as soon as possible just in case you have become HIV positive. In this case, you would be starting very early treatment and minimising the damage to your immune system.&lt;/span&gt;&lt;/p&gt;
&lt;h2 style=&quot;-qt-paragraph-type: empty; -qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/h2&gt;
&lt;h3 style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;strong&gt;How Does Emergency PEP work?&lt;/strong&gt;&lt;/h3&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong&gt;It takes a few days for HIV to become established in the body following exposure.&lt;/strong&gt; Once it is established you will have HIV for the rest of your life. However, if you begin taking PEP in time, the anti-HIV drugs will prevent the HIV (that&#39;s already in your body) from reproducing and it DIES out before it has a chance to multiply.&lt;/span&gt; &lt;span style=&quot;color: #99ccff;&quot;&gt;PEP drugs given at this time may help the body&amp;rsquo;s immune system to stop the virus from replicating (multiplying) in the infected cells of the body. The cells originally infected would then die naturally within a short period of time without producing more copies of HIV.&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;h3 style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;strong&gt;Can Emergency PEP protect me 100%?&lt;/strong&gt;&lt;/h3&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;PEP is not a &amp;lsquo;cure&amp;rsquo; for HIV. PEP may prevent HIV from entering cells in the body and so stop someone from getting HIV. PEP isn&amp;rsquo;t 100% effective. However, there have been very few reports of HIV infection after the use of PEP.&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;h3 style=&quot;text-indent: 0px; margin: 0px; text-align: center;&quot;&gt;&lt;iframe src=&quot;//www.youtube.com/embed/vVXzGpfyiFQ&quot; width=&quot;560&quot; height=&quot;314&quot; allowfullscreen=&quot;allowfullscreen&quot;&gt;&lt;/iframe&gt;&lt;/h3&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;h3 style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;strong&gt;But if the HIV is already in the body, isn&#39;t it too late?&lt;/strong&gt;&lt;/h3&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Not if you act quickly. After HIV gets in the bloodstream it takes some time before it permanently establishes itself in the body. If a person who has been exposed to HIV acts quickly to get PEP (within 72 hours) they stand a good chance of stopping the virus from establishing itself in their body.&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;h3 style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;strong&gt;So, if I take PEP I won&#39;t become HIV positive?&lt;/strong&gt;&lt;/h3&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Research indicates that taking PEP makes infection with HIV a lot less likely. But PEP doesn&amp;rsquo;t work every time. Some people who take it still end up with HIV afterwards. When people taking PEP have acquired HIV, it can fail because:&lt;/span&gt;&lt;/p&gt;
&lt;ul&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;not starting PEP quickly enough&lt;/span&gt;&lt;/li&gt;
&lt;li style=&quot;text-indent: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;the person doesn&amp;rsquo;t or isn&amp;rsquo;t able to take PEP as prescribed (every day for a month)&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;missing doses of PEP or not finishing the 28-day course&lt;/span&gt;&lt;/li&gt;
&lt;li style=&quot;text-indent: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;some anti-HIV drugs don&amp;rsquo;t work against some strains of HIV (HIV drug resistant, although this is rare)*&lt;/span&gt;&lt;/li&gt;
&lt;li style=&quot;text-indent: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;the initial viral load (the amount of HIV) in the body was too great for the drugs to be effective**&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;having unprotected sex or sharing needles, with further exposure to HIV, while taking PEP.&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;However, the sooner PEP treatment is begun after exposure to the virus, the more likely it is to work.&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-paragraph-type: empty; -qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;h3 style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;strong&gt;WHAT WOULD BE DONE WHEN RECEIVING EMERGENCY PEP AT PULSE CLINIC?&lt;/strong&gt;&lt;/h3&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;1. Consultation&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;2. Rapid screening for HIV, Hepatitis B virus with result in 15 minutes, accuracy 99.9%&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;3. Kidney function tests&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;4. PEP Medications&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;5. Test or treatment for possible sexually transmitted infections&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-paragraph-type: empty; -qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;h3 style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;strong&gt;WHAT HIV PEP DRUGS DO WE USE?&lt;/strong&gt;&lt;/h3&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;We use the latest gold standard PEP medicines with fewer side effects and better HIV prevention which will be taken for 28 days.&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;strong&gt;For adults:&lt;/strong&gt; &lt;span style=&quot;color: #99ccff;&quot;&gt;Tenofovir combined with either Tenofovir (TDF) and emtricitabine (FTC) as preferred backbone drugs and these are also the preferred drugs for treating HIV.&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong&gt;The recommended third drug, which is also recommended by WHO and CDC as a preferred drug for HIV treatment, will be chosen by your doctor.&lt;/strong&gt;&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;There are some of our clients who do not understand when our doctors try to explain about &lt;strong&gt;HIV drug resistant.&lt;/strong&gt; If you are unlucky and being exposed to such HIV, the classic PEP medications are not able to help you. That&#39;s why American CDC suggested on their PEP treatment guidelines that we should use a higher class of drugs that is less likely to be resisted by the HIV drug resistant type. These higher class medications are available at our clinics and they are costly. Much more expensive than the classic PEP medications generally used in low income countries. When our doctors prescribe this higher class PEP medications it is because they evaluate that your risk is very high and they are trying to keep the standard as high as American Center of Disease Control Guidelines for PEP treatment.&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-paragraph-type: empty; -qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;h3 style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;strong&gt;WHAT ELSE SHOULD BE DONE?&lt;/strong&gt;&lt;/h3&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Your doctor might advice that you get treatment as prevention for possible gonorrhoea/chlamydia/syphilis after unprotected sex or sexual accident. We recommend PCR multiplex to detect 14 STDs available at PULSE CLINIC.&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;h3 style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;strong&gt;YOU DON&#39;T NEED PEP IF...&lt;/strong&gt;&lt;/h3&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;- You are confident that your partner doesn&#39;t have HIV.&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;- The partner is HIV positive and on successful treatment (Known as &amp;lsquo;undetectable viral load&#39;)&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;- Human bites&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;- Another person&#39;s semen gets in your eye.&lt;/span&gt;&lt;/p&gt;

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