&lt;p style=&quot;text-indent: 0px; margin: 0px; text-align: center;&quot;&gt;&lt;span style=&quot;color: #808080;&quot;&gt;Written by &lt;a href=&quot;https://cms.pulse-clinic.com/pulseteam/2&quot;&gt;&lt;span style=&quot;color: #0000ff;&quot;&gt;Dr.Deyn Natthakhet Yaemim&lt;/span&gt; (Founding Director)&lt;/a&gt; on 6 June 2016, last updated 28 Fevruary 2021&lt;/span&gt;&lt;/p&gt;
&lt;hr /&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;PEP 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.&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;a href=&quot;https://www.pulse-clinic.com.sg/condom-broke-in-singapore-get-emergency-pep&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Condom break&lt;/span&gt;&lt;/a&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;&lt;span style=&quot;color: #99ccff;&quot;&gt;However, if you are unable to access PEP 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;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;WHAT IS PEP?&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;PEP means &lt;/strong&gt;Post-Exposure Prophylaxis. It refers to a management to prevent HIV infection for those who are HIV negative and potentially exposed to HIV, by taking PEP it means the person is taking AntiRetroviral medication to prevent/stop HIV from being established in the body of the person.&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;HOW DOES 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;HOW WELL DOES 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;The golden period for PEP medication is 72 hours after a potential exposure to HIV, and it is proven to be highly effective if it is started within this period. PEP can make sure that you won&amp;rsquo;t be infected with HIV, regardless of the means that you caught it. However, you must take it daily for at least 28 days, and on top of daily dosage, it must be at the same hour every day. This is because the PEP drug will show its full effectiveness if taken as mentioned.&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;IS PEP FOR ME?&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 the right tool for you to use to prevent yourself from getting HIV if&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/p&gt;
&lt;ul&gt;
&lt;li style=&quot;text-indent: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;you&amp;rsquo;re HIV-negative or don&amp;rsquo;t know your HIV status&lt;/span&gt;&lt;/li&gt;
&lt;li style=&quot;text-indent: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;you may have been exposed to HIV during sex (for example, if the condom broke) within the last 72 hours&amp;nbsp;&lt;/span&gt;&lt;/li&gt;
&lt;li style=&quot;text-indent: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;you shared needles with someone else within the last 72 hours&lt;/span&gt;&lt;/li&gt;
&lt;li style=&quot;text-indent: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;you were sexually assaulted&lt;/span&gt;&lt;/li&gt;
&lt;/ul&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 VIRUS IS ALREADY IN THE BODY, ISN&amp;rsquo;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;h3 style=&quot;-qt-paragraph-type: empty; -qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/h3&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&amp;rsquo;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 &amp;ndash; some people who take it still end up with HIV afterwards. It can fail because:&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 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;/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;- 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;/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 initial viral load (the amount of HIV) in the body was too great for the drugs to be effective**&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;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;At PULSE CLINICs, your doctor might advice that you get treatment as prevention for possible gonorrhoea, chlamydia, syphilis after unprotected sex or sexual accident. And they will suggest that you get tested to sreen for &lt;a href=&quot;https://cms.pulse-clinic.com/what-is-stds&quot;&gt;STIs/STDs&lt;/a&gt; such as &lt;em&gt;&lt;a href=&quot;https://cms.pulse-clinic.com/ureaplasma-parvum&quot;&gt;ureaplasma parvum&lt;/a&gt;, &lt;a href=&quot;https://cms.pulse-clinic.com/ureaplasma-urealytica&quot;&gt;ureaplasma urealyticum&lt;/a&gt;, &lt;a href=&quot;https://cms.pulse-clinic.com/mycoplasma-hominis&quot;&gt;mycoplasma hominis&lt;/a&gt;, &lt;a href=&quot;https://cms.pulse-clinic.com/mycoplasma-genitalium&quot;&gt;mycoplasma genitalium&lt;/a&gt;, &lt;a href=&quot;https://cms.pulse-clinic.com/trichomoniasis&quot;&gt;trichomonas vaginalis&lt;/a&gt;, &lt;a href=&quot;https://cms.pulse-clinic.com/lgv-lymphogranuloma-venereum&quot;&gt;LGV&lt;/a&gt;&lt;/em&gt; because up to 70% of people who are infected do not have any symptoms (&lt;a href=&quot;https://cms.pulse-clinic.com/asymptomatic-sexually-transmitted-infection&quot;&gt;asymptomatic infecitons&lt;/a&gt;) and pass on the infections to other people without knowing. Most of us think that STDs/STIs are transmitted through sexually contact only but in 2021 that&#39;s not true anymore because we know that there are numbers of STDs/STIs that spread via direct contact (&lt;a href=&quot;https://cms.pulse-clinic.com/stis-spread-by-direct-skin-contact&quot;&gt;skin-to-skin&lt;/a&gt;) such as touching.&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;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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