Post-exposure Prophylaxis: Can Early HIV/AIDS Infections be Prevented?

Written by Sadaf Qadir

With 36.7 million people living with the HIV infection globally (as of 2015), it is clear that HIV has a huge impact in global healthcare [1]. But what is HIV?

HIV stands for ‘Human Immunodeficiency Virus’ and, true to its name, attacks the immune system [3]. HIV targets immune cells called T-cells for destruction which results in a weakened immune system [4]. When the T-cell count falls very low, a person is said to have Acquired Immune Deficiency Syndrome or AIDS; however, a person may avoid getting to this stage if treatment is managed [5].

HIV is spread via bodily fluid contact which includes sexual activity, needle sharing, and breast milk [6]. New HIV infections occur due to transmission through these actions [6]. While there is no cure, an alternative for methods of treatment is taking antiretroviral therapy (ART) drugs, which reduce the chances of advancing to AIDS and prolongs HIV-infected peoples’ lifespans [2]. However, prevention methods through education and awareness have played a major role in decreasing the number of new infections.

In recent years, a new drug called Post-Exposure Prophylaxis (PEP) has been developed as a prevention method for people who suspect they have come in contact with HIV or people who know they have [7]. PEP involves taking ART drugs within 72 hours of exposure, every day for 28 days [8]. As of 2005, the medication is available to anyone who can access and afford it [8]. While the pill is expensive, ranging from $600-1000, it is possible for healthcare providers to apply for free PEP medications through the manufacturer [7].

PEP has been gaining more interest over the years as a prevention method and is used as an emergency option especially for healthcare workers [8]. However, it still has its limitations. PEP does have side effects including nausea, headache, fatigue, and general feeling of illness [8]. It is also not 100% effective [7,8]. In healthcare works, HIV infections were reduced by 79% post-exposure to the virus [8]. However, because the drug is still fairly new, there is not conclusive data on its implications in non-healthcare settings [8]. Additionally, concerns have been raised about PEP’s potential to be considered as the “morning after” pill for HIV/AIDS when it should be used as an emergency prevention method and not as a safety net for those who want to continuously engage in risky behavior [7]. As these drugs are taken more often, drug resistance can occur and different types and amounts are then required [8]. PEP has also led to the development of Pre-Exposure Prophylaxis, which may be an option for those who frequently are exposed to HIV (e.g. healthcare workers in Africa) [10].

As more research is conducted and more people around the world start considering PEP, it will become easier to gauge the efficacy and benefit of PEP. For now, it is useful to know that PEP is an option in case of an emergency [9].

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