Biomedical prevention of HIV - HIV PrEP and HIV PEP

HIV PrEP involves taking oral or injectable antiretroviral medications on an ongoing basis to prevent an HIV infection.

Intended for regular use as an ongoing HIV prevention method.

HIV PEP involves taking oral antiretroviral medications as soon as possible after a high-risk exposure to prevent an HIV infection.

Intended to prevent HIV transmission from a singular exposure.

HIV PrEP is taken both before and after exposures that carry a high risk of HIV.

Oral HIV PrEP involves taking a pill once a day, on an ongoing basis.

Long-acting injectable PrEP is first given as two initiation injections one month apart, followed by an injection every two months thereafter.

HIV PEP should be started as soon as possible after a high-risk exposure to HIV, up to a maximum of 72 hours afterwards.

HIV PEP involves taking oral pills daily for 4 weeks (28 days).

HIV PEP can be taken on more than one occasion, if needed. However, individuals who have taken HIV PEP and are at ongoing risk of HIV exposure should consider taking HIV PrEP.

HIV PrEP should be considered for individuals who do not have HIV and who participate in activities that have increased risk of exposure to HIV.^{Footnote *}

Some sexual activities that have increased risk of HIV, including sex with:

• no or inconsistent condom use; or
• a partner(s) whose HIV status is unknown; or
• a partner(s) who is living with HIV and who is not on treatment^{Footnote **}; or
• the use of drugs or alcohol; or
• the exchange for drugs or money.

Sharing drug use equipment is high risk for HIV.

A history of other sexually transmitted and blood-borne infections (STBBI) is a risk factor for HIV.

HIV PEP should be considered for individuals who do not have HIV and who have had a high-risk exposure to HIV.

A high-risk exposure could occur in a work context

• e.g., exposure to blood or bodily fluids in a healthcare setting

Some sexual activities are high risk for HIV exposure

• e.g., condomless sex with a partner who is living with HIV and who is not on treatment^{Footnote **}

HIV PEP may be recommended after a sexual assault.