For urgent after-hours in-person care the nearest clinic is White Cross Ascot, 90 Greenlane East, Remuera, Auckland. Phone 09 520 9555. For emergencies, please call an ambulance 111, or go to Auckland City Hospital, Park Road, Grafton.
PEP is time critical. The window is 72 hours, and sooner is better. If you think you have been exposed to HIV in the last three days, do not wait to see whether you feel unwell and do not wait for a routine appointment. Phone a clinic during opening hours and say it is about a recent possible HIV exposure. Outside opening hours, go to a hospital emergency department. Healthline is free on 0800 611 116 at any hour if you are not sure what to do.
Post exposure prophylaxis, almost always shortened to PEP, is a course of HIV medicines taken after a possible exposure to reduce the chance of the virus establishing an infection.
It is emergency treatment rather than routine care, and the single most important thing about it is timing. PEP has to be started within 72 hours of the exposure, and the earlier within that window it begins, the better it works. Every hour counts, which is why the usual advice is to make contact straight away rather than sleeping on it.
This guide explains what PEP is, when it is considered, what happens when you ask for it, what taking the course involves, and where to get it in Auckland including after hours.
PEP is assessed case by case, because whether it is appropriate depends on the type of exposure and on how likely it is that HIV was involved. Situations where people are commonly assessed for it include:
You do not need to work out for yourself whether your situation qualifies. That assessment is the clinician's job, and it is better to ask and be told PEP is not needed than to decide against it on your own and lose the window. If the answer is no, the appointment is still useful, because it usually leads into testing and advice.
It is worth knowing that an HIV positive partner whose treatment has made the virus undetectable does not pass HIV on through sex. If that is the situation, say so, because it changes the assessment.
The names are similar enough that they get mixed up, and the difference matters when you are asking for one of them.
| PEP | PrEP | |
|---|---|---|
| What it stands for | Post exposure prophylaxis | Pre exposure prophylaxis |
| When it is used | After a specific possible exposure | Before and during a period of ongoing risk |
| Timing | Must start within 72 hours of the exposure | Taken on an ongoing basis, arranged in advance |
| How long | A short course of about four weeks | Continued for as long as the risk continues |
| Typical situation | A condom broke last night | Someone at ongoing risk who wants standing protection |
If you are dealing with one incident that has already happened, PEP is the question. If the same worry keeps recurring, PEP is the wrong tool for it and PrEP is worth discussing. CityMed has doctors who prescribe PrEP.
The clinician will ask what happened, when it happened, and what is known about the other person's HIV status. These questions are asked to work out whether PEP is indicated, not to make a judgement, and being direct about the details is what gets you the right answer quickly.
Before starting, you will usually have blood taken. This includes an HIV test, which is done to establish where you stood before the exposure rather than to detect anything from the incident itself, since it is far too early for that. Tests of kidney and liver function are commonly done at the same time, and other sexually transmitted infections are usually screened for as part of the same visit.
Waiting for these results does not delay the start. Where PEP is indicated it is generally begun straight away and adjusted later if a result calls for it.
PEP is a course of antiviral medicines taken every day for about four weeks. The clinician will explain what you have been given, how to take it, and what to do if you miss a dose.
Finishing the course matters. PEP works by preventing the virus from establishing itself while your body clears the exposure, and stopping partway through undermines that. If side effects are making the course hard to take, contact the clinic rather than stopping on your own, because there are usually ways to manage them.
Modern PEP is generally tolerated well. Some people get nausea, tiredness, headache or loose bowels, particularly in the first few days, and these usually settle as the course goes on. Taking the medication with food helps some people.
Tell the clinic about anything else you take, including regular medication, contraception, over the counter products and supplements, because some combinations interact. That conversation is easier at the start than partway through.
During the course, and until follow up testing is complete, you will be advised to use condoms and not to donate blood. This is a precaution while the situation is still being confirmed rather than an indication that something has gone wrong.
PEP is not finished when the tablets run out. Follow up HIV testing is arranged after the course, and often at a further point after that, because the tests need time to become reliable. The clinic will tell you when to come back and it is worth putting the dates somewhere you will see them.
The follow up visits are also the point at which any other infections picked up in the initial screening are dealt with, and where a conversation about ongoing prevention makes sense.
Which door you use depends mostly on what time it is.
A GP practice that provides sexual health care can assess you and prescribe PEP. CityMed provides Pr/PEP as part of its sexual health service in Auckland CBD. Phone rather than booking online, and say it is about a recent possible HIV exposure, so the appointment is treated as urgent rather than slotted into the next free space.
Do not wait until Monday. If the 72 hours will run out before a clinic opens, go to a hospital emergency department, where PEP can be assessed and started. Auckland City Hospital on Park Road in Grafton is the closest to the central city.
Healthline is free on 0800 611 116, is answered at any hour, and can tell you where to go if you are not sure. Auckland Sexual Health Service also assesses and provides PEP, and their current hours and contact details are published by Health New Zealand.
If the exposure was a sexual assault, specialist services are available that provide medical care, including PEP, alongside support, and you can access them whether or not you want to involve the police.
Cost depends on where you are seen and on the circumstances of the exposure, and the funding rules change from time to time, so this article does not quote a figure. Our current consultation rates are on the fees page.
Cost should not be the reason someone lets the 72 hours pass. Raise it when you make contact and ask what applies in your situation, because there are circumstances in which PEP is funded.
PEP deals with one incident. If you find yourself considering it more than once, that is a signal that a standing form of protection would serve you better, and it is a normal thing to raise with a GP.
A full STI check at the follow up point is worth having, since HIV is rarely the only thing worth excluding after an exposure. For ongoing risk, PrEP is the option designed for it.
Up to 72 hours from the exposure, and the sooner the better within that window. Beyond 72 hours PEP is generally not started, because the opportunity to prevent infection has passed. If you are close to the limit, make contact immediately rather than waiting for a convenient time.
PEP itself is generally not started after 72 hours, but that does not mean nothing can be done. An appointment is still worth making, for testing, for advice, and to discuss ongoing prevention. Do not let a missed window become a reason to avoid the clinic altogether.
No preventive treatment is absolute. PEP substantially reduces the risk when it is started promptly and the full course is completed, which is why timing and finishing the course are both emphasised. Follow up testing is what confirms the outcome.
The consultation is confidential in the same way as any other. HIV is notifiable for public health purposes, which is separate from anyone in your personal life being informed. If you have questions about who sees what, ask at the appointment.
Often yes. Many people who are assessed for PEP do not know the other person's status, and the assessment takes account of the type of exposure and other factors alongside what is known. Not knowing is not a reason to stay away.
Phone CityMed on 09 377 5525 and say it is about a recent possible exposure. We provide sexual health care including Pr/PEP in Auckland CBD.
If it is outside our opening hours and the 72 hours is running, go to a hospital emergency department instead. Auckland City Hospital, Park Road, Grafton. Healthline is free at any hour on 0800 611 116.
For anything less urgent, book an appointment or get in touch.
This article is general health information and is not a substitute for individual medical advice or emergency care. Whether PEP is appropriate is decided by a clinician after assessing the exposure. If you think you have been exposed to HIV in the last 72 hours, seek medical advice immediately rather than acting on this page alone. Healthline is free on 0800 611 116 at any hour.
General health information | Reviewed by Dr. Terry Zhang, GP | CityMed Medical Centre, Auckland CBD
