Follow-up care through PEP as protection against HIV

5 Min. Lesezeit

Sometimes it does happen: you meet someone and end up in bed with them. During sex, the excitement is so great that you forget the condom during anal intercourse. It tears in the heat of the moment, or he comes in your mouth during a blowjob, or vice versa. All this is not so bad, even if one of you is HIV-positive. Things are a bit more complicated in the case of an untreated HIV infection. Which can be the case if the person in question doesn’t know about the infection, for example. But even then, there are ways to avoid an HIV infection, namely through a so-called PEP. What this is and how you can best proceed if you have had a risky contact, you will find out in this article.

How can PEP reduce my risk of HIV after a safer sex accident?

To reduce the risk of HIV infection at least a little, it makes sense to do the following things immediately after unprotected sex:

  • Unprotected anal sex carries a high risk of HIV infection. Immediately afterwards, wash your penis carefully but thoroughly with soap under running water. Pull back the foreskin (if present) completely and wash the glans, the outside of the foreskin and also its inside. Avoid any pressure on the mucous membrane.
  • Ejaculate in the mouth poses little risk. Nevertheless, if your sex partner has come in your mouth, you should spit out the semen immediately. And rinse your mouth four to five times with water. You should do the same if ejaculate gets into your eyes.

You should absolutely refrain from douching with the help of an anal douche. Although some people advise this and believe that it can reduce the risk of infection. It is not yet clear whether the risk of infection is actually increased by such a douche.

Postexposure prophylaxis (PEP) – Precaution after risk contact

If you have had sexual, unprotected contact with an HIV-positive person, you should not worry too much, but you should still see a doctor as soon as possible. PEP must start at least 24 to 48 hours after the risk contact if it is to be effective. The doctor will prescribe PEP as a precaution after contact with HIV. The whole treatment lasts four weeks. During this time, you will take certain HIV medicines. These are to prevent the HIV from taking hold in your body in the first place.

PEP – when it makes sense

You do not have to take PEP every time you have sex. Post-exposure prophylaxis is indicated if you have had unprotected oral or anal sex with a person who:

  • There is a reasonable suspicion of HIV infection
  • You are aware of the infection, but do not know for sure whether they are on therapy or whether the HIV therapy is working
  • You have an HIV infection with a detectable viral load


In addition to these three, there are other situations in which you should consider PEP together with a doctor:

  • You are a health professional and have been injured by a used syringe or other instruments that have previously come into contact with the blood of a person infected with HIV
  • You are a drug user and have used cutlery that was previously used by an HIV-positive person when injecting

Whether you need PEP is best clarified during a counselling session with an expert doctor (e.g. an HIV specialist), an outpatient clinic or a counselling centre, for example at the AIDS help centre in your area. In both cases, you don’t need to be afraid that your risk contact will become known; there is a strict duty of confidentiality. You can find a suitable contact point on the internet

Important note: Ideally, the sex partner with whom you had the “accident” should go along to such a consultation. In this way, they can give the doctor or counsellor important information about their HIV status, any therapy they have already started and any resistance they may have.

Where can you get a post-exposure prophylaxis?

You can’t get this treatment everywhere. If you have had a risk contact, you have to go to a specialised clinic or to a so-called HIV specialist. The outpatient clinics are open 24 hours a day, so it is possible to get an appointment regardless of the time of day. In HIV specialist practices, you can get PEP during the day during normal opening hours. When deciding where to go, you should always take into account that time is of the essence. In order to be able to start post-exposure prophylaxis as soon as possible, contact the institution that you can reach as quickly as possible. The telephone counselling service of the Aids Support Service will certainly help you.

Many side effects of PEP

Medicines contain certain ingredients that are supposed to fight a disease. Such ingredients or active substances can be very strong and put a strain on the body. That is why almost all medicines have side effects, including those of post-exposure prophylaxis. The most common are headaches, diarrhoea, nausea and vomiting. Before you start PEP, find out how you should react if any of these (or others) occur.

Protection through therapy

Perhaps you can be reassured by the knowledge that HIV infection is usually not possible if the HIV-positive person treats the infection with the help of the drugs available today. The drugs prevent the HI virus from multiplying in the organism. The decisive factor is that the person affected is below the detection limit. This method is called protection through therapy.

Protecting condoms

Many people don’t use them, but condoms are an effective way to protect against HIV and other sexually transmitted infections (STIs), such as chlamydia, gonorrhoea, hepatitis B and C, herpes and papillomavirus. Although there is ultimately no 100 per cent protection against infection, condoms are one of the best ways to protect you from negative consequences. They save you from having to go to the doctor and possibly suffering painful consequences due to an illness. All you have to do before sex is put the barely noticeable and less stinging „contraceptive on your penis. That is an acceptable price to pay for your health.

PreP as a precaution against sexual contact

If you have a lot of changing sexual partners, and you are not always sure whether they are infected with HIV and are taking appropriate therapy, you also have the option of starting PreP (pre-exposure prophylaxis). When you are HIV-negative, you take HIV medication to protect yourself from possible infection during your sexual activities. If you belong to the group of people with an increased risk of HIV, your health insurance will cover the costs of your PreP.

Sex with pills saves the PEP

By far the most effective way to protect yourself from HIV and other sexually transmitted diseases is to have sex with chicks or with a great sense of responsibility. If you act wisely, instead of sending your own mind on a temporary holiday due to excessive horniness, you have a very good chance of surviving every sex date, no matter how exciting, with a great deal of pleasure, completely unscathed and without HIV infection. Open and honest communication with the respective sex partner is helpful. If you have special preferences, find out before sex how they can be realised without risk. The rule here is that there is (almost) always a way, if the will is there. You just have to talk about it.

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