‘My first time on PEP was an eye-opener’

Writer James Dawson separates sexual health fact from fiction for National HIV Testing Week…

This week is National HIV Testing Week and the Terrance Higgins Trust, along with HIV Prevention England, would encourage all men who have sex with men to have a routine HIV test.

In most parts of the UK, getting tested is beyond simple. Make an appointment at your local sexual health clinic, or don’t – many offer walk in services. Drop-in clinics are mostly found in cities like London, Brighton or Manchester where transmission rates are higher than average.

If you’ve never been tested, it often involves little more than a pin-prick test and most clinics now offer immediate results. In centres that don’t offer an instant test, your results will be delivered anonymously within two weeks.

Knowing your HIV status is the best way to protect yourself and your sexual partners. If the furore around Charlie Sheen’s HIV disclosure last week has achieved anything, it’s a better understanding of what it means to live with HIV in 2015. If your test does come back positive, you’ll be put under medical treatment enabling you to live a long and healthy life as well as protecting your partners.

They say that prevention is better than cure, but in the case of HIV, there simply is no cure. There is, however, a panic room: How much do you know about PEP? PEP stands for Post-Exposure Prophylaxis and, if exposed to HIV, it can prevent the virus from infecting your body. In no way is PEP a replacement for a condom, as it isn’t 100% effective and offers no protection from hepatitis, syphilis, gonorrhoea, herpes or chlamydia.

PEP does offer a vital failsafe for when accidents happen or when bad choices are made. You might question why I’m writing this piece. Well, it’s because I recently completed my first course of PEP and it was quite an eye-opener.

I’m not going to go into the precisely why I sought PEP – this isn’t a reality show – but needless to say I’m not the first person to make poor choices regarding my sex life and I won’t be the last. Statistically speaking, I was at very low risk anyway, but the next day (nursing a hangover I’d describe as apocalyptic) I discussed the previous night’s error with my friends.

They agreed that while I was at little risk, imagine if, in a couple of month’s time, a test came back positive. And so I called my clinic the next morning and they asked me to come in within two hours. PEP is only effective for 72 hours following exposure, so time is of the essence.

I’m not going to lie. PEP is a faff. Less of a faff than living with HIV, I’d hazard, but a faff nonetheless. A nurse tested me for HIV and assessed whether I actually needed PEP. As I live in Brighton – a high risk area – it was agreed that I was a worthy candidate for PEP. They politely enquired as to whether this sort of thing happened regularly/I was an alcoholic/frequented chem parties/was a rent boy before handing over the pills.

PEP must be strictly adhered to. Three pills, one blue, two pink must be taken regularly as clockwork every twelve hours. Missing doses reduces the effectiveness of the treatment. A couple of times in the 28 day period, I had to turn around and head back to my flat when I forgot my medication. On top of the pills, I had to have follow-up appointments at five, fourteen and twenty-eight days. Like I said, a faff.

Interestingly, while at the clinic, I bumped into an acquaintance who was there for exactly the same reason as me. Awkward. Only afterwards did I question why it was awkward. Are we still Victorians? Is there something shameful about sex? About PEP? About HIV? No, there really isn’t, and that’s why I’m happy to talk about my own experiences here. To not do suggests I’ve done something wrong. I didn’t, I did exactly what you’re supposed to do.

My biggest worry, and the reason I’d never accessed PEP in the past, was I’d heard about horrific side effects. I’d heard legends of nausea, diarrhoea, pounding headaches and a month of dizziness. However – and here’s the twist – within the last year or so, PEP has changed. It’s now a new cocktail of ingredients with far, far fewer side effects.

Listen, everything, and I mean everything, upsets my stomach: penicillin, ibuprofen, coffee, milk, but I’m pleased to say I experienced next to NO side-effects during the month I was on PEP. The only slight change was a bit of sleepiness but I don’t know if that’s the pills or that I’m busy. It certainly wasn’t so bad I couldn’t go about my normal life. Everybody reacts to different medications differently, but I would say worrying about side-effects should no longer be a barrier to accessing PEP.

Of course, this leads us nicely to PrEP. PrEP is the same as PEP but taken as a precaution if a person is thought to be at high risk. This, in our case, would be men who have sex with men, especially those have many casual partners, sex workers or those in sero-discordant relationships. Despite hugely encouraging research data on transmission rates in both the UK and the US, PrEP is still not available on the NHS. It is hoped it may be made more widely available by 2017.

Someone needs to tell The Sun that the days of histrionic, plague-mongering are dead and buried. Although HIV is no longer a death sentence, it is as HIV+ friends tell me, one hell of a life sentence. As ever, always use a condom when having anal sex, do get tested at least once a year (more if you’re with multiple partners) and do consider PEP. With all best intentions, I’d love to say I’ll never make another bad life choice, but we all do. I really can’t be bothered to take three pills a day for the rest of my life, but I certainly feel calmer knowing PEP is there and certainly didn’t make me feel like death for 28 days. The next time you have a slip-up, don’t forget PEP.

PEP – The facts:

• PEP is not guaranteed to work, but has a very high success rate if the regime is followed carefully.
• It is a free treatment and can be accessed at a sexual health clinic or from an A&E department.
• The sooner PEP is started the more effective it is. Within 24 hours is the ideal, but it must be started within 72 hours of exposure.
• PEP must be strictly taken for 28 days. It is not effective if treatment is stopped.
• If you experience side-effects, a doctor can prescribe further medication to deal with them.
• While taking PEP, it is advisable to limit sexual contact and to avoid drugs and excessive drinking. Some other drugs and medications interact with PEP and your doctor will ask what other drugs you take.

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