HIV Post-Exposure Treatment (TPE): What to do in case of risk?

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The first few weeks after taking a risk can be tough. To prevent HIV infection, taking preventive treatment with antiretroviral drugs can be useful.

Indeed, if you have exposed yourself to the risk of HIV transmission during unprotected sex, or following a condom breakage, it is possible to start Post-Exposure Treatment (TPE).

What is post-exposure treatment?

It is an emergency preventive treatment, prescribed in case of risk taking in relation to the Human Immunodeficiency Virus. The TPE blocks the virus, in case of contamination before it has time to infect the body.

When should a TPE be initiated?

In the following situations, there is a risk for which post-exposure treatment is recommended:

  • Unprotected vaginal or anal intercourse or fellatio with ejaculation in the mouth with an untreated HIV-positive person* or with a person whose HIV status is unknown.
  • Sharing injecting equipment from someone who is HIV positive or whose HIV status is unknown

*The notion of TasP (in English Treatment as Prevention or prevention through treatment in French has been demonstrated by clinical studies and is a mode of prevention recommended by experts in HIV infection. Thus an HIV-positive person who has a undetectable viral load on treatment since 6 months is no longer contaminating.

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How is the therapy going?

If in doubt, go quickly to a service specializing in HIV treatment, to a Cegidd (free information, screening and diagnosis centre) or to an emergency service to meet with a healthcare professional. which will check whether or not it is necessary to initiate a TPE. The therapy consists of taking three antiretroviral (ARV) drugs for 28 consecutive days.

For the TPE to be effective, it must be initiated quickly after taking the risk, at best within 4 hours of exposure to the risk, and at the latest within 48 hours. Beyond 48 hours, it is estimated that the TPE is no longer effective.

ARVs can sometimes cause minor side effects, such as nausea, vomiting, or gastrointestinal upset that resolves quickly.

Monitoring includes:

A first consultation: screening for HIV and other STIs (Chlamydia, Gonococcal, Syphilis, hepatitis B). The results of this 1st assessment reflect the situation of the exposed person in relation to HIV and other STIs before the report at risk. It is too early for STI contamination to be detectable within 48 hours after the risk.

  • If a TPE is indicated, he is initiated at this 1st consultation.
  • The subsequent follow-up depends on whether or not you are put on TPE.

In the absence of TPE (because the risk does not justify TPE), a second and final screening is carried out 6 weeks after the risk has been taken.

If the results are negative, the person can be considered definitely HIV-negative and not infected.

If put under TPE:

  • 2nd screening 2 weeks after stopping TPE, i.e. 6 weeks after the risk.
  • And 3rd and last screening 2 months after stopping TPE, i.e. 3 months after the risk.

If the results are negative, the person can be considered definitely HIV-negative and uncontaminated.

To know :

the post-exposure treatment helps to prevent an isolated risk. It is not a morning after pill, but a therapy recommended in exceptional and emergency conditions. Protection during sexual relations, vaginal or anal, remains imperative.

Is HIV post-exposure treatment effective?

The success of therapy largely depends on the length of time between exposure to risk and the start of drug treatment. It is effective if initiated within 48 hours after exposure.

TPE is not an alternative protective tool to condoms and does not guarantee immunity against disease.

You were exposed to a risk of HIV transmission and you need to know more about post-exposure treatment? Download the documentation relating to the TPE or contact AIDS info Service on 0 800 840 800, confidential, anonymous and free call!

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