Question
Do I need to complete PEP for 28 days?
29 January 2024. Related: All topics, PEP/PEPSE, Side effects.
I’m on PEP right now and I have been before, but this time the side effects are crushing me. I had a stomach ache so bad I was crying and I’m also with a bad headache that I can’t study because of it.
I know 28 days is the standard (at least here where I live) but I saw some english site saying you could take for 5 days and see if the health clinic recommends you taking the remaining 23 days of PEP?
So i want to know if there’s any study on the efficacy based on the days the person was on PEP, because there’s no way i’m going to be able to take for a whole month.
Answer
Hi, how are you doing?
I am sorry to hear about the symptoms you are experiencing.
What is the name of the PEP you are taking and is it a different type to what you were taking before?
What was the website that has mentioned only using PEP for 5 days and then review?
Global guidelines are based off 21 day trials. There has been no research done to support only using PEP for 5 days and reviewing.
The recommendation of 28 days is based on low evidence which is more recommended for completion and a month is easier than 3 weeks to explain the duration of treatment.
The efficacy of PEP is given based on completing PEP for 28 days however this can largely be applied to 21 days though the actual effectiveness cannot be guaranteed.
Earlier than this and there is no evidence. This will also be effected by the actual risk and if your exposure was deemed high risk e.g., partner with high viral load without treatment, other STIs, use of drugs etc…
These all increase the risk of transmission.
There needs to be a balance between the actual risk that you personally have and how you are coping with the side effects. Have you tried managing your symptoms and are you sure they are related to your treatment? Has your doctor suggested anything for you to try?
Josh.
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