PEP – Post-Exposure Prophylaxis for HIV

Page last reviewed 8.10.2020

What is PEP (Post-Exposure Prophylaxis)?

PEP is a medication that effectively prevents HIV infection when taken within 72 hours of potential exposure to HIV. The national guidelines for post-exposure prophylaxis was published in 2018. The guidelines (in Finnish) can be found here.

Who is PEP meant for?

If you don’t know if your sexual partner is HIV-positive or whether they are on effective HIV medication and you did not use a condom, the following sexual situations are considered high risk in relation to HIV exposure:

  • Anal sex without a condom in sex between men.
  • Vaginal and anal intercourse without a condom with a person from a high prevalence country (for example parts of sub-Saharan Africa)
  • Vaginal or anal intercourse without a condom with a person selling or buying sex.
  • Vaginal or anal intercourse without a condom with a person who injects drugs and has a migrant background.
  • Vaginal or anal intercourse without a condom with a person living with HIV who is not on HIV medication.
The image shows pathways of when to take PEP and when not. It visualizes the same text as above under the heading "who is PEP meant for?"

Additionally it includes instructions on when not to use PEP. PEP is not needed when a condom was in use during the intercourse or when the sexual partner is on effective HIV medication.

How is it used?

A doctor can prescribe PEP after situations where you have an elevated HIV risk. The medication has to be started within 72 hours of the unprotected sexual intercourse. The earlier the medication is started the better it protects against HIV. Any doctor can determine the need for PEP after which a referral is made to a doctor specialized in infectious diseases. If you have had a high risk situation, contact your health center or emergency health center.

Before starting the PEP medication, you will be tested for HIV to make sure you are not HIV positive already. The medication is taken as a 28 day course. An HIV test is conducted both right after the 28 days and four months after the exposure to HIV.

Undetectable = Untransmittable

A person living with HIV who is on medication does not transmit HIV when the virus level is undetectable. Not even through unprotected sex.

Travel related HIV

Approximately half of HIV infections among Finnish people are travel related. The prevalence of HIV is significantly higher in many travel destinations than it is in Finland. Finnish people have been infected with HIV in Sub-saharan Africa, Thailand, Estonia and Russia, as well as European countries such as Germany and Spain. In some countries, such as Thailand (link in Finnish), it is possible to access PEP medication with a prescription in private hospitals.

Partners of injecting drug users

The prevalence of HIV among Finnish injecting drug users is very low, less than one percent. If you have a sexual partner who is a foreign injecting drug user, your HIV risk increases.