Question 1

Who should start PEP?

Accepted Answer

If you have had a high risk exposure within the last 72 hours (any unprotected anal or vaginal sex)

With a partner who is HIV positive

Or

Is in a HIV-risk group e.g.

Men who have sex with Men
Bisexual men
IV drug users
Sex workers
Victim of rape

Question 2

How is PEP given?

Accepted Answer

DSC clinic offers a 30-day oral antiretroviral drug regimen of Truvada (Emtricitabine 200mg, Tenofovir 300mg) for post-exposure prophylaxis (PEP) in the management of Human Immunodeficiency Virus (HIV) infection.. Rilpivirine or Dolutegravir may sometimes be combined with Truvada for a triple oral drug combination regimen.

Rilpivirine® 25mg Tab
Or
Dolutegravir® 50mg

Truvada®
(Emtricitabine 200mg, Tenofovir 300mg)

The approximate cost of PEP treatment at the DSC Clinic ranges from $400-$800.

Question 3

WHAT ARE THE COMMON SIDE EFFECTS?

Accepted Answer

Side effects of Truvada:

Diarrhoea
Nausea or vomiting
Stomach upset
Headache
Difficulty in sleeping
Feeling tired or weak

Side effects of Rilpivirine:

Nausea or vomiting
Stomach upset
Headache
Difficulty in sleeping
Drowsiness

Side effects of Dolutegravir:

Diarrhoea
Nausea
Headache
Difficulty in sleeping
Feeling tired or weak

Question 4

BASELINE SCREENING AND FOLLOW UP

Accepted Answer

The following tests will be done at your first visit:

HIV test
Appropriate STI test as recommended by your doctor

Your doctor will advise you on the necessary follow up visits, but it is recommended that repeat HIV tests be done at 1 and 3 months, in addition to completing all other appropriate STI tests.

Baseline tests will detect any pre-existing abnormality before treatment and can be repeated when necessary.

Question 5

IMPORTANT NOTES

Accepted Answer

There is supportive evidence based on biologic possibility, animal & other studies that PEP can potentially decrease the risk of HIV acquisition if taken early enough. PEP is not given for exposures after 72 hours.

The treatment is not 100% effective and there have been cases of people who have still been infected with HIV despite receiving PEP.

PEP is not given to everyone because of the potential side-effects and also if the risk of the exposure is deemed to be extremely low (less than 1 in 10,000 chance) such that benefits of taking the medication outweigh the risks.

PEP is also not useful if you have had multiple high risk exposures over a prolonged period of time or continue to be at high risk for exposure. In such case, you may be more suitable for Pre-Exposure Prophylaxsis (PrEP), which is taken as a preventive daily medication. Please speak to your doctor to find out more.

Question 6

S​AFE SEX ADVICE

Accepted Answer

Safe sex is essential in preventing future exposures.

You can practice safer sex by:

Having one partner at a time
Using a condom for oral, vaginal or anal sex
Going for regular STI & HIV screening

Question 7

WHERE TO GET PEP?

Accepted Answer

You can get PEP at the DSC Clinic during our operating hours.

Should you require PEP after our operating hours or over the weekends and the public holidays, you can head down to Tan Tock Seng Hospital A&E department.

For Occupational PEP, please proceed to the respective A&E department.

DSC Clinic Registration Hours
Public Clinic (Level 1)*	Monday to Friday Morning Session 8am – 11am Afternoon Session 1pm – 4pm
Women’s Clinic	Click here for more information on Women's Clinic
Please note that DSC operates by appointments and patients are strongly encouraged to make an appointment with us. Walk-in patients are only seen under emergency situations. If you wish to make an appointment, please visit our Appointment Booking page. We closed on Saturdays, Sundays and Public Holidays. In case of emergencies outside of our operating hours, please visit the nearest A&E Department. The Public Clinic sees both male and female patients. *All new cases and existing patients who have not seen a doctor for more than 2 years will be required to see a doctor for consultation

Type of Exposure	Estimated risk of HIV transmission from a known HIV-positive individual not on ART
Receptive anal sex	1 in 90
Insertive anal sex	1 in 666
Receptive vaginal sex	1 in 1000
Insertive vaginal sex	1 in 1219
Performing oral sex	< 1 in 10,000
Receiving oral sex	< 1 in 10,000
Sharing drug injecting equipment	1 in 149
Human bite / Semen splash to eye	< 1 in 10,000

Post Exposure HIV Prophylaxis

If you have had a high risk exposure within the last 72 hours (any unprotected anal or vaginal sex)

With a partner who is HIV positive

Or

Is in a HIV-risk group e.g.

Men who have sex with Men

Bisexual men

IV drug users

Sex workers

Victim of rape

Rilpivirine® 25mg T​ab​​OrDolutegravir® 50mg

Truvada®(Emtricitabine 200mg, Tenofovir 300mg)

The approximate cost of PEP treatment at the DSC Clinic ranges from $400-$800.​

Side effects of Truvada:

Diarrhoea

Nausea or vomiting

Stomach upset

Headache

Difficulty in sleeping

Feeling tired or weak

Side effects of Rilpivirine:

Nausea or vomiting

Stomach upset

Headache

Difficulty in sleeping

Drowsiness

Side effects of Dolutegravir:

Diarrhoea

Nausea

Headache

Difficulty in sleeping

Feeling tired or weak​

The following tests will be done at your first visit:

HIV test

Appropriate STI test as recommended by your doctor

Your doctor will advise you on the necessary follow up visits, but it is recommended that repeat HIV tests be done at 1 and 3 months, in addition to completing all other appropriate STI tests.

Baseline tests will detect any pre-existing abnormality before treatment and can be repeated when necessary.

There is supportive evidence based on biologic possibility, animal & other studies that PEP can potentially decrease the risk of HIV acquisition if taken early enough. PEP is not given for exposures after 72 hours.

The treatment is not 100% effective and there have been cases of people who have still been infected with HIV despite receiving PEP.

PEP is not given to everyone because of the potential side-effects and also if the risk of the exposure is deemed to be extremely low (less than 1 in 10,000 chance) such that benefits of taking the medication outweigh the risks.

Safe sex is essential in preventing future exposures.

You can practice safer sex by:

Having one partner at a time

Using a condom for oral, vaginal or anal sex

Going for regular STI & HIV screening​

You can get PEP at the DSC Clinic during our operating hours.

Should you require PEP after our operating hours or over the weekends and the public holidays, you can head down to Tan Tock Seng Hospital A&E department.

For Occupational PEP, please proceed to the respective A&E department.

DSC Clinic Registration Hours​​

Public Clinic (Level 1)*

Monday to FridayMorning Session8am – 11amAfternoon Session1pm – 4pm

Women’s Clinic

Click here​ for more information on Women's Clinic

Please note that DSC operates by appointments and patients are strongly encouraged to make an appointment with us. Walk-in patients are only seen under emergency situations.

If you wish to make an appointment, please visit our Appointment Booking page.

We closed on Saturdays, Sundays and Public Holidays.In case of emergencies outside of our operating hours, please visit the nearest A&E Department.*The Public Clinic sees both male and female patients.

**All new cases and existing patients who have not seen a doctor for more than 2 years will be required to see a doctor for consultation

Prevention

Vaccination

Condoms & Lubricants

Pre-Exposure Prophylaxis (PrEP)

Emergency Contraception

Rilpivirine® 25mg Tab
Or
Dolutegravir® 50mg

Truvada®
(Emtricitabine 200mg, Tenofovir 300mg)

The approximate cost of PEP treatment at the DSC Clinic ranges from $400-$800.

Feeling tired or weak

Going for regular STI & HIV screening

DSC Clinic Registration Hours

Monday to Friday
Morning Session
8am – 11am
Afternoon Session
1pm – 4pm

Click here for more information on Women's Clinic

We closed on Saturdays, Sundays and Public Holidays.
In case of emergencies outside of our operating hours, please visit the nearest A&E Department.
*The Public Clinic sees both male and female patients.