Sunday, May 1, 2011


Say you meet a guy/girl while drunk at a bar and you shag in the toilets with no condom on.. or if you share a needle with someone else while taking drugs.. or if you were walking down the street and a syringe was on the ground, you walk on it and get pricked... or you are a nurse and at a hospital you are exposed to blood some how... or say if you were raped god forbid.. if you feel for any reason you may have been in contact with HIV there is something you can do to prevent HIV infection from happening... PEP

Due to my current on going mission to get my ass over to Fiji to set up and camp and (hopefully) make a difference to a few peoples lives, the subject of HIV and sexual health is more than ever something that is on my mind and a subject i find myself wanting to know more about. In a kind weird way, id love to go on rampages of "safe sex" speeches and advertisements and spreading the word!!!.. but that gains nothing but people getting the shits and not wanting to talk to you.. so ive decided not to do that...

BUT... while having a rant about something i have been researching, i can also share info with you all that you may not of even been aware of before... in an interesting way.. i hope LOL

Do you know wtf PEP stands for when talking about HIV prevention?

I had no idea until 2 years ago when i was at the local Sexual Health Clinic (a free service that alot of Sex Workers use for our regular check ups, which are legally required in some states) and i was getting my 3 monthly testing done, all the usual - HIV, chlamydia, gonorrhea, syphilis, pap smear etc. Nothing new there.

There was one new thing tho, a different nurse! She was really nice and asked alot of questions regarding my health and advised me of services they offered..and then she mentioned PEP. I didnt know what it was, so i asked her to explain a little more.

PEP = Post Exposure Prophylaxis
A course of anti-HIV drugs that is taken shortly after possible exposure to HIV infection.

Now this info is fricken handy to have. I had no clue this sort of medication was available and i'd been a sex worker for 8/9yrs when i learnt about it. Why the hell isnt it public, common information? ESPECIALLY being in the sex industry! I would have thought all the brothels i'd worked at would have told us girls about this.. but nope, nothing.

Thank god i have never been in a situation where i felt i was at risk.. but i know many that have and if we had of known about this it might have put their mind at ease a little... or something..

There is where all the "facts" i have researched get a little fuzzy.

Basically how it works, they say its best to get to a hospital within 2hours of exposure for it to be most effective. It seems there are only certain doctors that give this medication, so you have to ask specifically for a doctor with PEP knowledge. The sooner you get treatment the better your chances are. They will still give PEP up to 72hrs after possible infection, but 1-12hrs has a better success rate.

They give you a heap of pills that you must take every day at certain times for 4 weeks. Apparently its a really strong pill and there are many side effects.. but i guess they are worth it when it comes to preventing getting HIV right?

They cant say how effective PEP is... there are sooooo many statistics on the web... different sites give different info.. one site i was at said:

"Out of all the people who have been given PEP, no one has contracted HIV. This may because the person was lucky and did not come in contact with HIV in the first place. No one knows"

I thought this was an awesome thing! I was so excited! 100% success rate! Holy crap!

But then i went to another site and their statistics were totally different.. and then another site and then another site.. blah blah blah.

One study stood out to me... excuse me while i bore you with some stats now lol

Routes of infection
Eligible participants had to have engaged in sex without condoms as follows:
**receptive or insertive anal intercourse
**unprotected vaginal intercourse
**receptive oral intercourse with ejaculation
Also, certain other potential routes of exposure were considered, including:
**sharing of needles for street drug use
**contact with a potentially infectious body fluid on a mucosal membrane or skin that was damaged because of a cut, scrape or abrasion

Analysing data from 702 participants, researchers found that there were a total of seven people who became infected with HIV (seroconverters) — about 1% of the group.
**The vast majority (95%) was exposed through unprotected sex and were men.
**The remaining participants were exposed through a combination of sex and needle use or needle use alone
All seven seroconverters were men and all had engaged in unprotected, receptive anal intercourse. By comparison, among non-seroconverters, 50% had engaged in similar sex acts.
On average, people who seroconverted initiated therapy 46 hours after exposure. Notably, three of seven seroconverters began to take PEP more than 56 hours after exposure. People who did not seroconvert initiated therapy earlier—on average 33 hours after exposure. This difference may be important because animal experiments suggest that the sooner PEP is started, the lower the risk of infection.
Although all seroconverters took PEP for four consecutive weeks, at least three reported that they missed “a substantial number of doses,” according the research team.
Repeated infection(s)?
Prior to entering the study, all seroconverters had other, potential exposures to HIV, including unprotected, receptive anal intercourse.
Continuous exposure
Three participants who seroconverted reported that they continued to engage in unprotected, receptive anal intercourse while taking PEP. This may have increased their exposure to HIV, overwhelming their immune systems and PEP.

So 7 out of 702 got HIV. All were males. 3 of those still had unprotected anal sex whilst on the medication. 3 of those missed some doses.

Another study said:

6 out of the 700 that returned for testing after 12 weeks were HIV positive. However all 6 had had possible HIV exposures up to 6 months before commencing PEP. Therefore it was very difficult to determine the exact moment of exposure and whether PEP had been successful or not.

and another:

In a South African study of 480 rape survivors taking a 6-week course of zidovudine and lamivudine, only one woman became HIV positive.

That was very good to read... the previous studies were mostly done on men and they were questioning as to whether PEP really did work as well against sexual exposure as it did to needle pricks/sharing needles where success was very high.

Another study looked at 2,000 non-occupational exposures to HIV from four countries (Australia, France, Switzerland, and the United States). Out of 350 people treated with PEP who reported being exposed to HIV-infected sources, none became infected as a result of PEP failure.

Now that is what i wana hear!! NONE infected! Thats a good bloody outcome!!

What does all this mean? I think it means hope for the world and our fight against HIV. But if only everyone knew that this course of action COULD be taken!!
So that means getting the word out. If you know someone who could be putting themselves at risk - tell them about PEP.. if you dont know how to bring it up (which i dont understand why it would be hard cos fuck it could save a life) send them here to read this blog.. if in the future an incident happens to someone you care about, remember this blog, remember those 3 letters PEP.


Ok lecture over... i will resume my fun blogs asap... i just needed to get this out :)


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