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Post-Exposure Prophylaxis after sexual exposure

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What is PEP?

PEP stands for Post-Exposure Prophylaxis. It is an emergency medicine that may protect you from becoming infected with HIV by starting antiretroviral drugs (ARVs) within 72 hours after being potentially exposed to HIV. If you are prescribed PEP, you will need to take it once or twice daily for 28 days.

Who should take PEP?

PEP should be started within 72 hours after a recent possible exposure to HIV, such as an unprotected sex with someone who has or might have HIV. PEP must not be used if your sexual partner is HIV negative or if you are already infected with HIV.

  • Although ARVs are approved for the treatment of HIV infection in Japan, PEP after sexual exposure to HIV is not the approved type of usage of ARVs.

How much does PEP cost?

The Japanese health insurance does not cover the cost associated with PEP and you will pay 100% of the followings:

Initial consultation fee: 20,000 yen
PEP medication fee: 10,000 yen/day (280,000 yen for 28 days)

  • If seen outside of service hours, 10,000 yen will be charged in addition to the fees listed above.

  • Additional sales tax will be charged.
  • The above expense includes fees for any examinations performed (e.g. hepatitis B, hepatitis C, and tests for monitoring side effects) during the 28 days of PEP but does not include any cost after PEP (i.e. after 29th day).

  • You can use a credit card for payment.


How to receive PEP

Service hours: 8:30am-3pm Weekdays; ACC Outpatient Clinic

  • At your initial visit, please tell a receptionist that you wish to hear more about HIV preventive medicine at ACC.
  • Please call us before visiting our hospital if you need to start PEP outside of our service hours.
    Dial 03-3202-7181 and tell the operator that you would like to consult with an ACC doctor about HIV preventive medicine.

Flow of the PEP consultation

  1. Consultation with a doctor
    A doctor will assess your risk of HIV acquisition and whether or not you should take PEP.

  2. Blood tests
    We will conduct blood tests to confirm that you are HIV-negative and assess whether or not you can safely start PEP.

  3. Informed consent
    A doctor will explain how to take the medications, the potential side effects, and how to manage side effects. Then, we will confirm your consent for PEP after you sign on the informed consent form.

  4. Administration of PEP
    During initial consultation, we will give you ARV for the first 14 days. If your initial consultation occurs outside of service hours, prescription is limited for the first 1-3 days and you will be asked to come back during service hours of the following weekday.

  5. Follow up visits
    We will schedule your follow-up visit 14 days after starting PEP. After we confirm that your blood test results are normal, we will give you ARVs for another 14 days.

  6. HIV testing
    We recommend testing for HIV, hepatitis B and hepatitis C after 1 month, 3 or 4 months, and 6 months after starting PEP. Fees for these tests need to be paid for separately.


Side Effects

ARVs for PEP may cause mild side effects such as nausea. These side effects can be treated and are not life threatening. Please ask your health care provider if you want more information about potential side effects.