Safer Sex accident / PEP

Sometimes accidents happen when practicing safer sex. For example, condoms can break or slip off or are simply forgotten in the heat of the moment.

If one partner is HIV-positive and HIV replication is not suppressed by medication, HIV can be transmitted. But there is no need to panic: In all probability, an HIV infection can still be prevented.

To this end, anti-HIV medication is taken for four weeks. The medication prevents HIV from taking hold in the body. This treatment is called post-exposure prophylaxis, or PEP for short, meaning protection after exposure.

Important: PEP should be started as soon as possible after exposure, ideally within two hours, if possible within 24 hours, but within 48 hours at the latest. Whether PEP can still be effective up to 72 hours (three days) after exposure is debated.

You can find all hospitals that offer PEP under “Addresses”.

When is PEP recommended?

PEP is usually carried out after having unprotected (anal or vaginal) sex with a person who

  • is likely to be HIV-positive and it is not known whether the person is on HIV therapy or whether the HIV therapy is effective
  • is HIV-positive and HIV is detectable in the blood (which is not the case if the HIV therapy is effective)

Other situations in which PEP may be advisable:

  • A member of medical staff has injured themselves with a syringe or other instrument that has previously come into contact with the blood of an HIV-positive patient.
  • During intravenous drug use, someone has used a syringe that has previously been used by an HIV-positive person.

Whether PEP is recommended is decided after a counselling session in an outpatient clinic or medical practice.

In the event of sex accidents, it can be helpful to take your partner with you to the session to provide information about their HIV status, any HIV therapy or drug resistance.

Where can I get post-exposure prophylaxis (PEP)?

Only specialised hospitals and medical practices have experience with PEP (please find an overview of appropriate points of contact here). The outpatient clinics listed there are open round the clock. During the regular consultation hours, PEP can also be obtained from medical practices specialising in HIV.

If in doubt, you should refer to the nearest medical practice or outpatient clinic.

Any questions are answered by the telephone counselling service of the AIDS Service Organisations in Germany.

What are the side effects of PEP?

PEP is a four-week therapy with anti-HIV medication. It can cause side effects such as headache, diarrhoea, nausea and vomiting.

Immediate measures after having unprotected sex

After having had unprotected sex with an HIV-positive partner, the risk of HIV transmission can be reduced to a certain extent by taking the following measures:

  • After unprotected anal/vaginal sex (high risk): Wash the penis with soap under running water. Pull back the foreskin and carefully wash the glans and the inner side of the foreskin (without applying pressure to the mucous membrane).
  • After semen has entered the mouth (low risk): Spit it out straight away and rinse the mouth with water four to five times.
  • After getting semen into the eyes (low risk): Rinse the eyes with water.
  • Important: Rinsing the vagina or rectum is not recommended. It is not known whether rinsing reduces or even increases the risk of infection.

Bear in mind: These immediate measures can reduce the risk to a limited extent only. They cannot offer the same level of protection as condoms/femidoms, HIV therapy or PrEP, nor can they – in the worst case – replace PEP!

Information on post-exposure prophylaxis (PEP) is available for download below.