By: Sex, much like life, can be unpredictable.
A one-night stand that wasn’t the safest. A condom that breaks in the middle of all your fun. Hell, you might just not have the proper protection at the right time. There’s no shame in a slip-up as long as you take the appropriate measures to get tested and take care of yourself afterward.
For many, especially those in the LGBTQ+ community, history and an ill-informed society inform our fears of slipping up around one risk in particular: contracting HIV. Despite the advances in treatment and prevention, the stigma against those living with HIV remains … but did you know you can fight infection even after you may have been exposed?
Well, you can. Enter Post-exposure prophylaxis, or PEP. You’ve heard of Plan B and other types of emergency contraception? Well, consider PEP your Plan P … a similar treatment that, like its more famous cousin, prevents an unwanted outcome after unprotected sex.
To help you better understand PEP and learn if it’s right for you, Sexual + Being is breaking down the drug and the differences and similarities between it and the morning-after pill.
What is PEP?
PEP is a series of HIV medicines that, when started within 72 hours after a possible exposure, work to prevent the virus from taking hold in your body. It can lower your chances of contracting it, especially if you take it soon after your exposure, and can be prescribed by your medical provider or at a clinic.
PEP and PrEP, or pre-exposure prophylaxis, are medications aimed squarely at preventing the spread of HIV — quite literally at two points of possible transmission: before you may be exposed to it (pre) and after an exposure (post).
PEP isn’t meant to be a consistent prevention method — that’s PrEP — and should only be used in emergency situations (although you can take it more than once without any issue). It can come with some side effects like nausea, but they are only mild.
How is PEP like the morning-after pill?
As you can probably infer by this point in the article, both PEP and the more standard morning-after pill are all about prevention after the fact. There’s an emphasis on retroactive treatment here.
While PEP focuses on preventing HIV from taking hold in your body, morning-after pills (like Plan B or ella) instead work to prevent the fertilization of an egg that could result in pregnancy. I like to think of them as relatives with different jobs — same idea, different focus.
The key to success for each lies in when they are taken. PEP must begin within three days, while most morning-after pills should be taken in the same 72-hour period to get the desired results — and for both sooner is better. The longer you wait in either case, the higher the risk is of either not working. Time is of the essence.
How they are different
While these two medications are similar in scope, they also have deep differences in access, cost, understanding, and more.
PEP isn’t just one pill and done. It’s a 28-day long prescription that must be taken in its entirety to work. If you are consistent, chances are high — but not 100 percent — that you will be able to beat the infection. Morning-after pills, however, are often more than one (like Plan B, which is a series of two pills).
Access for each is different, too. Morning-after pills can be found over-the-counter at most pharmacies (depending on where you live) for a relatively low cost that varies based on which brand you plan to take. PEP, on the other hand, must be prescribed by a doctor or medical professional — at a clinic, in an emergency room, at your doctor’s office, etc. — and monitored throughout the entirety of its consumption to ensure it is working.
There also tends to be a larger awareness barrier with PEP. Many of those who need it most may not know it exists, either from a lack of access to medical care or overall understanding of it as an option. Morning-after pills are simply more widely known.
Perhaps the biggest difference here lies in cost and who the treatments serve. Without insurance, PEP’s price adds up quickly, although there are lower costs options available for those who are uninsured — but can be taken by most, regardless of their gender identity. Most over-the-counter emergency contraception can be purchased for $50 or less and is made for those who can get pregnant.
As you consider PEP and/or emergency contraception, be sure to check out resources at sexualbeing.org for more information. Stay safe and remember: there’s always Plans B and P.
Ryan Carey-Mahoney
Ryan Carey-Mahoney is a writer and LGBTQ advocate based in Washington, D.C. A journalist at heart, he's worked in digital strategy for over five years and has yet to turn down an opportunity to proofread. Talk to him on social media (@thegoodcarmah) about bi+ visibility, politics, and Beyoncé.
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