Chapter 7: PEP: The 72-Hour Window

The Emergency Play

📋 Session Overview

Duration: 60-75 minutes

Part: Part III - Medical Shields

MATCH Connection: Medications (M)

🎯 Learning Objectives

💡 Key Concepts from the Ebook

📦 Materials Needed

🚀 Opening Activity (10 minutes)

Emergency Response: How Fast Would You Act?

Scenario: "It's Saturday night, 11pm. The condom broke during sex with a new partner whose HIV status you don't know. What do you do?"

Group brainstorm: What actions would you take? In what order? How quickly?

Reveal: Ideal response = Seek PEP within hours, not days. Introduce the 72-hour window concept.

📚 Core Content (30 minutes)

"PEP (Post-Exposure Prophylaxis) is the emergency brake in your safER sex toolkit. It is a course of medication taken after a potential exposure to HIV to prevent the virus from taking hold. It is not a substitute for regular prevention methods like PrEP or condoms, but it is a vital safety net for those moments when things don't go as planned."

Part 1: The 72-Hour Window (10 minutes)

🚨 MOST CRITICAL THING TO KNOW (from the ebook):
"The most critical thing to know about PEP is the time limit: it must be started within 72 hours (three days) of the potential exposure. The sooner you start, the more effective it is. Every hour counts. If you think you've been exposed to HIV, do not wait."
Time After Exposure Action Effectiveness
0-24 hours BEST window to start PEP Highest effectiveness
24-48 hours Still very effective Good protection
48-72 hours Still worth starting Protection decreases but still possible
After 72 hours Too late for PEP Not effective; test at 3 months instead

Part 2: When to Consider PEP (8 minutes)

From the ebook, PEP is typically prescribed after:

Key Principle

When in doubt, seek evaluation. Healthcare providers can help assess risk and decide if PEP is appropriate. Better to ask and not need it than to wait and regret it.

Part 3: How to Get PEP (7 minutes)

From the ebook: "PEP is a prescription medication. You can get it from:"

When you go, be clear and direct: "I need to start PEP because of a potential HIV exposure."

What will happen:

  1. Provider will ask about the exposure (when, type of contact)
  2. You'll be tested for HIV (must be negative to start PEP)
  3. You'll receive a starter pack or full prescription
  4. Follow-up appointments will be scheduled

Part 4: What to Expect on PEP (5 minutes)

From the ebook:

Aspect Details
Testing HIV test before starting to confirm negative status
The Course 28 consecutive days of HIV medications (once or twice daily)
Side Effects Possible nausea, fatigue; doctor can help manage
Follow-Up HIV testing after completion: 4 weeks and 3 months
Cost Often covered by insurance; assistance programs available

Completing the Full Course

Critical: Must take ALL 28 days, even if side effects occur or you feel fine. Stopping early reduces effectiveness. Set daily phone alarms as reminders.

Part 5: PEP IS NOT PrEP (Critical Distinction)

From the Ebook:

PrEP is taken before exposure to prevent HIV. It is for ongoing prevention.

PEP is taken after exposure to stop HIV from establishing itself. It is for emergency use only.

"If you find yourself using PEP more than once, it is a strong signal that you should talk to your doctor about starting PrEP for a more consistent, long-term prevention strategy."

💬 Discussion Questions (10 minutes)

Facilitate Group Discussion:

  1. What barriers might prevent someone from seeking PEP within 72 hours?
    • Stigma, cost concerns, not knowing it exists, fear of judgment, geography
  2. How can we normalize PEP as an emergency tool like we normalize emergency contraception?
    • Education, accessibility, de-stigmatizing language
  3. What would you tell a friend who's considering PEP but is scared or ashamed?
    • Practice compassionate, non-judgmental responses

🎨 Interactive Activity (15 minutes)

PEP Access Mapping

Purpose: Know where to go BEFORE an emergency happens.

Activity:

  1. Participants use phones to find nearest PEP provider (ER, urgent care, sexual health clinic)
  2. Save address and phone number in phones
  3. Calculate travel time from home/work
  4. Identify 24/7 options vs business hours only

Create wallet cards: Name, address, phone of 2-3 local PEP access points. Participants keep in wallet.

🔄 Closing & Reflection (10 minutes)

Chapter 7 Takeaway

"PEP is a powerful second chance. Know the 72-hour window, know where to get it, and don't hesitate to use it. It is a critical part of the modern safER sex landscape."

Reflection Prompt:

"If you or someone you know ever needs PEP, what's the first thing you'll do after reading this chapter?"

Take-Home Challenge

📌 Preview Next Session

Next: Chapter 8: Doxy-PEP: A New Tool in your Toolkit—a breakthrough antibiotic that can prevent bacterial STIs after sex. Over 70% reduction in syphilis and chlamydia risk.

Resources to Share

HARNESS Curriculum | Chapter 7 Complete

© Christopher Zacharie