Red flags & when to go in person for Post-Exposure Prophylaxis (PEP) Evaluation

Audience: adult

Post-Exposure Prophylaxis (PEP) is a treatment to reduce the chance of infection after possible exposure to HIV or other infections. It is most effective when started as soon as possible, ideally within 72 hours after exposure. Telemedicine can help provide initial evaluation and advice about PEP, but certain situations require in-person care. This guide explains when to seek in-person evaluation, what signs to watch for, and how telemedicine can support your care. Remember, PEP involves medications that need careful monitoring, and timely action is important. If you have any urgent symptoms or concerns, it is important to get immediate medical attention.

Red flags — go in person / ER

• Severe allergic reaction signs such as difficulty breathing, swelling of face or throat — seek emergency care immediately.
• High fever, worsening pain, or spreading redness at exposure site — go to a healthcare facility promptly.
• If more than 72 hours have passed since exposure without starting PEP — seek in-person evaluation urgently.

What telemedicine can do

• Initial risk assessment and counseling about PEP.
• Providing information about PEP medications and side effects.
• Arranging prescriptions and follow-up plans when appropriate.

What telemedicine cannot do

• Managing severe allergic reactions or emergencies.
• Performing physical examinations that require hands-on assessment.
• Providing PEP if more than 72 hours have passed since exposure without prior evaluation.

What is Post-Exposure Prophylaxis (PEP)?

PEP is a short course of medicine taken after possible exposure to HIV or certain other infections. It helps prevent infection if started quickly, usually within 72 hours. PEP is not a vaccine but a treatment to reduce risk after exposure through sex, needle sharing, or other means.

When to Use Telemedicine for PEP Evaluation

Telemedicine can be a good first step to discuss your exposure, assess your risk, and decide if PEP is appropriate. A healthcare provider can help you understand the treatment, possible side effects, and next steps. They can also arrange for prescriptions or referrals if needed.

Red Flags That Need In-Person Care

Certain signs mean you should go to a clinic or emergency room right away:

In these cases, telemedicine is not enough, and prompt in-person evaluation is important.

Preparing for Your Telemedicine Visit

Before your tele-visit, gather information about:

Having this ready helps the provider give you the best advice quickly.

After Your Telemedicine Visit

Follow the healthcare provider's instructions carefully. This may include:

Adherence to the full course of medication is important for PEP effectiveness.

How to prepare for your tele-visit

• Note the exact time and nature of the exposure event.
• List any symptoms you are experiencing.
• Gather your medical history and current medications.
• Prepare questions or concerns about PEP treatment.
• Ensure you have a private and quiet space for the telemedicine visit.

After your tele-visit

• Start PEP medication as soon as prescribed, ideally within 72 hours after exposure.
• Schedule any recommended follow-up appointments or lab tests.
• Monitor for side effects or new symptoms and report them promptly.
• Seek immediate in-person care if any red flag symptoms develop.
• Complete the full course of PEP medication as directed.

FAQs

What is the time window to start PEP after exposure?

PEP should ideally be started within 72 hours (3 days) after possible exposure to HIV. The sooner it is started, the more effective it is.

Can I get PEP through a telemedicine visit?

Telemedicine can help assess your risk and provide advice. In some cases, providers may arrange prescriptions remotely, but sometimes you will need to visit a healthcare facility to start PEP.

What if I miss the 72-hour window?

PEP is less effective if started after 72 hours. If this time has passed, you should still seek in-person medical evaluation for other prevention options and testing.

Are there side effects of PEP medications?

Some people experience side effects like nausea, fatigue, or headache. Your healthcare provider can explain what to expect and how to manage them.

Do I need follow-up testing after PEP?

Yes, follow-up HIV testing is usually recommended at several intervals after completing PEP to ensure you have not become infected.

Sources

1. Post-Exposure Prophylaxis (PEP) — Centers for Disease Control and Prevention (CDC).
2. HIV Post-Exposure Prophylaxis (PEP) — MedlinePlus, U.S. National Library of Medicine.
3. Postexposure Prophylaxis for HIV Infection — National Library of Medicine, NIH.
4. HIV Post-Exposure Prophylaxis (PEP) — Mayo Clinic.

This information is for educational purposes only and is not a substitute for professional medical care. Telemedicine guidance cannot replace in-person evaluation when urgent or complex care is needed. If you experience any emergency symptoms or have concerns, seek immediate medical attention.