Understanding PrEP and PEP

There are a range of options for HIV prevention today. Two important tools – PrEP and PEP – help reduce the risk of HIV transmission.

Health and social care staff play a key role by:

  • Supporting people to access prevention services
  • Sharing accurate information
  • Reducing stigma

They may also be able to provide access to condoms and/or injecting equipment provision, depending on their role.

What is PrEP?

PrEP stands for Pre-Exposure Prophylaxis. It is a medication taken before being exposed to HIV to stop the virus from taking hold in the body.

In Scotland, PrEP is a combination of emtricitabine + tenofovir taken,

  • Daily, or
  • ‘On demand’ (before and after sex)

When taken correctly, PrEP is highly effective at preventing HIV transmission during sex. In Scotland, PrEP is available free from NHS services.

Who might benefit from PrEP?

HIV PrEP is for anyone who is HIV negative and is at higher risk of getting HIV. Some people who may benefit from this include:

  • Gay or bisexual men, or other men who have sex with men
  • People who are from, or have partners from, countries where HIV is more common (such as parts of Africa), or who travel to those countries
  • People who inject drugs or have sex with someone who injects drugs
  • People who sell or exchange sex
  • People who are trans or non-binary
  • People who have sex with someone living with HIV who is not on effective treatment
What you need to know:

You don’t need to decide whether someone is at risk. Just be aware that PrEP is available. If someone asks about it, refer them to a sexual health clinic or their GP. 

Taking PrEP is a positive, proactive health decision and can support someone to take care of their sexual health.

What is PEP?

PEP stands for Post-Exposure Prophylaxis. It is an emergency HIV treatment taken after possible exposure to stop the virus from taking hold in the body. It is available from A&E departments and sexual health clinics.

The most important thing to remember about PEP is that time really matters. It should be taken as soon as possible after any potential exposure to HIV and it is effective for up to 72 hours afterwards.

It must be:

  • Started within 72 hours of the exposure (ideally, within the first 24 hours)
  • Taken for 28 days
When is PEP used?
  • After a needlestick injury
  • After unprotected sex with someone who may be living with HIV
  • After sexual assault
  • After sharing injecting equipment

PEP is not required if the person living with HIV is on effective treatment and has an undetectable viral load. 

What you need to know:
  • Time matters. If someone may have been exposed to HIV, help them access care urgently. PEP has a 72-hour window of effectiveness
  • If a colleague experiences an occupational exposure (e.g. a needlestick injury), report it immediately to Occupational Health for a PEP assessment
  • If Occupational Health is not available, call NHS24 on 111
  • Make sure you know how to direct people to your local sexual health service, and which sexual health, NHS, and A&E services provide access to PrEP and PEP. Find out more in our useful links section

Key points to remember

  • People living with HIV are part of every community—including workplaces and families. Using inclusive language and treating everyone with dignity helps reduce stigma and supports wellbeing.
  • PrEP and PEP are safe, proven tools to prevent HIV. 
  • The window in which to take PEP in order for it to be effective is small – it must be taken as soon as possible, up until 72 hours after potential exposure.
  • Some people may feel nervous or judged when asking about them -respond with empathy, not assumptions.
  • You don’t need to be a clinician to help – just knowing where to refer someone could make all the difference.