What this page covers. Emergency PEP (post-exposure prophylaxis) is a 28-day course of HIV-prevention treatment, started within 72 hours of a possible HIV exposure, that reduces the risk of HIV infection. This page covers how the 72-hour clock works, when PEP is recommended (not every exposure needs PEP), the 28-day regimen and side effects, baseline and follow-up testing, how to access PEP through Clinic365 or the public health system, the sexual-assault pathway, and the transition from PEP to PrEP for ongoing prevention.
The 72-hour clock. The 72-hour window runs from the moment of exposure (the sexual act, the needle-stick, the condom failure) — NOT from when you first noticed something might be wrong. Within those 72 hours, every hour matters: effectiveness is highest within 24 hours and drops the longer you wait. By 72 hours, PEP is no longer recommended because HIV will already have established systemic infection if it was going to. If you are approaching the 72-hour mark and Clinic365 does not have an appointment quickly enough, go to your nearest hospital Emergency Department.
How to access PEP through Clinic365. Book a same-day phone consult with a Specialist GP at Clinic365 — usually available within an hour or two of booking during business hours. The Specialist GP works through the risk assessment, prescribes a 28-day PEP course if appropriate, arranges your baseline pathology, and books your follow-up at 4–6 weeks and 3 months. The electronic prescription is sent to your nominated pharmacy. If you cannot wait for a Clinic365 appointment, your nearest hospital Emergency Department — the 72-hour clock matters more than which provider starts the course.
Why use Clinic365 instead of a hospital ED? Three reasons many patients choose us. (1) Speed and privacy — a phone consult is usually faster than an ED triage queue, and the conversation happens privately rather than in a public waiting area. (2) Continuity — we follow up at 4 to 6 weeks and 3 months for HIV testing and PEP-completion review, and we coordinate ongoing PrEP if appropriate. (3) Convenience — you do not have to physically attend an ED, and the electronic prescription is fillable at any pharmacy when you are ready. Choose based on your situation; if the 72-hour clock is tight, go with whichever is faster.
Risk assessment — does this exposure need PEP? Not every exposure needs PEP. The Specialist GP applies the standard HIV transmission risk matrix from current Australian guidance: (1) the sexual act type (receptive anal sex carries the highest per-act transmission risk; insertive anal, receptive vaginal, insertive vaginal, and oral all have decreasing risk); (2) the source partner's HIV status (known positive vs unknown vs known negative; if known positive on treatment with an undetectable viral load, transmission risk is effectively zero per U=U science); (3) the time since exposure; (4) other factors such as genital ulceration, menstruation, ejaculation, or shared injecting equipment. PEP is recommended for high-risk exposures, considered for moderate-risk, and generally not recommended for low-risk.
The 28-day course. PEP is a 28-day course of combination HIV-prevention treatment prescribed per current Australian PEP guidelines — typically a two-NRTI backbone (the foundation drug class) plus an integrase-class anchor agent. The exact regimen depends on the source patient's likely resistance profile, your renal function, drug interactions with anything else you take, and pregnancy status if applicable. The 28 days are continuous — missed doses reduce effectiveness, and stopping early carries a real risk of seroconversion. The Specialist GP gives you a clear dosing schedule and contact details for any side-effect concerns during the course.
Side effects. Modern PEP is far better tolerated than older regimens. Most patients complete 28 days without significant issues. The most common side effects are nausea, mild diarrhoea, fatigue, and headache during the first week, usually settling within days as the body adjusts. Anti-nausea support can be co-prescribed if needed. Severe side effects (renal impairment, hepatitis, severe rash) are uncommon but warrant immediate review — these are why baseline bloods are checked at day 0 and follow-up is built into the pathway. Alcohol does not interact specifically with PEP, but heavy drinking adds to nausea and risks missed doses, so moderation is sensible during the course.
Baseline and follow-up testing. Standard baseline tests at PEP initiation: HIV antigen/antibody test (must be negative — starting PEP in someone with undiagnosed HIV is not effective and can cause resistance), hepatitis B blood test (surface antigen, surface antibody, core antibody), hepatitis C antibody, syphilis blood test, renal function (creatinine and eGFR — some PEP regimens are renally cleared), full blood count, and chlamydia, gonorrhoea, and Mgen swabs or urine test depending on the exposure. Follow-up: HIV testing at 4 to 6 weeks post-PEP-completion (some current guidelines accept 6 weeks as enough with 4th-generation antigen/antibody combination tests) and at 3 months. Hepatitis B at 3 months if your baseline immunity status was uncertain. STI re-test if baseline was positive or symptoms emerge — see the full STI screen for what is covered. We arrange all of this through pathology collection centres across Australia.
Cost. See our fees page for current Clinic365 consultation pricing. PEP medication itself is subsidised on the PBS for eligible exposures, so a 28-day course is comparatively low cost at a pharmacy. For Aboriginal and Torres Strait Islander patients, PEP is also available through Aboriginal Community Controlled Health Services (ACCHS) and via Closing the Gap (CTG) Co-payment Reduction. For people without Medicare, the unsubsidised cost is higher.
Window-period considerations. Two related but distinct ideas: PEP itself has a 72-hour window from exposure; HIV testing also has a window — that is, the time from a possible exposure until a test can reliably detect early infection. The standard 4th-generation HIV antibody/antigen test has a window of about 4 to 6 weeks; the HIV RNA viral load test detects infection earlier (about 7 to 14 days). The baseline HIV test at PEP initiation must be negative. The follow-up HIV tests at 4 to 6 weeks and 3 months post-PEP confirm whether PEP succeeded. See when to test after exposure for full window-period detail.
From PEP to PrEP. If you have needed PEP, the question is whether you would benefit from ongoing HIV pre-exposure prevention (PrEP) for future exposures. PrEP discussion is recommended at every PEP visit. The Specialist GP can transition you straight from PEP to PrEP at the end of the 28-day course, after a final HIV test confirms negative status. PrEP is a daily oral HIV-prevention medication (or "2-1-1" on-demand dosing for episodic exposures in MSM) that effectively eliminates HIV risk when taken correctly.
Sexual assault and PEP. If your possible exposure was non-consensual, current Australian guidance and 1800RESPECT recommend going to a hospital-based Sexual Assault Response Team (SART), where you will be offered: PEP if eligible; emergency contraception; STI baseline screening; forensic medical examination if you choose; mental health and support services; and coordination with police if you choose. Specialist sexual assault services exist in every Australian state and territory, with hospital-based triage as the standard entry point. Nationwide 24/7 support is available through 1800RESPECT on 1800 737 732, with trained operators who can also direct you to the closest local service.
Confidentiality. PEP consultations at Clinic365 are private. We do not notify your regular GP, employer, school, or any insurer (private health, life insurer) by default. Notifiable HIV diagnoses are reported to state Departments of Health under public health legislation, but this notification is anonymous from your perspective and used only for surveillance and contact tracing — not shared with your social or professional network.
If you tested positive for HIV. If you tested positive for HIV on baseline or follow-up testing, your treatment-arrangement consult is free — we connect you with specialist HIV services in your state for ongoing care. HIV is a manageable chronic condition with modern treatment; early starting of treatment achieves an undetectable viral load (U=U) which both protects your health and means transmission risk to partners is effectively zero. Peer support and treatment navigation are also available through community organisations on request.
Book a same-day consult. See the hero section above to book a same-day Specialist GP phone consult. For Melbourne residents who want in-person, see emergency PEP in Melbourne. For ongoing HIV prevention, see PrEP online. For bacterial-STI prevention alongside HIV prevention, see DoxyPEP.
