Post-Exposure Prophylaxis (PEP)

[Manforallseasons]

Check this out: https://www.pulse-clinic.com/pep/
Also Bumrungrad Hospital

[Mancs]

(Manforallseasons got there before me)

This may be worth calling the number:
https://www.pulse-clinic.com/pep/

If no use I would try calling the major private hospitals, like Bumrungrad and BNH on Soi Convent to see if they would do it on a Sunday. Or just walk in to ask. I read one has to start taking the tablets within 72 hours.

[spaghetios]

Hey Guys,

All government hospitals and Private hospitals have the medication required for PEP in stock.

It is substantially cheaper to use a Government Hospital than a Private clinic like Pulse but, it was super easy at Pulse.

PEP must be started within 72 hours to be effective but you should start as soon as possible.

[sglad]

Hey Guys,

All government hospitals and Private hospitals have the medication required for PEP in stock.

It is substantially cheaper to use a Government Hospital than a Private clinic like Pulse but, it was super easy at Pulse.

PEP must be started within 72 hours to be effective but you should start as soon as possible.

Thanks for sharing this info, spaghetios. If it's not too personal, might you consider sharing with us the costs you incurred at Pulse, the kind of service you received (I'm guessing it was good as you said it was "super easy"), how they treated sensitive information, whether they respected your privacy/confidentiality and anything else you think might be useful to anyone who might need PEP?

Moses/Jellybean, thanks for setting this thread up. As not everyone might be aware of what PEP means, might you consider changing the title to something like:

"What to do if you think you've been exposed to HIV - Post Exposure Prophylaxis (PEP)"

[spaghetios]

When going for PEP or PREP at Pulse, you will need to have the following blood tests:

- Liver Function
- Kidney Function
- Rapid HIV test
- Rapid Syphilis test
- Rapid Hep B test

These tests are 500 baht each and there are other optional tests such as a test to see if you have a natural immunity to Hep B.

The consultation with the doctor is also 1000 baht.

In terms of PEP, the medication will cost between 3300 and 20300. This depends on the brand you’re comfortable purchasing, I just went with the cheapest.

https://www.pulse-clinic.com/pep/

For Prep, you have the same tests but the drugs cost between 1100 and 3300. Personally when on Prep, I’ve gone for the most expensive because real Truvada has 0 side effects with me where as the cheaper ones make me nauseous for a few days.

https://www.pulse-clinic.com/prep/

Government hospitals are cheaper but they won’t do all of the same blood tests. If you can, I would definitely advise going to the Red Cross as they have super advanced tech such as NAT HIV tests which show infection after just 7 days.

[frequent]

While deliberately infecting other people with a disease is always to be disapproved, a number of posters seem still to be living in the Dark Ages when it comes to HIV. For those who have access to the First World medicine of their home country, or even the Red Cross in Bangkok, contracting HIV is no longer the death sentence of 30 years ago; it is simply another chronic condition that weakens the body’s immune system - like diabetes - and can be similarly managed

[frequent]

I should add that I’ve just come back from dinner in Soi 4 where one of my companions contracted HIV almost as soon as he retired to Bangkok 10 years ago, and one of the restaurant managers has been HIV+ for even longer. Both get their drugs (free I think) from the Red Cross here in Bangkok. I’m sure each does not live a monastic existence but makes sure their contacts take precautions. They are two among many of the people in Bangkok I know (because they’ve told me) to be HIV+

At one stage around 15 years ago I recall reports based on studies of MSM people that it was almost impossible to guarantee not having sexual contact with men who, knowingly or unknowingly, were HIV+ simply by patronizing Babylon Sauna

[spaghetios]

I should add that I’ve just come back from dinner in Soi 4 where one of my companions contracted HIV almost as soon as he retired to Bangkok 10 years ago, and one of the restaurant managers has been HIV+ for even longer. Both get their drugs (free I think) from the Red Cross here in Bangkok. I’m sure each does not live a monastic existence but makes sure their contacts take precautions. They are two among many of the people in Bangkok I know (because they’ve told me) to be HIV+

At one stage around 15 years ago I recall reports based on studies of MSM people that it was almost impossible to guarantee not having sexual contact with men who, knowingly or unknowingly, were HIV+ simply by patronizing Babylon Sauna

I really hate this attempted classification of HIV as simply a 'chronic condition' that is 'manageable' because it masks the admitted horrors of HIV.

Yes, it's true that HIV can be managed today and that once you're undetectable you cannot transmit HIV to another person. However, viral loads can change day to day and someone who may have last tested undetectable may not be undetectable today unless they've been undetectable for a long time and are continuing to take their meds - this is why Prep is your best friend.

Further to that, the long term effects of modern HIV medication are relatively unknown but they still have damaging effects on the heart, liver and kidneys. Your risk of a heart attack on HIV medication in your advancing years is substantially increased and there's an interesting documentary on YouTube about this weird Stealthing topic where those with HIV discuss the amount of heart attacks they've had and the damage done by their meds to their other internal organs.

The issue is that, especially in Asia, those with HIV will rarely admit their infection which means you can't make a properly informed choice when engaging in sexual behaviour and so you have three options - Use condoms, use Prep, use both.

If you have HIV, yes you can manage it a lot better than 25 years ago but if you don't have it then you should do absolutely everything you can to prevent infection.

[frequent]

I really hate this attempted classification of HIV as simply a 'chronic condition' that is 'manageable' because it masks the admitted horrors of HIV.

Yes, it's true that HIV can be managed today and that once you're undetectable you cannot transmit HIV to another person. However, viral loads can change day to day and someone who may have last tested undetectable may not be undetectable today unless they've been undetectable for a long time and are continuing to take their meds - this is why Prep is your best friend.

Further to that, the long term effects of modern HIV medication are relatively unknown but they still have damaging effects on the heart, liver and kidneys. Your risk of a heart attack on HIV medication in your advancing years is substantially increased and there's an interesting documentary on YouTube about this weird Stealthing topic where those with HIV discuss the amount of heart attacks they've had and the damage done by their meds to their other internal organs.

The issue is that, especially in Asia, those with HIV will rarely admit their infection which means you can't make a properly informed choice when engaging in sexual behaviour and so you have three options - Use condoms, use Prep, use both.

If you have HIV, yes you can manage it a lot better than 25 years ago but if you don't have it then you should do absolutely everything you can to prevent infection.I’ll let my elderly HIV+ friends know that they’re risking their brief lives by taking their medication

Remind us - weren’t you already on PrEp and decided to come off it before this trip. If you’re so worried about the long-term effects of HIV medication, why are you less concerned about the long-term effects of PrEP? http://www.thebodypro.com/content/72567/weighing-risks-of-tdfftc-prep-side-effects-in-peop.html

[spaghetios]

I obviously did not say that HIV+ people shouldn't take their medication, that would be outrageous but you attempted to present HIV as if it were nothing more than an inconvenient infection which is not true.

Truvada is one pill (made up of two medications) which is generally not taken by someone every day for their rest of their life. Truvada is also a modern medication which is generally taken alone for Prep whereas most HIV+ persons are on more than one pill or, eventually will be.

[frequent]

I obviously did not say that HIV+ people shouldn't take their medication, that would be outrageous but you attempted to present HIV as if it were nothing more than an inconvenient infection which is not true.

Truvada is one pill (made up of two medications) which is generally not taken by someone every day for their rest of their life. Truvada is also a modern medication which is generally taken alone for Prep whereas most HIV+ persons are on more than one pill or, eventually will be.My “attempt” represents modern, up-to-date, informed opinion - http://theconversation.com/how-hiv-became-a-treatable-chronic-disease-51238 - whereas you seem focused on scare-mongering. The recommended regime for PrEP is daily since the lead time before it becomes effective is a recommended 7 days - https://www.cdc.gov/hiv/basics/prep.html. It’s not the HIV equivalent to the morning-after pill for breeders

As a diabetic I can assure you I’m intimately familiar with the daily medication regime for chronic illnesses - in my case Lantus insulin injected twice daily, 2000 grams of metformin, 120 grams of Gliclazide, a new drug called Jardiance, once of whose unpleasant side effects can be thrush, and that’s beside the blood pressure and cholesterol drugs that are a common co-requirement

[spaghetios]

I'm not sure why you continuously misrepresent what I'm saying but I didn't say that when on Prep, you don't have to take it every day. I said that it is generally not taken every day of your life - Your Doctor will counsel you to take breaks when on Prep at times where you feel you can without putting yourself at risk. Having taken Prep since 2015, I have been encouraged by some Doctors to take one month off every three months even when liver and kidney blood tests don't show any warning signs.

You having diabetes is irrelevant - it is not the same as HIV. The HIV virus can and often does mutate to the point that people have to change medications or take additional medications to prevent progression to AIDS. HIV+ people are always on drug regimens that are personal to them, their strain and how their body handles the virus. You can read more about the awful medications below:

https://www.poz.com/drug_charts/hiv-drug-chart

I would also advise you to read the following on 'Why people with HIV still die' before you continue to harp on about how HIV is no big deal:

http://www.thebody.com/content/art12281.html#

HIV is a big deal, it is preventable and any stigma surrounding it (when based on facts) is completely reasonable.

[frequent]

Oh dear, another of the Pursed Lips Brigade to be added to the Ignore list

[Dimsumbear]

Language barrier when accessing government hospitals is proven to be very challenging, could i assume price and service wise Red Cross could be a nice midway from private practices (i.e. Pulse) and hospitals? Does Red Cross accept non-local tourist patients? If so, could anyone enlighten me with the costs and what to expect when accessing PreP at Red Cross in Bangkok?

[scottish-guy]

All I will say in this debate is that if I were HIV+ and facing certain death without treatment, then any potential side effects or concerns over how long the medication might stay effective (given that most adequately and timeously treated people are living almost normal life spans these days) would very much take second place to getting on a medication programme ASAP.

I completely agree that prevention is better than (no) cure - but as far as I'm aware PREP is available but not routinely available even in the UK and one would have to be almost aggressively proactive to get on it.

There is certainly no UK public health push to get sexually active high risk HIV- people on it (which there absolutely should be, until a Vaccine is found) - it is left to individuals to find out for themselves how, why and where to get it and we all know what happens when you leave people to find out things for themselves - in most cases, nothing.

Same goes for PeP - I suspect most people don't even know it exists, far less where and how to access it. At least this thread will provide valuable information to people who find themselves in a specific situation in Thailand, but one has to question why Governments and Health Authorities (even in first world countries) are not making more of an effort to educate people. I don't think I've ever seen any Govt/Heath Service publicity for PreP or PeP in the UK

[mr giggles]

The medication doesn't work for all people and some people cannot take it due to deleterious side-effects. The condition of being HIV+, can be managed- but for many people it still limits their lifestyle and they can suffer serious ill-health even if it's not fatal.

Waiting for your smart-alecky reply, no doubt it's brewing like last week's pile of horse dung.

[frequent]

Now there's a novel concept - having a permanent medical condition can "limit your lifestyle". Who'd've thought!?

[Halfhansum]

Just a thought, if you go to the red cross in Bangkok asking for PEP, they will be confused and tell you it is called PEEP ...Lol
The girl on the desk said, you look, P and E and P say PEEP ..Lol

[wildboy]

Protect yourself before any sex!!