Emergency contraception is usually offered to women, and routine empiric treatment for STDs and hepatitis B is offered to both men and women in addition to crisis intervention and psychological counseling. Patients with repeated HIV exposures requesting PEP pose serious ethical dilemmas for health care providers. Referrals to ongoing interventions such as substance abuse treatment and counseling and self-help groups are a further possibility. The risk of using PEP to avoid safer-sex techniques, though perhaps real for a small minority, should not justify withholding treatment from any individual with a significant exposure. The only experience to date on PEP is from San Francisco, through a project involving the University of California Center for AIDS Prevention and the San Francisco Department of Health.
Some private physicians provide PEP out of their offices to known patients.
Others who are not convinced of the efficacy of the treatment or are concerned regarding the evolution of resistant strains are refraining from introducing PEP until a standard is set. Reproduced with permission. Inc. All rights reserved. Noncommercial reproduction is encouraged. Subscription lists are kept confidential.