You should consider PEP

Go straight to your nearest sexual health clinic or hospital Accident and Emergency department.

It's important that you do not exceed the 72-hour time limit as PEP isn't likely to be prescribed any later than this. It's best to start PEP as soon as possible after exposure, preferably within 24 hours.

You'll need to explain to the doctor when and how you were at risk and any other relevant information (e.g. your partner’s HIV status, the type of sex you had, whether your partner is in a group with high rates of HIV).

If your partner is HIV positive, the doctor will also need to know their viral load and whether they're on antiretrovirals. If the person you had sex with is living with HIV, but has been on treatment for at least six months and has an undetectable viral load, you will not need PEP.

Before receiving PEP, you'll be asked to take an HIV test. It's essential to check that you didn’t already have HIV before this risk. This is because taking PEP if you already have HIV can cause complications for treating HIV in the future.

If you're seeking PEP following a sexual assault it's important to tell the medical staff. Sexual assault can cause internal physical trauma that can make it easier for HIV to be passed on.

Sexual assault is a crime and the police are there to help you if you choose to report it. If you're concerned about going straight to the police, you might like to get some support and advice by contacting a helpline.

SurvivorsUK online helpline gives support to men who have been sexually assaulted or abused and can help you find services.

Rape Crisis helpline is open every day of the year (including bank holidays) between 12-2.30pm and 7-9.30pm on 0808 802 9999.

When people have been put at risk of HIV, PEP may prevent HIV infection after the virus has entered the body.

PEP:

• Can stop you becoming infected with HIV.
• Must be started as soon as possible after exposure, preferably within 24 hours. It can be prescribed up to 72 hours (three days) after unprotected sex, but it's best not to wait that long.
• Is available for free from NHS sexual health (GUM) clinics and hospital Accident and Emergency departments (A&E).
• Involves taking anti-HIV medicines for up to four weeks. Now uses newer medication with fewer side effects.

PEP is not a cure for HIV and is not guaranteed to prevent HIV from taking hold once the virus has entered the body. Condoms remain the most efficient way of preventing the transmission of HIV and other STIs.

The people who are likely to be prescribed PEP are those who have had receptive or insertive anal sex or receptive vaginal/frontal sex (or shared injecting equipment) with someone who is HIV positive and has a detectable or unknown viral load.

It's also recommended if you've had receptive anal sex with someone with an unknown HIV status who is from an area with high rates of HIV, such as sub-Saharan Africa.

If you've had insertive anal sex, insertive or receptive vaginal/frontal sex (or shared injecting equipment) with someone with an unknown HIV status from a high-risk area for HIV it may be considered.

It'll also be considered if you've had insertive vaginal/frontal sex with someone who is HIV positive with an unknown or detectable viral load.

If you know the person you had sex with had HIV, then the medical staff will ask you whether you know their most recent viral load test results and whether they're on antiretrovirals.

If the person you had sex with is living with HIV, but has been on treatment for at least six months and has had an undetectable viral load, you won't need PEP.

If you can't get PEP it's important to remember that even though you've been at risk of HIV it doesn't mean that transmission has occurred.

The only way to know this for sure is to take an HIV test. We recommend talking to someone at the hospital or clinic about getting tested.

If you do have HIV, it's far better to know as treatment means you can expect to live a long and healthy life, whereas if you don't treat HIV it's likely you'll become ill.

If you’ve been at risk from HIV, there is a chance you may have picked up other sexually transmitted infections or that you or your partner might need emergency contraception.

You can be checked for these confidentially at any sexual health clinic.

If you think you might be at risk of HIV again in the future, you might want to consider pre-exposure prophylaxis (PrEP).

PrEP is a pill you can take to protect you from HIV. It is extremely effective when taken properly, and means that you’re protecting your own HIV negative status.

You'll be able to find out if you should be on PrEP and if you're eligible for PrEP on the NHS at your local sexual health clinic.

Hormones are safe to take at the same time as PEP. There’s no evidence that PEP or PrEP drugs diminish the effects of hormone therapy for trans people.

There has been little research so far regarding HIV risk following genital surgeries for both trans women and trans men. Some types of lower surgeries may theoretically increase susceptibility to HIV and other STIs.

Using condoms with vaginal, frontal or anal sex will protect you from HIV and other STIs. You also might want to find out about PrEP if you think you might be at risk in the future.

If you have any concerns about your sexual health following lower surgery, it’s best to discuss them with your doctor.

CliniQ has more information on PEP/PrEP for trans and non-binary people.

Remember, whatever happens we're here for you. If you'd like help or support, get in touch with THT Direct on 0808 802 1221.