PEP (HIV Post-Exposure Prophylaxis) is a race against time. We offer same-day prescriptions through online consultation.
Consultations are available daily from 9:00 to 22:00. If you suspect exposure, hesitation is your biggest loss.
What is PEP (HIV Post-Exposure Prophylaxis)?
PEP is an emergency prevention method that reduces the risk of HIV infection by starting antiretroviral drugs as soon as possible (at most within 72 hours) after possible exposure to HIV through sexual activity or an accident. The effectiveness decreases with time, so please consult us as soon as possible if you suspect exposure. Mona Aoyama Clinic offers same-day prescriptions through online consultation (self-pay medical service).
PEP's effective time frame
To achieve the effectiveness of PEP, it is necessary to start medication as soon as possible after exposure (ideally within a few hours, and within 72 hours at most). The effectiveness decreases as time passes.
| Time elapsed since exposure | Effectiveness | Recommended action |
|---|---|---|
| Within 2 hours | Most effective | Immediate initiation of medication recommended |
| Within 24 hours | High effectiveness expected | Prompt consultation recommended |
| Within 48 to 72 hours | Effectiveness expected but decreases with time | As prompt a consultation as possible recommended |
| Over 72 hours | Outside PEP indication | Testing recommended if concerned |
Determining if you can make it within 72 hours
With online consultation, we will ship and deliver your medication after your examination. If too much time has already passed since exposure, delivery may not make it within 72 hours. Please check the scenario that is closest to your situation.
| Time elapsed since exposure | Recommended course of action |
|---|---|
| ~24 hours | You'll have plenty of time with an online consultation. Please apply immediately. |
| 24-48 hours | There's a high chance that delivery will make it in time. Please apply as soon as possible. |
| 48-72 hours | Delivery may not make it in time. [To be confirmed: Information on same-day in-person pickup] Please also consider visiting an HIV/AIDS treatment hub hospital or emergency room near you. |
| Over 72 hours | Not eligible for PEP. We will guide you to testing to confirm infection status, so please consult us. |
Even if you are unsure, letting time pass is the worst option. Please contact us first.
The effectiveness decreases as time passes.
Cases where PEP is necessary
If you have engaged in any of the following acts, you should consider taking PEP. Even if you are unsure, please consult us first, as the effectiveness decreases with time.
- Had unprotected sex
- Condom broke or came off during sex
- Had sex with multiple partners
- The partner's HIV status is unknown or known to be infected
- Experienced sexual assault
- Healthcare worker who had a needle-stick injury during work, etc.
If you have been a victim of sexual violence, you can receive support that includes not only medical care but also evidence preservation and counseling. You can also consult with a One-Stop Support Center nationwide (common short dial #8891).
What is HIV?
HIV (Human Immunodeficiency Virus) is a virus that infects CD4-positive lymphocytes (a type of white blood cell) responsible for the body's immune function, gradually weakening the immune system. It is mainly transmitted through sexual activity (especially unprotected sex), blood-borne infection (e.g., sharing needles), and mother-to-child transmission. Immediately after infection, there are either no symptoms or temporary flu-like symptoms such as fever, fatigue, and swollen lymph nodes. In many cases, several years to 10 years can pass without any noticeable symptoms.
What is AIDS?
If left untreated, the immune system significantly weakens, leading to "AIDS," a condition where opportunistic infections (infections by pathogens that normally do not cause disease) and cancer develop. With advancements in treatment, early detection and continuous appropriate treatment now allow individuals to live a life almost identical to healthy individuals without developing AIDS.
PEP Set Contents
Our PEP set includes not only medication but also a home testing kit.
| Contents | Purpose | Timing of use |
|---|---|---|
| Antiretroviral drugs (28 days' supply) | Oral medication for HIV infection prevention | Start medication within 72 hours of exposure, continue for 28 days |
| HIV test kit (1st) | Confirmation of HIV infection status at the time of exposure | Use on the same day as starting medication (do not delay medication while waiting for results) |
| HIV test kit (2nd) | Confirmation of infection status after PEP medication | During follow-up after medication completion |
| Hepatitis B test kit | Confirmation of Hepatitis B infection status | Use on the same day as starting medication |
Why is Hepatitis B testing necessary?
Some antiretroviral drugs also contain components effective against the Hepatitis B virus. If someone infected with Hepatitis B stops taking the medication after 28 days, the suppressed virus may become active again, worsening hepatitis. Therefore, it is necessary to confirm the infection status beforehand. If the result is positive, we will provide guidance on how to monitor the condition after completing the medication.
If the test kit shows a positive result
If an HIV test kit shows a positive result, it becomes a case for treatment, not PEP (prevention). Do not continue or stop taking the medication on your own; always contact us. We will connect you to an appropriate medical institution for confirmatory testing and treatment. Instructions for using the test kit can be found in the enclosed manual. If you have any concerns about the results, please contact us at any time.
Dosage and duration
28 consecutive days of medication are required
With PEP, you take antiretroviral drugs continuously for 28 days (4 weeks). Interrupting the course not only reduces the preventive effect but also risks developing drug-resistant viruses, so it is crucial to take the medication for the prescribed period. The effectiveness and side effects vary from person to person.
Once you receive the medication, start taking it immediately.
There is no need to wait for the test kit results before starting the medication. International guidelines also recommend not delaying the first dose while waiting for test results. Once you receive the medication, take the first dose immediately, and use the test kit on the same day.
Main side effects
The main side effects observed in the early stages of taking antiretroviral drugs are as follows. Most of them subside with continued medication.
| Symptom | Common period | 対処法 |
|---|---|---|
| Nausea | Beginning of medication to a few days | Can be alleviated by taking it after meals or using antiemetics |
| Fatigue | Beginning of medication to about 1 week | Observe progress with rest and sufficient sleep |
| Diarrhea | Beginning of medication to a few days | Hydration, please consult if symptoms are severe |
| Headache | Beginning of medication to a few days | Can be managed with over-the-counter pain relievers in some cases |
If symptoms persist severely, please do not stop taking the medication on your own, but consult us.
What to tell us
- If you have ever been diagnosed with kidney disease (affects drug selection)
- If you are infected with or have been diagnosed with Hepatitis B
- If you are pregnant, breastfeeding, or may be pregnant
- Any medications or supplements you are currently taking (to check for interactions)
Follow-up testing after medication
Even if PEP is taken to completion, a certain period is required to confirm that you are not infected. The general timeline is as follows:
| Timing | Content |
|---|---|
| 4 to 6 weeks after exposure | HIV test to confirm infection status |
| 12 weeks (3 months) after exposure | Final confirmatory test performed |
If you experience flu-like symptoms such as fever, sore throat, rash, or swollen lymph nodes during this period, please contact us as it could be acute HIV infection. Also, until confirmation is complete, we recommend using condoms to prevent transmission to your partner.
After PEP - Switching to PrEP
PEP is an emergency measure for "after something has happened." If there is a continued risk of infection, switching to PrEP, which is taken in advance for prevention, is more reliable and less psychologically burdensome. It is a more rational approach than repeatedly taking PEP.
You can consult us about switching once HIV negativity is confirmed in the follow-up test. For details, please see the PrEP page.
PEP does not prevent STIs other than HIV.
PEP is a medication to reduce the risk of HIV infection and does not prevent other sexually transmitted infections such as Chlamydia, Gonorrhea, Syphilis, or Hepatitis B. If you have engaged in risky behavior, we recommend getting tested for other STIs as well. We also offer STI testing online.
Important Notes Regarding Unapproved Medical Products
- Unapproved medical product: The antiretroviral drugs used at our clinic for HIV prevention (PEP) are not approved in Japan for this purpose.
- Method of acquisition: The physician imports the drugs through personal import procedures (obtaining Yakkan Shomei from the regional health and welfare bureau).
- Availability of approved medical products in Japan: In Japan, approved antiretroviral drugs are available for HIV infection treatment. However, their use for prevention is not approved.
- Safety information from other countries: PEP is an established prevention method recommended by guidelines in various countries, including the US CDC, and there is accumulated data on its safety during 28 days of administration. However, side effects such as nausea, diarrhea, and fatigue, as well as rare cases of kidney and liver function impairment, have been reported.
- Health damage relief system: Health damage caused by the use of unapproved medical products is not covered by the Pharmaceutical Side Effect Relief System.
- Cost/Effectiveness: As it is a self-pay medical service, health insurance does not apply, and the full cost is borne by the patient. PEP reduces the risk of infection but does not guarantee complete prevention of infection.
For detailed fees, please check the pricing page or inquire during your consultation.
Flow of examination and prescription at our clinic
| STEP | Content |
|---|---|
| 1. Order/Pre-consultation | Select your desired plan and place an order. You will then answer a questionnaire sent via LINE or email. By accurately providing the date and time of risky behavior, we can quickly determine the suitability of PEP. |
| 2. Online Consultation | The doctor will conduct counseling and prescribe medication via video call. All you need is a smartphone or PC. |
| 3. Shipping | Same-day shipping for video calls completed by 15:00 daily. Delivered in privacy-conscious packaging. Includes antiretroviral drugs (28-day supply), two HIV test kits, and a Hepatitis B test kit. |
| 4. Start medication/testing | Once the medication arrives, start taking it immediately. Use the test kit on the same day to confirm current infection status. After completing the medication, follow-up testing will be done with the second HIV test kit. |
Hesitation is your biggest loss.
PEP (HIV Post-Exposure Prophylaxis) is a race against time. We offer same-day prescriptions through online consultation.
