PEP (Profilaxis Post-Exposición) is a 28-day course of emergency HIV medication. It must be started within 72 hours of a high-risk exposure (e.g., a condom break with a partner of unknown status), but the sooner you start it, the more effective it is. In Spain, it is free on the public health system.
🚨 Where to Go Right Now
Do not wait for a convenient appointment. Your route depends entirely on the time of day.
| Time / Day | Where to Go | What to Expect |
|---|---|---|
| Anytime | Urgencias (Emergency Room) at a major public hospital | 24/7 capacity. Do not go to a pharmacy or local health centre. |
Major Hospitals
- Madrid: Hospital Clínico San Carlos or Hospital La Paz.
- Barcelona: Hospital Clínic.
Do not go to a local Centro de Salud (local health center) or a normal Farmacia. They do not stock antiretroviral medications and cannot help you. You must go to a hospital.
🗣️ Navigating Triage
Spanish hospital emergency rooms are crowded. Be direct with triage nurses so they understand the urgency and don't leave you in the waiting room for hours.
- Use the terminology: "Necesito PEP. Profilaxis post-exposición por riesgo sexual." (I need PEP. Post-exposure prophylaxis for sexual risk).
- State the timeline: "La exposición fue hace [X] horas." (The exposure was [X] hours ago).
- Be direct about the exposure: Be clear that it was high-risk, condomless sex. If the partner is known to be HIV-positive and NOT undetectable, tell them immediately.
The Starter Pack: The hospital will usually give you the first few days of medication right there in the emergency room. The follow-up is mandatory. They will give you an urgent referral to the infectious diseases department (enfermedades infecciosas) to collect the rest of the 28-day supply from the hospital pharmacy.
💊 The Medication: What to Expect
The standard Spanish PEP regimen usually consists of Truvada (or a generic equivalent) taken alongside an integrase inhibitor — typically dolutegravir (Tivicay).
- It is a strict regimen: PEP is not a morning-after pill. It is a mandatory 28-day course, and you cannot miss doses.
- Side effects are manageable: You may experience nausea, fatigue, or diarrhea, though not everyone does. The clinic will often prescribe anti-sickness medication alongside your PEP.
- Do not stop: Never stop taking PEP without speaking to a doctor first.
💶 Cost
- Residents with Tarjeta Sanitaria Individual (TSI): PEP is free via the SNS.
- EU/EEA visitors with EHIC: Emergency care is covered. Present your European Health Insurance Card.
- Non-EU Citizens / Undocumented: Spanish hospitals have an absolute legal duty of care in emergencies. They will not deny you PEP if you are within the 72-hour window, but you may be billed afterwards if you do not have travel insurance.
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