PEP (Post-Exposure Prophylaxis) 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 California, access points exist 24/7.
🚨 Where to Go Right Now
Your route depends entirely on the time of day and where you are.
| Time / Day | Where to Go | What to Expect |
|---|---|---|
| Weekday Daytime (SF) | SF City Clinic or UCSF Ward 86 | Call ahead. Specialists on site. Full 28-day course available. |
| Weekday Daytime (LA) | LA LGBT Center Clinic | Same-day urgent care slots. Call (323) 993-7500. |
| Evenings / Weekends / Anytime | Nearest hospital Emergency Room | State EMTALA law requires ER assessment regardless of insurance. |
| Anytime (Statewide) | PlushCare / MISTR / Nurx (telehealth) | Emergency telehealth PEP consultation. Can start a bridge prescription within hours. |
Do not wait until Monday. Every hour reduces PEP's effectiveness. If it's a weekend and your clinic is closed, go directly to the nearest hospital ER. California law prohibits ERs from turning away PEP candidates based on inability to pay.
🗣️ Navigating Triage
Whether at a clinic or ER, explain the situation clearly.
- At the ER Triage: "I've had a potential HIV exposure and I need PEP — Post-Exposure Prophylaxis."
- State the timeline: "The exposure was [X] hours ago. I know I have a 72-hour window."
- Be direct about the exposure: Explain exactly what happened (e.g., receptive anal sex without a condom) to help the doctor assess the risk. ER triage staff are not always sexual health specialists, so be precise.
The Starter Pack: ERs will typically give you a 3-to-5-day starter supply of PEP. The follow-up is mandatory. You must follow up with a specialist clinic (SF City Clinic, LA LGBT Center, or your primary care doctor) the next business day to receive the remainder of the 28-day course and baseline blood tests. Do not miss doses or stop early.
💊 The Medication: What to Expect
The standard California PEP regimen is typically Truvada (TDF/FTC) + dolutegravir (Tivicay), or the newer single-tablet combination Dovato.
- 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, particularly in the first week. The clinic can prescribe anti-sickness medication.
- Do not stop: Never stop taking PEP without speaking to a doctor first. An incomplete course does not protect you.
💶 Cost
- Medi-Cal: Free.
- ACA Insurance: Emergency PEP is covered; may have a copay depending on the plan.
- Uninsured (ER): EMTALA ensures treatment; billing is handled after. Do not let fear of cost stop you. A financial counselor will work with you after treatment begins.
- Gilead Advancing Access: PEP assistance programme for uninsured patients — request at the clinic.
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