PEP (Post-Exposure Prophylaxis) — or PPE in Italian — 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. Italy's PEP access is built into the emergency system and is free or near-free.
🚨 Where to Go Right Now
Do not wait for a convenient appointment. Go immediately to the Pronto Soccorso (emergency room).
| Time / Day | Where to Go | What to Expect |
|---|---|---|
| Anytime | Pronto Soccorso with Malattie Infettive (Infectious Diseases) | You don't need an appointment or referral. Walk in. |
Major Hospitals
- Milan: Ospedale Luigi Sacco (Via G.B. Grassi 74) or Ospedale Niguarda (Piazza dell'Ospedale Maggiore 3).
- Rome: IRCCS Spallanzani (Via Portuense 292) or Policlinico Umberto I (Viale del Policlinico 155).
- Bologna: Policlinico Sant'Orsola (Via Albertoni 15).
- Florence: AOU Careggi (Largo Brambilla 3).
- Naples: Ospedale Cotugno (Via Quagliariello 54).
- Turin: Ospedale Amedeo di Savoia (Corso Svizzera 164).
Do not wait to see if symptoms develop. Do not wait until Monday. Go to the Pronto Soccorso now.
🗣️ Navigating Triage
Tell the triage nurse clearly what you need. You'll likely be given a yellow or green triage code — not immediately life-threatening — and wait for the infectious disease team (infettivologo). Stay and wait.
- Use the terminology: "Ho avuto un rapporto a rischio HIV. Ho bisogno della PPE — Profilassi Post-Esposizione." (I had an HIV-risk exposure. I need PEP).
- State the timeline: Tell them exactly how many hours ago the exposure was.
- Be direct about the exposure: Be direct about the nature of the exposure — receptive anal sex without a condom, partner status unknown, etc. This is clinical information, not a confession.
The Starter Pack: The hospital will typically dispense a short starter pack at the initial visit. The follow-up is mandatory. You must attend a follow-up appointment at the Malattie Infettive clinic to collect the remainder of the 28-day course. Do not miss that appointment.
💊 The Medication: What to Expect
The standard Italian 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
- Italian SSN residents: Free under emergency care provisions.
- EU citizens with EHIC (TEAM card): Free or at the Italian ticket rate.
- Non-EU visitors: Emergency care is provided regardless. You may be billed afterward — travel insurance covers this.
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