Urgent HIV PEP in New York

Getting urgent PEP assessment now

Tell the receiving service that a possible HIV exposure occurred and give the exact time. PEP should start as soon as possible when indicated, ideally within 24 hours and no later than 72 hours. Do not wait for a routine booking confirmation, source-person testing or insurance authorization. If the chosen site cannot assess and start treatment promptly, use an emergency department or another PEP-capable service. Bring medicines and available reports without delaying travel. Confirm the first dose, full 28-day supply, early contact and follow-up HIV tests. An online submission or a negative baseline screen is not completion of urgent care.

Urgent HIV PEP evaluation

Possible HIV exposure is time-sensitive. Seek PEP assessment as soon as possible, ideally within 24 hours and no later than 72 hours after a qualifying exposure. PEP is a 28-day course of antiretroviral medication used after exposure; it is different from ongoing PrEP. Do not wait for symptoms, a partner’s results, insurance approval or a routine appointment. If a clinic cannot assess you promptly, go to an emergency department or another service able to start PEP.

How urgent HIV PEP evaluation works

PEP medicines help stop HIV from establishing infection after exposure. Starting promptly and completing the prescribed course matter. The clinician considers the exposure route, body fluid, timing and source information. A negative baseline HIV test assesses earlier infection; it cannot rule out infection from the exposure that just occurred.

Eligibility: Urgent HIV PEP evaluation

PEP may be recommended after a significant sexual, injection-related or other nonoccupational exposure when the source has HIV without sustained suppression, or when source status is unknown and the exposure warrants treatment. Not every contact transmits HIV. A clinician makes that assessment without using identity, appearance or symptoms as a substitute for evidence. Occupational exposures use a workplace exposure pathway. Pregnancy or breastfeeding does not justify delaying an urgent assessment.

What to expect: Urgent HIV PEP evaluation

Get an immediate exposure assessment

Tell the service the exact date and time, what happened, any prior PrEP doses and what is known about the source. If sexual assault occurred, urgent care can also address injuries, pregnancy prevention, other infections and support; PEP decisions should not wait for reporting or paperwork.

Start indicated medication without avoidable delay

A baseline HIV test and renal, hepatic, hepatitis, STI or pregnancy testing may be needed. When PEP is indicated, the first dose should not be delayed waiting for laboratory results that are unavailable immediately.

Make the course workable

Confirm where the medication will be dispensed, how the full 28-day supply will be obtained and whom to call for side effects or a missed dose. The regimen is selected for age, pregnancy, organ function and interactions.

Keep the follow-up plan

CDC recommends early contact around 24 hours to check access and tolerance, with clinical/laboratory follow-up at 4–6 and 12 weeks after exposure. Your clinician specifies the HIV antigen/antibody and nucleic-acid tests and any timing adjustments.

Preparing for your appointment

Take a medication list, previous HIV results and information about the source if available, but do not delay care to gather documents. Say if you are already taking PrEP, have hepatitis B, kidney disease or are pregnant. Ask whether a starter supply or full course is being provided. Leave with a reachable clinical contact and a plan for every dose and follow-up test.

Risks and when to seek help

Contact the prescribing team for persistent vomiting, inability to keep pills down, a missed dose or difficulty obtaining medication. Severe allergy, breathing difficulty or other serious symptoms need emergency care. Do not double doses or stop the course using an online protocol. PEP is not guaranteed prevention, and it does not treat every STI or prevent pregnancy.

Follow-up and treatment review

Testing immediately after the final pill does not replace the scheduled follow-up. Antiretrovirals can affect HIV detection, so routine untreated-infection window estimates do not determine the PEP testing plan. Report fever, rash or other possible acute HIV symptoms between visits. If future exposure is likely, discuss a clinician-managed PEP-to-PrEP transition rather than leaving a prevention gap while waiting for the final test.

Appointments, costs and coverage

Urgency comes first. Ask the receiving service to confirm that it can evaluate and start PEP now; an online form alone is not treatment. Public NYC sexual-health services and emergency departments are alternative routes when a requested clinic is unavailable. Ask the receiving service to address medication access and costs during urgent care.

Questions about your care

My HIV test is negative today. Do I still need PEP?

Possibly. The test cannot exclude the exposure that just happened. Eligibility depends on timing and exposure details, so seek urgent assessment within the 72-hour window.

Can I test the day after finishing PEP and be done?

That test does not replace follow-up at the recommended intervals. CDC’s 2025 guidance uses laboratory antigen/antibody testing with NAT in follow-up because antiretrovirals can delay detection. Ask your clinician for the exact dated plan.

What if more than 72 hours have passed?

Seek evaluation for testing, other infection care and future prevention. PEP initiation beyond 72 hours is not routinely recommended in CDC guidance; do not self-start borrowed medication or assume later testing eliminates the need for assessment.

Can I move directly from PEP to PrEP?

Yes, a clinician can plan an immediate transition when ongoing risk warrants it, with the required HIV assessment and continuing tests. Do not create the transition by skipping or combining prescribed medicines yourself.

Medical sources

Source: New York State PEP clinical guideline Source: CDC 2025 nonoccupational PEP recommendations

Source: CDC 2025 nonoccupational PEP recommendations

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