Urgent HIV PEP evaluation in NYC and Long Island

PEP is emergency medicine after a possible HIV exposure. New York guidance says to start immediately, ideally within two hours and no later than 72 hours.

Do not wait for symptoms. Book the earliest available evaluation, call Nao Medical, or use the 24/7 NYC PEP Hotline if our timing will not meet the 72-hour window.

PEP is time-sensitive

If the exposure was within 72 hours, act now. Call Nao Medical at (917) 310-3371, call the 24/7 NYC PEP Hotline at 844-373-7692, or go to an emergency room or NYC Sexual Health Clinic. Do not delay care while comparing options.

Key clinical guidance

These points affect medication safety, test timing, or follow-up. The linked primary guidance supports each summary.

The first dose is an emergency

New York guidance says PEP should begin immediately, ideally within two hours. CDC says as soon as possible, ideally within 24 hours. PEP should not begin later than 72 hours after exposure.

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

Minimum follow-up after PEP starts

CDC recommends a 24-hour follow-up, laboratory antigen/antibody plus diagnostic NAT testing at four to six weeks, and final testing with both assays at 12 weeks after exposure. Narrow exceptions can change the interim test.

Source: CDC 2025 nonoccupational PEP recommendations

The essentials at a glance

Start within 72 hours

New York guidance says ideally within two hours; CDC says ideally within 24 hours. Both set 72 hours as the latest start.

Take it for 28 days

If prescribed, PEP is a 28-day course of antiretroviral medication.

Testing should not cause delay

When PEP is indicated, the first dose should not be delayed while laboratory test results are pending.

What to expect from care

The exact plan depends on your history, test results, coverage, and medication choice. These are the usual steps.

Immediate exposure assessment

Tell the clinician what happened, when it happened, the body fluid and exposure site, source information when known, and any current PrEP use.
Baseline testing

Complete baseline HIV testing, creatinine, liver enzymes, and hepatitis B testing. If a rapid point-of-care antigen/antibody test is used, obtain a laboratory antigen/antibody test in parallel without delaying the first PEP dose. Pregnancy testing applies when relevant; hepatitis C and STI testing depend on the exposure. Some patients also need an HIV nucleic acid test.
First dose without unnecessary delay

If PEP is indicated, begin promptly rather than waiting for all laboratory results to return.
Complete the full course

Take the prescribed regimen every day for 28 days and contact the care team about side effects or missed doses.
Follow-up and PrEP transition

Complete a 24-hour follow-up, interim testing at four to six weeks, and final HIV testing at 12 weeks. Discuss a direct transition to PrEP if future exposure is possible.

When nonoccupational PEP may be considered

Nonoccupational PEP, often called nPEP, is used after a possible exposure outside the workplace. Examples can include sex, sharing injection equipment, sexual assault, or another contact in which potentially infectious fluid reached a mucous membrane, broken skin, or a puncture site.

The clinician evaluates whether the exposure presents a substantial risk and what is known about the source person's HIV status and viral suppression. When the source status is unknown, the decision is made case by case. PEP is not recommended for exposures with no substantial HIV transmission risk.

Share the exact exposure time and date.
Explain whether condoms or PrEP were used and whether any doses were missed.
Bring a medication and allergy list if it is immediately available.
Do not delay the visit while trying to contact the source person.

What testing and follow-up can include

A rapid or laboratory blood antigen/antibody test is recommended at baseline. If a rapid point-of-care antigen/antibody test is used, obtain a laboratory antigen/antibody test in parallel without delaying the first PEP dose. Routine baseline testing includes serum creatinine, ALT and AST, hepatitis B testing, and pregnancy testing when applicable. Hepatitis C and STI testing are selected for the exposure. An HIV diagnostic NAT is added in some situations, including recent long-acting injectable PrEP.

CDC's 2025 guidance calls for contact within 24 hours to confirm medication access, tolerability, and adherence. Interim laboratory antigen/antibody testing plus diagnostic NAT is generally performed four to six weeks after exposure. Final testing uses both assays at 12 weeks. A clinician may adjust the interim schedule under the limited exceptions in the guideline.

Pregnancy and breastfeeding are not reasons to withhold indicated PEP. Breastfeeding requires patient-centered counseling about continuing versus interrupting feeding while PEP is taken and HIV acquisition is excluded. New York guidance advises avoiding breast or chestfeeding for three months after exposure, while allowing it when HIV-negative status is confirmed.

Sexual assault, a new exposure during PEP, and occupational needlesticks can change the care pathway. These situations still require prompt evaluation and should not delay the first assessment.

Take each dose at the time prescribed.
Call if vomiting, rash, jaundice, muscle pain, or another concerning symptom occurs.
Return sooner for fever, rash, sore throat, swollen glands, or flu-like symptoms.
Keep the final HIV testing appointment even when the full course was completed.

PEP cost, privacy, and urgent alternatives

Many insurance plans, including Medicaid, cover emergency PEP. Medication assistance may be available for uninsured or underinsured patients. Coverage should be addressed without slowing the first-dose decision.

Nao Medical visits are confidential clinical care. If Nao Medical cannot evaluate you within the 72-hour window, use the NYC PEP Hotline, an emergency room, or an NYC Sexual Health Clinic immediately.

NYC 24/7 PEP Hotline: 844-373-7692.
Nao Medical: 917-310-3371.
For sexual assault and immediate danger, use emergency services and specialized support.
For a workplace exposure, follow the employer's occupational-exposure protocol or seek emergency care.

Find urgent PEP care

These clinics are included in the current PEP booking route. Current appointment timing must still fit within the 72-hour limit. If it does not, use the 24/7 NYC PEP Hotline or an emergency department immediately.