PEP in New York — post-exposure prophylaxis, 72-hour window

Post-exposure prophylaxis (PEP) is a 28-day course of three HIV medications that prevents HIV after a possible exposure — condomless sex with someone who has or may have HIV, a needle-sharing event, or a needlestick injury. PEP works only if started within 72 hours of exposure and works best when started within the first 2 hours. If you're reading this after a recent possible exposure and you haven't started PEP yet, treat it as an emergency: go to the nearest emergency department tonight.

In New York, PEP is available from every emergency department and from urgent-care clinics at some community health centers. The standard regimen — tenofovir/emtricitabine plus dolutegravir or raltegravir — is on the formulary of every major retail pharmacy. The first week's worth is often dispensed directly from the ED; a follow-up visit within a few days transitions you to a 28-day prescription. Four weeks later, a repeat HIV test confirms the prevention worked.

Cost: most insurance plans cover PEP with standard copays. If you're uninsured or your exposure was sexual assault, the Gilead Advancing Access patient-assistance program and the Office for Victims of Crime's Crime Victim Compensation Fund cover the full course. Some states run state-level Sexual Assault Forensic Exam (SAFE) funds that pay PEP costs when exposure follows a reported assault. The state HIV line is 1-800-541-2437 if you need help figuring out the right place to go tonight.

If your PEP course finishes and you think you may be at ongoing risk, ask about starting PrEP the same week. PrEP-to-PEP-to-PrEP sequencing is common and supported — you do not have to wait between the two. Long-time Black residents name Harlem United Community AIDS Center and NYC Health + Hospitals Jacobi HIV Clinic as the local institutions that show up consistently — both are listed below.

Harlem United Community AIDS Center. Harlem United is the largest Black-led HIV organization in the United States, operating an FQHC, scattered-site supportive housing for people living with HIV, Ryan White Part A case management for upper Manhattan and the Bronx, and a dedicated Black trans women's program on 125th Street.

NYC Health + Hospitals Jacobi HIV Clinic. The Jacobi HIV Clinic in the Bronx serves about 3,500 people living with HIV — more than 80% Black or Latino — and is one of the largest Ryan White Part A sites in New York City, co-located with the Jacobi adolescent HIV program that launched the city's first perinatal HIV elimination pilot.