PEP in South Carolina — 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 South Carolina, 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 1-803-898-0749 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 MUSC Ryan White Clinic and Palmetto Community Care as the local institutions that show up consistently — both are listed below.

MUSC Ryan White Clinic. The MUSC Ryan White Clinic in Charleston is South Carolina's largest Ryan White Part C grantee, serving about 2,400 people living with HIV across the Lowcountry; MUSC co-runs the Palmetto State's EHE Charleston plan with Roper St. Francis Healthcare.

Palmetto Community Care. Palmetto Community Care in North Charleston (formerly Lowcountry AIDS Services) is the Ryan White Part B case-management contractor for the Lowcountry region, with a dedicated Black-women-focused prevention program and the state's highest-volume community rapid-testing van.