STIs we refer on: HIV, hepatitis, and where PrEP and PEP come from

Most STIs we can test for and treat from start to finish. A few need specialist care that sits beyond a single course of treatment, and HIV-prevention medicines are best accessed through dedicated NHS services. Being clear about where our care ends and where to turn next is part of doing this properly. This article explains what we diagnose and refer, and where PrEP and PEP come from.

HIV: diagnosed here, treated by specialists

We test for HIV as part of standard screening. If a result is positive, the doctor confirms it with a repeat test, supports you through the news, and refers you the same day into specialist HIV care, whether NHS or private. We do not provide the ongoing treatment ourselves, because HIV is managed by specialist teams who do it day in, day out.

The important thing to know is that modern HIV treatment is highly effective. People diagnosed today and treated promptly can expect a normal life expectancy, and effective treatment reduces the virus to a level where it cannot be passed on to partners. Early diagnosis is a real advantage, not a catastrophe, which is the whole reason regular testing matters.

Hepatitis B and C: diagnosed here, referred for care

We test for hepatitis B and hepatitis C where relevant. A positive result is referred on for specialist assessment. Hepatitis C is now curable in most people with a short course of modern antiviral tablets, given under specialist care. Hepatitis B is managed long term by specialists, and we can arrange vaccination for those who are not immune and want protection. As with HIV, our role is accurate diagnosis, a clear explanation, and a prompt referral into the right hands.

What PrEP and PEP are

PrEP and PEP are HIV-prevention medicines, and they are different from treatment:

• PrEP, pre-exposure prophylaxis, is medication taken before potential exposure to prevent HIV. Taken consistently, it is highly effective at preventing infection.

• PEP, post-exposure prophylaxis, is a short course started after a possible exposure to stop HIV taking hold. It must be started quickly, within 72 hours of exposure and ideally much sooner, and is taken for 28 days.

These are valuable, well-evidenced medicines. We do not provide them, because they are best delivered through services set up for the regular monitoring that goes with them.

Where to get PrEP and PEP on the NHS

The NHS provides both, free, and is the right route:

• PrEP is available free from NHS sexual health clinics, which assess your suitability and provide the regular monitoring that goes with it.

• PEP is urgent. If you may have been exposed to HIV in the last 72 hours, contact an NHS sexual health clinic during opening hours, or go to an accident and emergency department outside those hours. The sooner it is started, the better it works, so do not wait.

If you are unsure where to go, NHS 111 can direct you to the nearest service. For PEP in particular, speed matters more than choosing the perfect provider, so act on the clock rather than shopping around.

Why we draw the line here

Drawing a clear line around what we do, and pointing you to specialist and NHS services for the rest, is not a gap in care. It is how care should work. You get accurate testing and honest results from us, and the conditions that need specialist teams or dedicated prevention services reach those teams without delay. The NHS offers PrEP and PEP free to those who need them, and for these specific needs that is genuinely the right door to knock on.

The honest summary

We diagnose HIV and hepatitis, support you, and refer promptly for the specialist care they need, where modern treatment is highly effective. PrEP and PEP are HIV-prevention medicines we do not provide: the NHS offers both free through sexual health clinics, and PEP must be started within 72 hours of exposure, so act fast and use A and E or 111 if a clinic is closed.

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