Last Wednesday, in scorching midday heat, about twenty members of the longtime HIV/AIDS activist group ACT UP held a protest in front of Mt. Sinai Medical Center’s entrance at Madison Avenue and 100th St., their shirts soaked in sweat. They carried posters reading “Why Didn’t Your E.R. Know About HIV Morning-After Drugs?” and “How Many More Infected Before You Get It Right?” Walking in a circle, they chanted: “What do we want? PEP on demand. When do we want it? Now!”
Passersby, when I asked them, generally had no idea what PEP was. Nearby, Mt. Sinai staffers on their lunch break watched the protest impassively. “There was a mix-up that night,” said a female employee who asked not to be named. “We’ve never had a problem with this before.”
Well, what is PEP? Short for “post-exposure prophylaxis,” it is the practice of starting a month-long course of HIV meds within 72 hours of possible exposure to the virus to prevent permanent infection. In 2005, the U.S. Centers for Disease Control issued evidence of PEP’s effectiveness plus guidelines for PEP usage, and the New York State health department did the same in 2008 – and again as recently as this year – for ERs throughout the state, requiring them to administer PEP to medically qualified patients who request it.