HIV prevention has changed completely in the last decade. Today there are medications that can prevent infection before a risky encounter (PrEP) and even after one (PEP). If you live in or travel through Medellín, both are available — here's how they work and how to get them properly.
The one thing to remember from this whole article:
If you think you were exposed to HIV in the last 72 hours — condom broke, condomless sex with someone of unknown status, shared needles — PEP can still prevent infection, but the clock is running. Message the office right now and say it's about PEP. Every hour counts.
PrEP: protection before exposure
PrEP (pre-exposure prophylaxis) is a medication taken by HIV-negative people to prevent infection. Taken as prescribed, it reduces the risk of getting HIV from sex by about 99%. It is one of the most effective preventive tools in all of medicine.
The standard scheme is one pill a day. For some people (cisgender men who can plan sexual activity in advance), an "on-demand" scheme around the time of sex is also an evidence-based option — whether it suits you is exactly the kind of thing to decide in consultation.
Who should consider PrEP?
- Anyone with several partners or non-exclusive relationships, especially if condoms aren't used 100% of the time.
- People whose partner lives with HIV and is not (yet) confirmed undetectable.
- Anyone who has needed PEP before, or has had a recent bacterial STI.
- Travelers and digital nomads with active dating lives — being in a new city changes behavior more than people expect.
What starting PrEP involves
- Before starting: an HIV test (you must be negative), kidney function check, and hepatitis B status — all simple lab tests.
- While on PrEP: follow-up roughly every 3 months with an HIV test and periodic kidney monitoring, plus STI screening (PrEP prevents HIV, not the others).
- Stopping and restarting: safe, but has rules — do it with medical guidance.
PEP: the emergency option after exposure
PEP (post-exposure prophylaxis) is a 28-day course of HIV medication started after a potential exposure. It is highly effective — but only if started fast:
- Ideal: within 24 hours of the exposure.
- Limit: 72 hours. After that it is no longer recommended.
- You take it for 28 consecutive days, then confirm with follow-up HIV testing.
PEP is for emergencies, not a routine strategy — if you find yourself needing it more than once, that's the signal to talk seriously about PrEP.
Getting PrEP and PEP in Medellín
Both are available in Colombia. As a private patient (which is how most expats and travelers do it), the path is simple: a consultation, baseline labs, and a prescription filled at a local pharmacy — generic combinations are available and considerably cheaper than in the US or Europe. If you're already on PrEP from your home country, bring your records (or just your pill bottle) and continuity is easy to arrange, including follow-up labs while you're in Colombia.
If you're enrolled in the Colombian health system (EPS), coverage for PrEP has been expanding; whether your EPS provides it, and how fast, varies — that too is worth mapping out in consultation.
Common myth: "PrEP is for promiscuous people." PrEP is for people who plan ahead. Nobody calls a seatbelt reckless. Prevention is simply intelligent — and it's always a judgment-free topic in this practice.
The honest fine print
- PrEP and PEP prevent HIV only. Condoms remain the tool that also blocks syphilis, gonorrhea and the rest.
- PrEP works when it's actually taken. Adherence is the whole game.
- Side effects are usually mild and temporary (some nausea the first weeks); kidney monitoring is part of responsible follow-up.
Start PrEP — or get PEP now
Consultations in English or Spanish, in person or by telemedicine. PEP requests are prioritized.
This article is educational and does not replace a medical consultation. Medication decisions must be made with a doctor. In an emergency in Colombia, call 123.