PEP and PrEP in Railay
If a condom broke last night, or you woke up to a situation you did not plan for, there is medication that can stop HIV taking hold — but only if it starts fast. PEP and PrEP in Railay matter more here than in a town with a hospital on the doorstep, because PEP must begin within 72 hours and the boats do not run all night.
PEP — treatment after an exposure
PEP stands for post-exposure prophylaxis. It is a 28-day course of anti-HIV tablets taken after a possible exposure, and it stops the virus establishing itself while your body clears the initial infection.
The rules are simple and strict. It must start within 72 hours. It works substantially better at six hours than at sixty. And you must complete all 28 days, even once you feel entirely fine, because a course stopped early gives you the side effects without the protection.
On Railay there is one extra consideration: do not wait for a convenient boat. If it is late and the clinic is closed, message us rather than deciding to sort it out tomorrow afternoon.
When PEP is worth taking
The nurse assesses the actual risk with a nurse from our Ao Nang clinic, rather than issuing it to everyone who asks. It is usually offered after:
- Condom failure, or no condom, with a partner of unknown status
- Sex with someone known to be HIV positive and not on effective treatment
- Sexual assault
- Sharing injecting equipment
- A needlestick injury
If the risk was genuinely negligible you will be told so honestly rather than sold a month of antiretrovirals. That conversation is worth having even when the answer is no — most people leave considerably less anxious than they arrived.
PrEP — prevention before exposure
PrEP is the same principle in advance. Taken correctly it is highly effective at preventing HIV, and it suits people whose circumstances involve ongoing rather than one-off risk — which for the seasonal population here is a realistic description.
It requires a negative HIV test before starting, along with kidney function bloods and hepatitis B screening. Those checks are not bureaucracy: starting PrEP while unknowingly HIV positive can cause drug resistance that limits future treatment, and PrEP drugs also affect hepatitis B.
Follow-up testing continues every three months while you remain on it, which is straightforward to arrange if you are here for a season.
What neither protects against
Neither PEP nor PrEP does anything about the rest of sexual health. Syphilis, gonorrhoea, chlamydia and hepatitis C are entirely unaffected, and rates of those have risen among people relying on PrEP alone and dropping condoms.
We test for the others at the same visit — see STD testing — and repeat that testing during the course. Being on PrEP is a reason to test more often rather than less.
Side effects, and finishing the course elsewhere
Most people tolerate the medication well. Some get nausea, headache or tiredness in the first week, which usually settles. Taking it with food helps considerably. If vomiting stops you keeping tablets down, contact us rather than skipping doses.
Many travellers start a course here and leave part-way through. We supply the full 28 days where possible, plus written documentation of the drug, dose and dates, so a doctor anywhere can take over without restarting.
Take it at the same time each day and set an alarm — a fortnight of late nights and boat schedules makes it easy to lose track. Keep the tablets with you rather than in a room you might not get back to, and carry them in hand luggage when you fly. Follow-up HIV testing is at four to six weeks and again at three months after the original exposure.
The conversation itself
People put this off because they expect judgement, and it is worth saying directly that there will not be any. The nurse needs enough information to assess the risk — roughly when, what kind of contact, and what is known about the other person — and nothing beyond that.
Nobody asks who, nobody comments, and nothing is recorded outside your own confidential file. On a peninsula where a few hundred people all know each other in season, that matters more than usual, and it is taken seriously.
If the exposure involved assault, the nurse can also talk through emergency contraception and documentation of injuries, at whatever pace suits you, with no obligation to involve the police unless you want to.
Frequently asked questions
How quickly do I need to start PEP?
Within 72 hours, and as close to immediately as you can manage. At 70 hours it is still worth starting. After 72 hours it is no longer effective, so do not spend a day thinking it over.
What if it is the middle of the night?
Message us. This is one of the few situations where the clock genuinely matters more than the hour, and a doctor will respond rather than leaving it until the clinic opens.
How much does PEP cost?
You are paying for a 28-day course of antiretroviral medication plus baseline blood tests, so it is one of the more expensive treatments we provide. The full cost is explained before you commit.
Will anyone be told?
No. Treatment is confidential and nothing is reported to your resort, employer, insurer or embassy.
Can I take PrEP for just a season?
Yes — event-based and short-course PrEP are both recognised approaches for defined periods. It still needs baseline tests first, so allow a little time rather than arriving the night before.
Can a doctor bring it to my room?
The first assessment involves blood tests and is better at the clinic, but a doctor resort visit can handle follow-up reviews.
A nurse-led clinic, part of the Takecare network
Takecare Clinic Railay is staffed by experienced English-speaking nurses, and works together with Doctor Ao Nang Takecare Medical Clinic in Ao Nang. The two clinics share doctors, records and treatment plans, so a doctor is involved whenever one is needed — reviewing a case, prescribing, or coming over to Railay — and care started on the peninsula continues without repetition if you cross to the mainland. It also means a second clinical opinion is a phone call away rather than a boat ride.
Come in, or we come to you
Takecare Clinic Railay is open 8am–10pm daily on Railay, and reachable 24 hours by phone, WhatsApp and Line — so if something happens after we close, message rather than wait until morning. Walk in without an appointment, call +66 81 718 9080, message WhatsApp or Line. If you would rather not move, ask for a doctor resort visit and we will come to you. For anything that cannot wait for a boat, see evacuation and hospital transfer.