How to get PEP in Alicante, Spain.

[Tirednortherner]

Hello

I was spiked by injection last night. We are staying in Alicante. I am physically ok but as the status of the needle is unknown I need to access PEP drugs within the next 56 hours.

I have googled lots but limited information available. I do not wish to go to an ED unless there is no other option.

All advice appreciated.

Thanks

Go to the hospital.

I think if you call 112 (they should have English speakers available) they should be able to advise. It'll probably need to be an ED for PEP, I think you'll need a doctor to prescribe it.

I'm so sorry you're dealing with this. It's not (possibly) quite the same, but this is about sexual assault and consular assistance, whether or not you have decided to report to the police:

www.gov.uk/government/publications/spain-information-for-victims-of-rape-and-sexual-assault/alicante-guidance-for-victims-of-rape-and-sexual-assault

Thanks everyone.

If a GP can prescribe it I will get an appointment tomorrow and commence treatment but I do not know if in Spain a GP can prescribe it.

Googling suggests HIV clinics and hospitals can prescribe. Then you'd need to go to the pharmacy to get it.

I’ve an (online) appointment tomorrow, if nothing else they can direct me. And it was only £25 including the prescription.

the only sexual health clinic I can find doesn’t offer PEP, and the hiv clinic is by referral only.

I live in Spain. In Catalunya not Alicante but I will call the hospital in Alicante for you now and ask what the procedure is in this instance. Give me 10-15 minutes.

Ok.
I called these people Hospital Universitario de Sant Joan d'Alacant. They said you can go to their "urgencies" department and you will be seen by a doctor and they have a preventative medicine unit there and they will assess the situation for you. I don't know if they will charge your though. I'm now going to call some pharmacies in Alicante to ask them for advice.

Thanks so much, this is so kind! And so helpful

Ok spoke to the pharmacy and also to the A and E department of Hospital Universitario de Sant Joan d'Alacant. The pharmacy said go to A+E.
A+E also said go to A+E. You will be seen by a doctor there.
If you have an old EHIC card that is still valid, there is no charge. After Brexit a new EHIC card was brought in and assuming you have the right to it (which you should assuming you are a British citizen) then there is no charge. If you don't have the EHIC you have one month to send it to them so you could be treated tonight, and then you have a month to send them the card retrospectively once you have got it.

If for some reason you are not eligible for the EHIC(unlikely) then the fee is 175 euros plus VAT and then the cost of the prescription. Prescriptions tend not to be too expensive here but until you see a doctor they cannot say exactly how much because it depends on the medicine.

The impression I got was "the sooner the better" and that noone would blame you for going to A+E tonight for this, indeed that is what I have been told is the suggested course of action by the pharmacy (as opposed to waiting until tomorrow to see GP).

Please know that the culture of needing to be at death's door to warrant going to A+E does not apply here at all. This is a situation where rapid medical attention is preferable and everyone understands that. The GP might have to refer you to the Unidad de Prevencion anyway so you might as well cut out the middle man.

Good luck.

Even with the EHIC there will be a charge for the actual medicine. I'm not sure how much but I have a friend who had to take it once here and I will call him now and ask him. He also had to go the EHIC route.

Thanks so much for all your help! I am going to dig out the ehic card / look into the alternative and go either tonight or tomorrow. You’ve been so helpful - can’t thank you enough xx

Ok some googling suggests that yes, you need to go to the hospital as it can only be administered there, and that the cost is between 20-50 euros for the medicine. However I cannot be sure of either of these points having not heard it directly from the doctors but the info is from reputable Spanish newspapers.

Basically - go to A+E. Good luck.

How awful to have had that happen to you, OP. How very kind of you to do that research for OP @Changednamesorry, I hope you can act on it and that you will be okay. All the best.

Sorry, go to A+E tonight I should have specified. There is also some evidence that the sooner the medicine is administered the better so just forget waiting overnight or any of that and go to the hospital.

For peace of mind remember you are still at a very low risk so try not to drive yourself mad with it. But go down to the hospital tonight and get seen. If you have the EHIC already you will only pay the cost of the medicine which would be the same if you went to the doctor tomorrow. Also A+E waits tend not to be too ridiculous here at all and also explain the situation to the woman at the front desk and explain that it is time sensitive and hopefully they will see you quickly.

Again, DO NOT act with a UK mentality on this. Any Spanish person would be down at urgencies for this getting seen without even thinking twice. The stories from the UK of "oh I'll just wait it out, ok I've got chest pain and I've lost my sight in one eye but I don't want to be a nuisance so I'll call the GP in the morning" have Spanish people, laymen and doctors alike, baffled.

I'll check the thread again in an hour or so, I will also PM you my WhatsApp so you can message me directly and quick if you need. I'll be up for at least another hour or two. Get down the hospital!

@Changednamesorry You’ve been absolutely marvellous, well done. Really heartwarming

good luck OP x

Hi I'm so sorry this has happened to you. To hopefully reassure you though, the risk of HIV from this kind of exposure is very very very low and PEP would not be prescribed for this kind of incident in the UK - see attached prescribing table in photo.

This is because HIV doesn't live outside of the body for more than a few seconds, so even with a contaminated needle, the HIV would not be infectious after a few seconds, even if you were dealing with an assailant who was HIV+ve and not on treatment (unusual these days).

Please get advice from your healthcare provider but I just wanted you to know this info to hopefully reduce any panic about potential HIV infection.

The full guideline for PEP prescribing if you do want to read it and understand the rationale for this is here: www.bhiva.org/PEP-guidelines

Certainly has and this is why MN is such a great forum.

Oh how frightening!! But what an outstanding response from @Changednamesorry - you have been so kind, and gone above and beyond.
I will save all of this, in case I ever need it in Spain.
good luck, OP. Sounds like it’s A&E whatever.

Ok I spoke to my friend who had to take it a couple of years ago here in Barcelona, also via having the EHIC he said he can't remember the actual price of the prescription but he thinks between 40-60 euros but could have been as little as 10, but he remembers it wasn't expensive in any way.

I had to go to Urgencias in Spain last night (for a totally different reason) and they were amazing. I was seen within minutes of arriving by an English speaking doctor and was out and back at my hotel with a prescription within an hour. Please go. Go now. It will be easier than you expect. I didn’t have my EHIC so it cost €81, would have been free if i had it.

PEP is most effective if started in the first 24 hours, and although you have up to 72 hours to access it, the likely efficacy will lessen the longer you leave before starting it, so perhaps get to A&E sooner rather than later. Though as HelloMama says, it may not be deemed necessary.
You are possibly more at risk of hep B or C from this sort of injury and could do with a hep B vaccine (or booster if already vaccinated).
But better to get seen and assessed soon.

Good luck!!!

So impressed with the advice you've had.