'If you know, it might be in time' — Providing anonymous online consultation for HIV PEP, an emergency prevention option with low awareness

Kaguya Clinic has strengthened its information dissemination and online consultation/prescription system for HIV Post-Exposure Prophylaxis (PEP).

Under the supervision of physicians specializing in emergency and intensive care, the clinic has set up an online window for anonymous pre-consultation within a limited timeframe following potential HIV exposure.

Identity verification and physician assessment are conducted prior to any clinical decisions or prescriptions.

Background: The 'Emergency Prevention' option for HIV is not widely known.
According to reports from the AIDS Trend Committee of the Ministry of Health, Labour and Welfare, Japan reported 994 new cases in 2024 (662 HIV infections, 332 AIDS patients). Approximately 60% of new HIV infections are attributed to same-sex sexual contact.

However, the existence of 'PEP', an emergency preventive measure initiated after potential exposure, remains largely unknown even among relevant groups.

According to the 2025 nPEP recommendations from the U.S. Centers for Disease Control and Prevention (CDC), evaluation and initiation should be considered as soon as possible after potential HIV exposure, ideally within 24 hours, and no later than 72 hours. Physicians determine the suitability of prescriptions based on exposure circumstances, medical history, concurrent medications, and necessary tests.

While 'every hour counts,' three barriers in Japan hinder access for those in need:
- Lack of awareness: Not knowing PEP as an option.
- Inability to meet time constraints: Difficulty accessing medical institutions during weekday business hours.
- Privacy concerns: Psychological resistance to visiting a clinic.

Kaguya Clinic's Initiative:
- Awareness → Providing information based on CDC/WHO international guidelines.
- Time constraints → Online consultation and 24/7 reception.
- Privacy concerns → Anonymous consultation and privacy considerations.

By aiming to enable consultation, diagnosis, and prescription from home when deemed appropriate by a physician, the clinic lowers the threshold for medical care, creating a pathway for people to seek expert advice at the necessary time.

PEP is a preventive oral treatment performed based on a physician's judgment after behaviors carrying an HIV exposure risk. It does not guarantee efficacy; results vary depending on timing, exposure status, and medication adherence. Physicians make individual assessments for prescriptions.

Comment from supervising physician, Dr. Shota Tsuru (Specialist in Emergency Medicine and Intensive Care/STI care):
'In emergency settings, I have repeatedly encountered situations where "if only it had been a little earlier." PEP is an area where time matters immensely. However, if people do not know it exists, they cannot act, and even if they do, many are stopped by the barrier of going to a clinic. I believe creating an entry point where anyone can consult a specialist even at night, without anyone knowing, is a meaningful step today.'