PEP after needle sharing
and drug use: what you need to know.
Sharing needles or injecting equipment with another person is one of the highest-risk routes for HIV transmission. PEP is available, it works, and you deserve access to it regardless of the circumstances that led to the exposure.
Medically reviewed by Jude Ozioko, Pharmacist (PCN 024035) • Last reviewed October 2026
⏳ Within 72 hours of a needle-sharing exposure? Start PEP now. Order on WhatsApp →
This article is written without judgement. People use drugs for many reasons, and the circumstances around needle sharing are rarely simple. What matters right now, if you are reading this within 72 hours of sharing a needle or injecting equipment with another person, is accessing PEP quickly. The rest of the conversation can happen later.
PEP is available to you. You do not need to explain yourself to anyone at Zivoko. You do not need to disclose details beyond the nature and timing of the exposure. You need medication, and we can help you get it.
Understanding the transmission risk from injecting equipment.
Sharing a needle, syringe, or any injecting equipment with another person introduces that person’s blood directly into your bloodstream. Unlike sexual transmission, where HIV must traverse mucosal membranes and the per-act risk varies, needle sharing involves direct bloodstream-to-bloodstream contact. The per-act HIV transmission risk from sharing injecting equipment is estimated at approximately 63 per 10,000 exposures to an HIV-positive source, making it one of the higher-risk exposures in the transmission hierarchy.
This risk applies to any shared injecting equipment: needles, syringes, water used to dissolve drugs, cotton filters, spoons or bottle caps used to heat drugs. All of these items can carry blood that retains viable HIV, particularly when the interval between uses is short. The risk is highest when the equipment is shared immediately after another person has used it.
If you have shared any of this equipment with someone whose HIV status is unknown or positive in the last 72 hours, PEP is strongly indicated. Do not wait.
Everything you need to know about accessing PEP in this situation.
PEP works the same way for needle-sharing exposures as for any other HIV exposure. It is a 28-day course of antiretroviral medication that blocks HIV from establishing infection in your body after exposure. It must be started within 72 hours of the exposure, and earlier is significantly better. The first 24 hours are the most critical window.
To order PEP through Zivoko, you do not need to disclose that the exposure involved drug use. Our pharmacists will ask for the timing of the exposure and the general nature of it to confirm eligibility. You can simply describe it as a needlestick exposure or blood contact. No further detail is required.
After confirming eligibility, PEP is dispatched in plain packaging for same-day delivery in Lagos, Abuja, and Port Harcourt, and nationwide otherwise. The course is 28 days of daily tablets. Our pharmacists provide full support throughout including dosing guidance, side effect management, and missed dose advice.
Other infections and longer-term considerations.
PEP addresses HIV. Needle sharing also carries risk for hepatitis C, which can survive on injecting equipment for days and for which no vaccine currently exists, and hepatitis B, for which vaccination is available and effective. Both are blood-borne infections transmissible through shared equipment.
If you have shared injecting equipment, a comprehensive blood-borne virus screening including hepatitis B, hepatitis C, and HIV is warranted in addition to PEP. A doctor can order this panel, and a medical laboratory scientist at a private laboratory processes the samples. Post-PEP follow-up testing for HIV at 6 weeks and 90 days from the exposure is necessary regardless of whether you feel well.
If you are in a position where needle sharing is a recurring risk, we want to offer information rather than advice. Harm reduction approaches including access to clean needles, safer injecting guidance, and opioid substitution therapy where available can significantly reduce HIV and hepatitis transmission risk. If any of this is relevant to your situation, our team can discuss it with you privately and without judgement, and can connect you with appropriate harm reduction resources in your city.
What reduces the risk if injecting drug use continues.
If you are going to inject, the single most effective risk reduction step is using a new sterile needle and syringe for every injection and never sharing any part of the injecting equipment with another person. This eliminates the HIV and hepatitis C transmission risk from injecting almost entirely.
- Use only new, sealed needles and syringes for every injection. In Nigeria, these are available at pharmacies without a prescription.
- Never share water, cotton, spoons, or any equipment used in the preparation or injection process, even if they appear clean. HIV and hepatitis C are not visible to the naked eye.
- Dispose of used needles and syringes safely in a puncture-resistant container rather than leaving them where others might accidentally be injured.
- Get vaccinated against hepatitis B if you have not already. A three-dose series from a doctor or nurse provides long-lasting protection.
- Test regularly for HIV and hepatitis C. Quarterly testing for people who inject drugs is recommended by WHO. Early detection of either infection allows for early treatment with much better outcomes.
Questions about PEP and needle-related exposures.
QI accidentally pricked myself with a needle I found on the ground. Do I need PEP?
The risk from a discarded needle found in a public place is generally low because HIV degrades rapidly outside the body once blood dries. The risk is higher if the needle appears freshly used with visible wet blood. If you have been pricked by a needle in a known drug use area and there is visible fresh blood, speaking to a pharmacist or doctor within 72 hours for a risk assessment is prudent. For most discarded needle pricks with no visible blood, PEP is not typically indicated, but an HIV test at the appropriate window period provides reassurance.
QI shared a needle about 50 hours ago. Is it too late for PEP?
No. PEP is effective when started any time within the 72-hour window. 50 hours still falls within that window. It is significantly better to start now than to wait another 22 hours and miss the window entirely. Contact Zivoko immediately. Every remaining hour in the window still matters.
QWill Zivoko report me to the police for drug use if I order PEP?
No. Zivoko is a pharmacy service, not a law enforcement body. We have no obligation and no intention of reporting customers to any authority. Pharmacists operate under healthcare confidentiality obligations. Your interaction with us is private. The only thing we care about in this conversation is whether you are within the 72-hour window and whether you need PEP. Nothing else.
Shared a needle in the last 72 hours?
You deserve care. No explanations required. No judgement from our team. Message us on WhatsApp right now and we will get PEP to you before the window closes.
Order PEP Now →Your circumstances do not change your right to HIV prevention.
PEP is for everyone within 72 hours of a genuine exposure. No exceptions.
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