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Post-Exposure Prophylaxis

Although avoiding exposure to HIV is the only reliable way of preventing HIV infection, post-exposure prophylaxis (PEP) can decrease the risk of infection after exposure to HIV. The following are key healthcare provider resources from the Federal government on PEP for both occupational exposure and non-occupational exposure (nPEP).

Occupational Exposure

Exposure to blood-borne pathogens can present serious risks to health care providers. Prompt post-exposure treatment for HIV and hepatitis B virus can be effective, but because each exposure case is unique, determining who should receive prophylaxis and which drugs are most appropriate is not always easy. Key guidelines and resources from the Federal government include:

Non-occupational Post-Exposure Prophylaxis (nPEP)

Non-occupational exposure is any direct mucosal, percutaneous, or intravenous contact with potentially infectious body fluids that occurs outside perinatal or occupational situations (e.g., sexual contact; sharing of injection drug needles or other equipment). Antiretroviral (ARV) therapy is an important prophylactic intervention for appropriate persons with nonoccupational exposures. Key guidelines and resources from the Federal government include:

  • Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV In the United States [PDF HTML] – The U.S. Department of Health and Human Services (DHHS) Working Group on Nonoccupational Postexposure Prophylaxis (nPEP) made the following recommendations for the United States: For persons seeking care <72 hours after nonoccupational exposure to blood, genital secretions, or other potentially infectious body fluids of a person known to be HIV infected, when that exposure represents a substantial risk for transmission, a 28-day course of highly active antiretroviral therapy (HAART) is recommended. [Source: CDC]
  • Nonoccupational Exposure Considerations [Source: NIH – AIDSinfo]
  • Nonoccupational Postexposure Prophylaxis – chapter in Guide for HIV/AIDS Clinical Care, a manual developed to provide HIV/AIDS clinicians with ready access to practical, current, treatment information so that they may provide quality care to people living with HIV. Written and edited by expert clinicians who are part of the Ryan White HIV/AIDS Program (RWP) system, this document reflects the broad clinical expertise within the RWP. [Source: HRSA-HIV/AIDS Bureau]
  • nPEP Steps: Guide to Non-Occupational Exposure – A quick guide for health care personnel developed in consultation with the National Clinician's Postexposure Prophylaxis (PEP) Hotline. Based on most current U.S. Public Health Service guidelines for non-occupational exposure. [Source: The Mountain-Plains AIDS Education and Training Center, supported by a grant from HRSA]