Who is eligible for PEP?

There are no absolute rules governing whether or not PEP will be prescribed for someone presenting for treatment after exposure to HIV. A decision will be made after considering three key factors:

The number of hours since the exposure incident occurred
Whether the patient’s partner is known to be HIV+ or considered to be at high risk of infection
The type of activity which lead to a risk of HIV exposure

Time

PEP is most effective when started within 24 hours but can be accessed up to 72 hours after exposure. Anyone requesting PEP more than 72 hours after exposure may not be considered eligible, although it may be prescribed in some circumstances.

HIV status/risk

If the presenting patient’s partner is known to be HIV positive, PEP will almost always be administered unless the risk of transmission is considered to have been very low. Where the patient’s partner is known to be from an area or group known to be at high risk of HIV, PEP will also generally be considered. If the patient’s partner is not from any group or area known to have a high HIV prevalence, treatment is not usually recommended unless there are other factors that need to be considered.

Situation

The situation in which HIV exposure may have taken place will also be taken into account when deciding whether or not to prescribe PEP. Sexual activities can normally be classified on a sliding scale with receptive anal intercourse as the most risky to Cunnilingus (oral sex performed on a woman) as the least risky. The type of sex which is reported, together with details of whether any physical trauma occurred, will be considered in conjunction with information about the patient’s partner and the estimated time of exposure.

PEP is also commonly administered in healthcare settings if medical personnel receive needle-stick injuries or other forms of occupational exposure. In such cases time is not usually a factor as PEP can be sought immediately, but the nature of the exposure is considered along with what is known about the source of possible infection.

Last updated April 2010