Continue a 30- day course of ARV prophylaxis (PEP) if exposure is classified as "risk" and exposed person is HIV negative.
Eligibility: any exposure classified as risk in the last 72 hours.
- Vaginal fluid
- Spinal fluid
- Pleural fluid
- Amniotic fluid
- Synovial fluid
- Ascites fluid
Type of contact:
- Skin penetrated with contaminated needle (hollow or non-hollow)
- Large amount of substance on mucous membrane
- Sexual intercourse no condom
- Risk substance on lacerated skin/ open wound
- Regardless of known/unknown HIV status
Remove infectious substance.
- Wash exposed wounds and skin sites thoroughly with soap.
- Flush mucous membranes with water.
- Do not use bleach, antiseptics or other caustic substances.
Standard <35kg: AZT/3TC
Standard ≥35kg: TDF/3TC
Alternative < 35kg: d4T/3TC
Alternative ≥35kg: AZT/3TC
New HIV test is mandatory to confirm negative HIV status, But: don't delay starting PEP if HTC is not immediately available (no test kits, night, etc.) Do HTC as soon as possible.
- PEP is safe in pregnancy and breastfeeding.
- Severe anaemia (<8g/dl) is contraindication for AZT/3TC.
- Severe renal failure is contraindication TDF/3TC.
Additional prevention measures after rape/sexual exposure:
- Give emergency contraception (EC) within 72 hours if needed.
- Repeat dose if vomiting occurs within 1 hour of taking EC.
- Explain that next menstrual period should occur before or around the expected time.
- Consider giving presumptive treatment for STIs.
At 30 days (after completing ARV prophylaxis):
- Assess adherence
- Give 60 condoms
At 3 months and 6 months:
- Repeat HTC