Last Updated: June 2023
Key recommendations PEP risk assessment following an acute sexual assault should not generally differ from that of a consensual sexual exposure. Most victims presenting to Australian sexual assault services have suffered receptive penile-vaginal intercourse by a sole, presumed heterosexual man, the risk of which is estimated to be 1:3,000,000. An assessment for PEP should occur …
Key recommendations Immediately assess all children presenting following a potential HIV exposure for PEP, ideally in conjunction with a paediatric infectious diseases specialist includes following alleged sexual abuse, human bites and splash injuries. Consider whether a forensic examination is indicated, and if so, refer to your local child protection unit in a timely manner for …
People living in correctional or detention facilities who are potentially exposed to HIV have the same right to assessment and PEP provision as the general population. This guideline, including consent, confidentiality and scope of testing, applies equally to this population. People living in correctional or detention facilities who are potentially exposed to HIV sexually, through …
People living in correctional or detention facilities Read More »
People who started PEP while overseas may have been prescribed antiretroviral drugs which are not recommended in Australia. Frequently, they may not have had all recommended baseline tests as recommended in Table 4. All baseline tests recommended in this guideline should be completed as soon as possible. If not originally prescribed, the person should transition …
Recommendations on whether and when to discontinue PEP after missed doses is largely empirical, informed by the biological and pharmacological properties of each agent, as well as expert opinion. Advice provided to those who miss dose(s) will depend on both the time since the last dose, as well as the number of missed doses. Maintenance …
There may be several reasons a patient may decline PEP, including: personal risk assessment not based on current evidence, or clinician recommendation concern about medication side-effects concern about longer-term toxicity lack of awareness about the use and likely efficacy of PEP. If the exposure is one where PEP is recommended, clinicians should discuss patient concerns …
People at risk of HIV acquisition who decline PEP Read More »
This response may relate to anxiety and fear about a negligible exposure or to undisclosed, more serious risk behaviours. Clinicians should follow this advice: the decision to prescribe PEP should be based on the risk of HIV acquisition discussing the low risk of the exposure (Appendix A) may reassure people who may have overestimated the …
People at negligible risk of HIV transmission who request PEP Read More »
Disproportionately higher rates of HIV acquisition occur among people who have previously used PEP.13-15 It is recommended that clinicians follow this guidance: patients who present for repeat PEP should be treated in a non-judgemental manner each presentation should be assessed as per the risk assessment process described in this guideline (see section: Assessment of the …
People who re-present for PEP after completion of a PEP course Read More »
Two-drug PEP and PrEP consist of the same medication, and a subsequent exposure that occurs while someone is on a current course of PEP is similar to an exposure that occurs while taking PrEP. When used for PrEP, co-formulated tenofovir-disoproxil and emtricitabine is proven to prevent HIV acquisition.97,98 From the ANRS Prévenir trial of daily …
People who re-present with additional high-risk exposure(s) while taking a PEP course Read More »
Many patients who present for PEP have ongoing risk factors for HIV acquisition and so should be recommended to commence PrEP on completion of PEP, either daily or on-demand or event driven. Note: on-demand and event-driven PrEP is only efficacious for anal sex, and not for vaginal, front hole or neovaginal sex.100 Comprehensive information on …
These guidelines are pending endorsement by the Blood Borne Viruses and Sexually Transmitted Infections Standing Committee (BBVSS).
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