Individuals who have been sexually assaulted
Those who present due to sexual assault should be assessed for their need for PEP as early as possible after the event. This is usually best done in a specialist sexual assault centre (where specialist counselling and forensic testing can also occur). However, PEP, if indicated, should not be delayed pending referral. Male-to-male sexual assault clients should always be offered PEP. There are no data on HIV prevalence for convicted sexual assailants in Australia; however, from studies on HIV point prevalence in Australian correctional services it ranges between 0 to 0.6%, with most jurisdictions reporting below 0.1%. Given that the risk of exposure is low, PEP is generally not recommended following heterosexual sexual assault; however, the decision to prescribe PEP should be made on a case-by-case basis. Factors such as multiple assailants, trauma or an assailant who is from a high prevalence country may increase the exposure risk. Emergency contraception should always be offered for women or trans men in this situation.