Introduction
Post-Exposure Prophylaxis (PEP) after Non-Occupational and Occupational Exposure to HIV Australian National Guidelines (Fourth Edition) 2025Last updated: August 2025 Quick access tools Download a pdf version of the guidelines or the PEP decision making tool Guidelines PDF Decision making tool Overview This is the fourth edition of the Australian National Guidelines for Post-Exposure Prophylaxis (PEP) […]
What’s New (2025)
A Decision Making in HIV PEP tool now supplements the guidelines, providing a summary of the information required to prescribe PEP. Removal of the “very high prevalence population (MSM who inject drugs)” category from Table 2: PEP recommendations after NON-OCCUPATIONAL exposure. Removal of the “estimated HIV acquisition risk if source is viraemic, by population group” […]
Glossary
Term Definition AFP Alpha fetoprotein Ag/Ab Antigen/antibody test AIDS Acquired immunodeficiency syndrome AOD Alcohol and other drugs ART Antiretroviral therapy ARV Antiretroviral BBVs Blood- bome viruses CK Creatine kinase eGFR Estimated glomerular filtration rate EUC Electrolytes, Urea, Creatinine FBC Full Blood Count FTC Emtricitabine GP General practitioner HBV Hepatitis virus hCG Human chorionic gonadotropin HCV […]
Immediate Management of HIV Exposure
Do not douche the vagina or rectum after sexual exposure. After oral exposure, spit out blood/body fluids and rinse mouth with water. Wash wounds and skin sites that have been in contact with blood or body fluids with soap and water. Irrigate mucous membranes and eyes (remove contact lenses) with water or saline. Do not […]
PEP Efficacy: Background and Evidence
There is currently no data from RCTs that provides evidence of the efficacy of PEP in preventing human HIV acquisition. Animal data has been informative in determining the importance of: starting PEP as early as possible following an exposure event; the 72-hour post-exposure window period for starting PEP; and the 28-day duration of the course.6-10 […]
Assessing HIV Transmission Risk
U=U Robust evidence has proven that HIV is untransmissible by sexual activity when the source is on treatment and has an undetectable viral load.33-36 This is now referred to in global health promotion programs as ‘undetectable = untransmissible’ or U=U.37 However, source information is often unavailable in PEP decision-making. If doubt exists, PEP should be […]
When to prescribe PEP
PEP for Non-Occupational Exposure Situations where non-occupational PEP should routinely be offered: Anal or vaginal intercourse (either receptive or insertive) with a partner known to have HIV with an unknown or detectable viral load. Receptive anal intercourse with a source of unknown HIV serostatus from a high prevalence population (MSM, TGD, or from a HPC). […]
Clinical Assessment and Follow-up
In making a clinical assessment, health practitioners should consider the gender, culture, language, and literacy level of the person seeking care, as well as their intellectual capacity. The following details should be discussed and documented in the patient’s history. Information about the exposure a. Date and time of exposure. b. Type of exposure, including blood […]
Laboratory Assessment and Follow-up
After a potential exposure to HIV, individuals should have baseline and follow-up testing for HIV and other infections (depending on the mode of exposure). Table 4 sets out the recommended schedule of testing for individuals who are prescribed PEP. Table 4: Laboratory evaluation of individuals who are prescribed PEP Test Baseline (Week 0) Week 2 […]
Prescribing PEP
Important note for healthcare workers who have not previously prescribed HIV PEP Traditionally, the medication used for 2-drug PEP – tenofovir disoproxil 300mg /emtricitabine 200mg (TD/FTC) – was only available from emergency departments, sexual health clinics, HIV specialists, or other accredited HIV s100 prescribers. However, due to the widespread uptake of PrEP, generic formulations of […]