The risk factors for acquiring HIV from a sexual assault will determine whether or not PEP should be offered to a patient.
Consider if exposure <72 hours AND at increased risk:
Risk factors for consideration of PEP
- Assailant known to be HIV +ve
- Men who have sex with Men (MSM)
- Situations include multiple assailants and sexual assault that has occurred in a higher risk setting (e.g., sex-on-site venues).
- Assailant from high prevalence country (HPC)[2] AND anal or vaginal assault
- There is no evidence that perpetrators of sexual assault have a higher prevalence of HIV than the general population
The situations where PEP is recommended include:
- Receptive anal intercourse with
-Person from high prevalence country
-NZ MSM or
-HIV positive source or
- Receptive vaginal, insertive vaginal intercourse or insertive anal intercourse with HIV +ve source
N.B. Risk of transmission from single exposure is VERY LOW even in high-risk situations.
If meet time and risk criteria above:
- Gather information indicated on attached sheet. Ring Infectious Diseases (ID) Physician on call via Chch Hospital (ph 364 0640) to discuss.
- If they agree to see patient urgently (e.g. if in daytime hours), arrange this. Alternatively, they may suggest giving starter pack, with urgent follow up by them, next working day.
- Discuss with the patient; obtain blood for base line HIV and also syphilis, Hep B, FBC, LFT and renal function (copy to ID clinic) before starting medication. Discuss medications and give the drug information sheet.
- Give patient drugs, drug information and follow up appointment details. Fax referral letter regarding patient to ID clinic [fax 364 0952]
For additional information See online DSAC manual :search HIV PEP
[2] Sub-Saharan Africa, North Africa (Sudan),SE Asia (Thailand, Cambodia, Indonesia), South Asia (India, Pakistan), China, The Caribbean, Papua New Guinea, Eastern Europe (Russian Federation, Ukraine), Latin America (Argentina, Brazil, Colombia, Belize, Guatemala, Honduras)