HIV Postexposure Prophylaxis Algorithm: Sexual Assault

HIV Postexposure Prophylaxis Algorithm: Sexual Assault
                             
            Significant mucosal exposure?1
            Yes Yes         No  
                   
  Survivor presents within 36 hours?  

███
STOP

 
    Yes             No  
                   
  Perpetrator is known to be HIV−   Perpetrator is known to be HIV+
    No       Yes         Yes     No No  
                     
  Survivor prepared to start PEP?

███
STOP

      Refer to HIV Specialist
Consider early treatment
   
    Yes   No                      
                           
      Offer initial dose and reassess
in 24 hours
2
               
                               
                           
      Prepared to initiate PEP?              
        Yes     No No                
           
  Individual complicating factors?3

███
STOP

    Recommend return for
testing
    No       Yes  
     
  Begin prophylaxis
and refer to
HIV Specialist
  Immediately consult with
HIV Specialist regarding
prophylaxis regimen.
4
               
NOTES

1Defined by direct contact of the vagina, anus or mouth with the semen or blood of the perpetrator with or without physical injury, tissue damage, or presence of blood at the site of the assault.
2Prophylaxis should be initiated within 36 hours of the assault.
3Complicating factors: pregnancy; other medical conditions; drug interactions.
4If Specialist not available on site, 24-hour consultation information available at www.hivguidelines.org

REFERENCES

Source: New York State Department of Health. www.hivguidelines.org
Available at: http://http://www.hivguidelines.org/wp-content/uploads/2009/05/pep_card.pdf

(Rev. 4/2012)

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