Post-exposure prophylaxis (PEP) is a medical measure aimed at preventing the development of infection after a likely high-risk exposure to HIV.
PEP includes the following steps:
- first aid;
- counseling and HIV risk assessment;
- HIV testing after obtaining informed consent;
- depending on the degree of assessed risk, a short course (28 days) of antiretroviral therapy (ART) with support and follow-up.
HCT is performed both in case of occupational exposure to HIV or a high probability of such exposure, and in case of accidental exposure that is not related to professional activities. If a person has had sexual contact that was accompanied by violence, condom damage or slippage, accidental needle stick, accidental contact with blood (contact with mucous membranes, damaged skin, etc.), it is necessary to receive medical PrEP as soon as possible within the first hours after contact, without waiting for test results, optimally up to 2 and no later than 72 hours after contact. The optimal duration of PrEP is 28 days.
The risk of HIV infection during sexual violence may be higher than during consensual sex, as trauma increases the risk of HIV transmission. The risk of infection also increases in the presence of STIs (both in the active and passive partner), as well as if an adolescent girl is subjected to sexual violence (immaturity of vaginal and cervical cells increases susceptibility to HIV infection). First aid after a possible exposure to HIV should be provided immediately after the exposure to reduce the time of contact with infected biological fluids (including blood) and tissues.
In case of a needle or other sharp instrument injury, the procedure is as follows:
- Immediately wash the area of contact with soap and water.
- Hold the wounded area under running water for several minutes or until bleeding stops to allow blood to flow freely from the wound.
- If there is no running water, treat the injured area with a disinfectant gel or handwashing solution.
- Do not use harsh substances such as alcohol, bleaching liquids, and iodine, as they can cause irritation of the wounded surface and worsen the condition of the wound. Do not squeeze or rub the injured area. Do not suck blood from the wound that remains after the injection.