Talking to your doctor about nPEP

May 2007     View PDF     En español

Suggested follow-up schedule for nPEP

The CDC has funded a 24-hour national PEP registry for non-occupational HIV exposure: 1-877-448-1737 and www.HIVpepregistry.org. Its purpose is to collect information about the use and impact of nPEP among people at risk for HIV. The registry is entirely anonymous and no names or personal identifiers are collected.

Visit #1: Medical Evaluation

• Conduct risk assessment of patient.
• Conduct assessment of source if known (HIV status, CD4+ cell count, medication and viral load history including resistance test results).
• Gather information about patient’s medical history, including current medications, allergies, alcohol and drug use, previous exposure to HIV, HBV and HCV and earlier use of nPEP.
• Conduct physical exam.
• Conduct appropriate lab work (see table of recommended evaluation on page 5)
  Women: pregnancy test (discuss contraception plans).
  Screen and treat STIs as needed.
  Any other blood tests (EKG, CXR, etc.) if indicated by medical history and exam.
• A 3–5 day supply of medication provided or prescribed initially.
• Discuss an HIV prevention and risk reduction plan.
• If the patient is a victim of a rape, sexual assault or domestic violence, provide referrals to rape crisis or domestic violence counseling and other referrals as appropriate.

Note: HIV RNA tests are NOT recommended for diagnosing HIV infection. The false positive rate is high and may cause undue anxiety for the patient.

Visit #2: Week 1

• Patient returns for lab work and HIV antibody test results. (Conduct post-test counseling.)
• Review any side effects or other problems.
• If antibody test is negative, labs are normal, and there are no serious side effects from nPEP, dispense remaining three weeks’ medication.
• If antibody test is positive, consult Federal Guidelines for treating HIV disease.

Visit #3: 1 month

• Review side effects or other problems.

Visit #4: 6 weeks

• Follow-up HIV antibody screening. (Conduct pre-test counseling.)
• If antibody test is negative, confirm results at visit 5.
• If antibody test is positive, consult Federal Guidelines for treating HIV disease.

Visit #5: 3 months

• Follow-up HIV antibody screening. (Conduct pre-test counseling.)
• If antibody test is negative, confirm results at visit 6..
• If antibody test is positive, consult Federal Guidelines for treating HIV disease.

Visit #6: 6 months

• Confirm HIV-negative test results. (Conduct pre- and post-test counseling.)
• If antibody test is negative, revisit prevention and risk reduction plan.
• If antibody test is positive, consult Federal Guidelines for treating HIV disease.

Choosing an nPEP regimen

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Recommended lab evaluation