What are contraindications for HIV postexposure prophylaxis (PEP)?

Updated: Jul 08, 2021
  • Author: Derek T Larson, DO; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

According to the World Health Organization (WHO), PEP is contraindicated if the exposed person is already HIV-positive due to a previous exposure, if the patient is chronically exposed to HIV, if the exposure does not pose a risk for transmission, or if the exposure occurred more than 72 hours previously. [3]

Because nPEP carries a risk for adverse effects and toxicities, it should be used for only infrequent exposures. Persons who engage in behaviors that result in frequent recurrent exposures that would require sequential or near-continuous courses of antiretroviral medications (eg, multiple sex partners who rarely use condoms or injection-drug users who often share injection equipment) should not receive nPEP. In these instances, exposed persons should instead be provided with intensive risk-reduction interventions. [5] In addition, HIV pre-exposure prophylaxis (PrEP) should be discussed to prevent future infection.


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