What is included in the long-term monitoring of HIV postexposure prophylaxis (PEP) following a sexual assault?

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

Patients evaluated for PEP should be educated about the symptoms of acute HIV seroconversion (notably fever, sore throat, lymphadenopathy, and/or diffuse rash) [32]  and instructed to seek medical care if they develop. Follow-up with a primary care provider or infectious disease physician should occur at 4-6 weeks, 3 months, and 6 months regardless of whether PEP was initiated in order to screen for medication side effects, to evaluate for symptoms of seroconversion, and to test for development of infections. If initiated, PEP adherence should be stressed, as overall adherence rates are around 60% but are commonly reported to be below 30%, often due to medication side effects such as nausea. [33]

Patients who are pregnant or become pregnant should be advised on the risk of HIV-transmission with breast feeding.

All patients should be advised to abstain from sexual encounters or strictly adhere to condom usage for all encounters (including oral sex) until 3 month follow up, as risk of secondary HIV transmission is highest during the acute phase of illness.


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