HIV transmission risk is low and often negligible when the source of the exposure has a low or undetectable viral load and is lower if the source is circumcised (if a cis-gender male and the circumcision is healed) or is taking antiretroviral medications as pre-exposure prophylaxis (PrEP). įactors that decrease the risk of HIV transmission: Similarly, across the 4 PEP scenarios, there are shared factors that decrease the risk of HIV infection. Factors that increase the risk of HIV transmission include early- and late-stage untreated HIV infection and a high level of HIV RNA in the blood, the presence of genital or anorectal ulcers from sexually transmitted infections (STIs), and direct blood-to-blood exchange, such as syringe sharing during injection drug use. HIV transmission risk depends on the viral load of the source with HIV and the type of exposure. Risk of Infection Following an Exposure to HIVįactors that increase the risk of transmission: Many factors that contribute to HIV infection are shared by the 4 PEP scenarios outlined below. The first dose of PEP should be administered within 2 hours of an exposure (ideal) and no later than 72 hours after an exposure. After an exposure has occurred, HIV infection can be prevented with rapid administration of ARV medications as PEP. HIV infection can also be prevented with use of antiretroviral (ARV) medications taken as pre-exposure prophylaxis (PrEP). HIV transmission can be prevented through use of barrier protection during sex (e.g., latex condoms), safer drug injection techniques, and adherence to universal precautions in the healthcare setting. Preventing new HIV infections is crucial to the success of New York State’s Ending the Epidemic Initiative. Fortunately, with rapid initiation of PEP, infection can be blocked. Despite the availability of prevention measures, exposures occur that pose the risk of transmission. This guideline was developed by the New York State Department of Health (NYSDOH) AIDS Institute (AI) for healthcare practitioners in any medical setting (e.g., emergency department, sexual health clinic, urgent care clinic, inpatient unit primary care practice) who manage the care of individuals who request post-exposure prophylaxis (PEP) after a possible exposure to HIV.
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