PEP is generally not recommended | Right Decisions

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DGRefHelp - NHS Dumfries & Galloway
Sexual health
Post-exposure prophylaxis for HIV
PEP after sexual exposure - information for clinicians
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PEP for HIV: Quick guidance for risk assessment & initial management
PEP is generally not recommended

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

The risk of transmission is very low, the potential toxicity and inconvenience of PEP is likely to outweigh the benefit unless there is a clear specific extenuating factor which increases the risk including the following factors:

more detailed knowledge of the local prevalence in within the index case population
breaches in the mucosal barrier such as genital ulcer disease and trauma following sexual assault or first intercourse
multiple episodes of exposure within a short period of time e.g. group sex
sexually transmitted infection in either partner

PEP should very rarely be given when the risk has been assessed & discussed.

When PEP is not offered (or offered and then declined)

Ensure emergency contraception and follow up pregnancy testing (if applicable)
Explore/administer Hep B immunisation
Take bloods for storage HIV, Hep B, Hep C and advice on follow up blood tests starting at 45 days post exposure
Refer to Sexual Health for testing for sexually transmitted infections commencing 2 weeks post exposure (see referral form within PEP pack)
Promote safe sex/avoidance of blood donation until all results at end of follow up are available and negative
Advice to seek medical assistance on the onset of any acute illness during the follow up period including any new rash or flu like illness