Risks when the index is known to have HIV | Right Decisions

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DGRefHelp - NHS Dumfries & Galloway
Sexual health
Post-exposure prophylaxis for HIV
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PEP after sexual exposure - information for clinicians
Risks when the index is known to have HIV

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 patient may know that the index partner has HIV. Where the index partner has been on anti retroviral treatment (ART) for at least 6 months with an undetectable plasma HIV viral load (HIV VL) at the time of last measurement & that measurement was within the last 6 months and with good adherence, PEP is not recommended for any exposure.

The index patient's viral load status and ART history should be confirmed with their HIV specialist. This can only be done with consent from the index patient. Where it is not possible to confirm this, PEP decisions should then be made assuming the patient has a ‘detectable viral load’.

In patients cared for in Scotland D&G viral loads below 40 copies/ml are reported as undetectable. Other services may define loads up to 200 copies/ml as undetectable. It is important to explore with the index patient’s clinic how they define undetectable and whether the results would indicate if PEP is needed.

If the viral load is detectable/not known HIV PEP is recommended if the patient gave or received anal sex or received vaginal sex without a condom (or the condom burst/ came off). In some circumstances it may also be considered if patient performed insertive vaginal sex on an HIV positive index partner. See PEP for HIV: Quick guidance for risk assessment & initial management.