Sexual health

HIV post-exposure prophylaxis (PEP) information for health professionals

The Queensland Health Initiating post-exposure prophylaxis after non-occupational and occupational exposure to HIV guideline has been rescinded. Please refer to the Post-Exposure Prophylaxis (PEP) after Non-Occupational and Occupational Exposure to HIV: Australian National Guidelines (Fourth Edition) 2025.

What is post-exposure prophylaxis (PEP)?

Post-exposure prophylaxis (PEP) is a 28-day course of antiretroviral therapy (ART) that can reduce the risk of acquiring HIV after potential exposure.

Act fast - PEP is time-critial

PEP must be started within 72 hours of exposure. It is most effective the sooner it is started.

Health professional should refer to the Australian National Guidelines for Post-Exposure Prophylaxis (PEP) after Non-Occupational and Occupational Exposure to HIV which outlines the management of individuals who have been exposed (or potentially exposed) to HIV in both occupational and non-occupational settings.

Contact the closest public health unit for clinical advice or 13 HEALTH (13 43 25 84) for information on where to access PEP.

Occupational HIV exposures in a Queensland Health workplace

For potential HIV exposures, follow the local blood and body fluid exposure management procedure and refer to the Queensland Health Occupational Exposure to Blood and Body Fluids Procedure for guidance on managing exposures and accessing PEP.

Who should be offered PEP?

PEP is recommended for individuals who may have been exposed to HIV as described below.

PEP should be considered

PEP is not recommended (negligible-risk exposure)

Sexual exposure - e.g. unprotected anal or vaginal sex with a person known to be HIV-positive or of unknown HIV status.
Injecting drug use - e.g. sharing needles or injecting equipment with a person known to be HIV-positive or of unknown status.
Occupational exposures - e.g. needlestick injuries with potentially infectious fluids.
Other exposures - e.g. contact between non-intact skin and blood or high-risk body fluid.

Intact skin contact with blood or low-risk body fluids (e.g. saliva, urine, sweat).
Exposure to a source confirmed to be HIV-negative.

Where can individuals access PEP in Queensland?

PEP is available at the following locations:

Most public hospital emergency departments in Queensland

Patients accessing emergency departments must be referred for follow-up care and assessment.

Sexual health clinics and specialist HIV services

These clinics provide comprehensive PEP services, including risk assessment, prescription and follow-up care.
It is advised that individuals should call ahead to confirm opening hours and availability.

General practitioners (GPs)

Any prescriber can provide a private prescription for the medication used for 2-drug PEP - tenofovir disoproxil 300mg/emtricitabine 200mg (TD/FTC)
TD/FTC is available from most community pharmacies at a reasonable cost. The medications used are not Therapeutic Goods Administration for TD/FTC with no repeats must written.
Prescribers should refer to the Australian National Guidelines for Post-Exposure Prophylaxis (PEP) after Non-Occupational and Occupation Exposure to HIV to assess if the client fits the recommendation for 2-drug PEP
Linkage to a specialist or specialised s100 prescriber for discussion regarding HIV pre-exposure prophylaxis (PrEP) should be considered where future HIV risk is likely and /or there have been multiple previous PEP presentations
If 3-drug PEP is recommended, contact the local public health unit or the closest PEP providing site for advice on where to obtain the third drug.

Steps for health professionals

Comprehensive guidance on PEP decision-making, management and what to prescribe is available in the Australian National Guidance for Post-Exposure Prophylaxis (PEP) after Non-Occupational and Occupational Exposure to HIV.

Conduct a risk assessment
- Assess the type of exposure (e.g. sexual, occupational, or injecting drug use).
- Determine the HIV status of the source (if known).
- The ASHM PEP Decision-Making Tool is available to guide the assessment.
Initiate PEP if indicated
- If PEP is required, provide the medication or a prescription to be filled immediately.
- Ensure the patient understands the importance of starting treatment as soon as possible (within 72 hours of exposure) and completing the full 28-day course.
- Refer to the Australian National Guidelines for Post-Exposure Prophylaxis (PEP) after Non-Occupational and Occupational Exposure to HIV for guidance on which medicine to prescribe.
Starter packs
- A small supply of medications also referred to as 'starter packs' may facilitate rapid initiation of PEP if the full course is not available in a timely manner or further specialist follow-up/advice is being sought.
- Starter packs are available at some general practice/primary care locations and most Queensland Health hospitals. Health practitioners should call to confirm availability.
Refer for follow-up
- Arrange a follow-up appointment with a sexual health clinic, HIV specialist or GP.
Counsel the patient
- Discuss the importance of adherence to the PEP regimen.
- Inform the patient about potential side effects (e.g. gastrointestinal upset headaches) and how to manage them. Refer to the Patient information sheet: PEP medications (PDF 70 kB) in the Resources for health professionals section below.
- If relevant, advise on risk-reduction strategies, including safe sex practices and the use of sterile injecting equipment.

Special populations

Children under 16 years

Assess all children presenting with potential HIV exposure and consider the need for PEP, ideally in consultation with a paediatric infectious disease specialist.

Children younger than 16 years who qualify for PEP should receive combination therapy at appropriate doses as per the Children's Health Queensland Guideline Post-Exposure Prophylaxis for HIV.

Children should be provided with the full 28-day PEP course at the initial presentation.

People living in rural and remote settings

In settings where timely specialist advice is unavailable or access to the full 28-day course is delayed, health professionals may prescribe a starter pack and seek urgent medical review.

Ensure patients are referred for follow-up with a specialist PEP provider or sexual health service and have adequate medication supply until such follow-up can occur.

Guidance for prescribers

The Australian National Guidelines for Post-Exposure Prophylaxis (PEP) after Non-Occupational and Occupational Exposure to HIV recommend providing the full 28-day course at initiation, where possible, to improve adherence and completion rates.

If a full 28-day course cannot be provided, ensure sufficient medication is dispensed to support adherence until the follow-up appointment.

Referral for prompt follow-up and continuation of PEP should be made, and individuals should be counselled that completing the full 28-day course is essential for effectiveness.

As per the Australian National Guidelines for Post-Exposure Prophylaxis (PEP) after Non-Occupational and Occupational Exposure to HIV, if a 3-drug PEP regime is recommended and the third drug is not available, 2-drug PEP may be initially prescribed. Contact the local public health unit or the closest PEP providing site advice on where to obtain the third drug.

Preventing future HIV exposures

For prevention of further exposures, encourage patients to adopt:

consistent condom use
safe injecting practices
HIV PrEP following completion of the PEP course.

Resources for health professionals

ASHM PEP Guidelines: Comprehensive guidance on PEP decision-making and management.
StaySTIfree: Translated PEP information in Arabic, Chinese, Filipino, Japanese, Korean, Spanish, Thai or Vietnamese.
Visit the Get PEP website.
Non-Occupational HIV Post-Exposure Prophylaxis - Drug replacement form (PDF).
Guideline for the management of care for people 14 years and over disclosing sexual assault (PDF).
Patient information - PEP medication sheet (PDF 70 kB)