HIV Non-Occupational Post-Exposure Prophylaxis (nPEP) Following Sexual or High-Risk Encounter

Pathway Background and Objectives

It is essential that patients who are exposed to Human Immunodeficiency Virus (HIV) receive prompt and appropriate antiretroviral therapy to decrease the risk of becoming infected with the virus and developing Acquired Immunodeficiency Syndrome (AIDS). In 2016 and 2025, the Centers for Disease Control and Prevention updated its post-exposure prophylaxis guidelines. Based on these changes we have developed a clinical pathway to provide a consistent approach to management. The pathway objectives are to:

  • Ensure that all patients who are potentially exposed to HIV receive prompt and appropriate antiretroviral therapy to decrease the risk of becoming infected with the virus and developing HIV/AIDS

  • Ensure that all patients who are potentially exposed to HIV have obtained the appropriate baseline laboratory testing

  • Ensure appropriate follow up and monitoring for patients potentially exposed to HIV

Algorithm  Educational Module

For HIV Pre-Exposure Prophylaxis (PrEP) guidelines, please see the Co-Management Guideline for HIV PrEP available via the Connecticut Children’s Leaders in Advanced Solutions in Pediatrics (CLASP) Program at Connecticut Children’s.

CLASP tools incorporate an evidence-based, algorithmic approach to expand the capabilities of community providers and provide appropriate levels of treatment for common pediatric conditions. Tools outline when, how, and under what circumstances community providers refer patients to pediatric specialists. 

  • Percentage of patients prescribed the appropriate type medication

  • Percentage of patients all PEP patients having obtained baseline HIV, and Hepatitis B and C testing

  • Percentage of patients with sexual assault having obtained Syphilis, Chlamydia, Gonorrhea and HcG (if appropriate) testing

  • Percentage of patients with Infectious Disease clinic follow up within 2 months of exposure

  • Average length of stay in ED (minutes)

  • Pathway adherence bundle: percentage of patients with appropriate type of medication and AND obtained baseline HIV, Hepatitis B and C testing

  • Hassan El Chebib, MD
  • Grace Hong, DNP APRN
  • Joanna Young, PharmD

The clinical pathways in the above links have been developed specifically for use at Connecticut Children’s and are made available publicly for informational and/or educational purposes only. The clinical pathways are not intended to be, nor are they, a substitute for individualized professional medical judgment, advice, diagnosis, or treatment. Although Connecticut Children’s makes all efforts to ensure the accuracy of the posted content, Connecticut Children’s makes no warranty of any kind as to the accuracy or completeness of the information or its fitness for use at any particular facility or in any individual case.