Public Health Service Guidelines for the Management of Possible Sexual, Injecting-Drug-Use, or Other Nonoccupational Exposure to HIV, Including Considerations Related to Antiretroviral Therapy

Summary

The most effective methods for preventing human immunodeficiency virus (HIV) infection are those that protect against exposure to HIV. Preventive behaviors include sexual abstinence, sex only with an uninfected partner, consistent and correct condom use, abstinence from injecting-drug use, and consistent use of sterile equipment by those unable to cease injecting-drug use. Some health-care providers have proposed offering antiretroviral drugs to persons with unanticipated sexual or injecting-drug-use HIV exposure to prevent transmission. However, because no data exist regarding the efficacy of this therapy for persons with nonoccupational HIV exposure, it should be considered an unproven clinical intervention. Health-care providers and their patients may opt to consider using antiretroviral drugs after nonoccupational HIV exposures that carry a high risk for infection, but only after careful consideration of the potential risks and benefits and with a full awareness of the gaps in current knowledge.

To address concerns related to providing antiretroviral agents to persons after nonoccupational HIV exposure, CDC convened a meeting in July, 1997 of scientists, public health experts, clinicians, members of professional associations, representatives from industry, ethicists, and members of affected communities. This report reviews the topics raised at the meeting, provides background information on patient management options, and presents considerations for antiretroviral therapy.