Case of the Month: Using PEP to Manage Sexual Exposure

Case Summary
A family physician called the CCC about a male patient who had been in a monogamous relationship with another man for the past four months. The patient had had multiple sexual exposures with this partner, the most recent exposure taking place 72 hours before the consultation call. Could this patient be a candidate for PEP?

CCC Consultant Advice
In this scenario, a more detailed history of sexual exposures within the last three weeks would be helpful. If the only exposure in the last three weeks had been within 72 hours, yes, this patient would be a candidate for PEP. Note that PEP is not intended for the treatment of acute HIV, so acute HIV infection should be ruled out for this patient. The treating clinician should monitor the patient for signs of acute HIV infection and draw a viral load immediately. HIV testing should be repeated based on the recent sexual exposure history.

For more information on management of potential exposures and PEP provision, see the CCC’s newly updated PEP Quick Guide.

Because CCC consultations are based on information provided by the caller or clinician accessing the online consultation center, without the benefit of a direct evaluation or examination of the patient, consultations are intended to be used as a guide. They do not constitute medical advice and are not to serve as a substitute for medical judgment. This Case of the Month includes consultation based on the most up-to-date evidence at the time of its publication. To learn about current recommendations, please call one of our clinical consultation lines.