A new clinical tool has been released to support HIV post-exposure prophylaxis (PEP) prescribing.
HIV PEP involves taking antiretroviral drugs daily for 28 days to reduce the risk of acquiring HIV following exposure.
The Australian-first clinical tool walks clinicians through the steps needed prior to commencing a patient on PEP, from conducting a HIV risk assessment through to when it is and is not recommended.
Jude Armishaw, a nurse practitioner and clinical advisor who worked on the tool, said it was critical that people potentially exposed to HIV start PEP as soon as possible, ideally within 24 hours post-exposure, and no later than 72 hours.
“When prescribing PEP to reduce the risk of HIV, there are many factors prescribers must consider while under immense time pressures,” she said.
“This Australian-first resource is comprehensive yet easy to navigate and supports clinicians to confidently prescribe PEP on a case-by-case basis.”
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Health and community services organisation WAAC welcomed the release of the resources.
Chief executive Dr Daniel Vujcich said: “While PEP represents a crucial component of our public health toolkit for HIV prevention research demonstrated that primary care physicians face significant barriers to PEP prescribing, particularly knowledge gaps and uncertainty around clinical protocols.”
He said the ASHM quick guide would empower clinicians to confidently integrate PEP into routine practice.
“For busy clinicians – especially those in generalist roles – concise, evidence-based guidance is essential, and the ASHM tool addresses this critical need,” Dr Vujcich added.
“It is absolutely essential that patients presenting with potential HIV exposure receive timely, appropriate care at their initial point of contact, rather than facing delays that could extend beyond PEP’s 72-hour therapeutic window.”
He said clinicians could also refer their patients to WAAC’s website for straightforward consumer information on PEP.
The new clinical tool accompanies the release of the fourth edition of the Australian National Guidelines for PEP after Non-Occupational and Occupational Exposure to HIV.
The newest edition covers the latest evidence-based recommendations on prescribing PEP to encourage full adherence and provide person-centred care.
It includes information about prescribing in an inclusive and culturally safe manner, by using appropriate language when consulting with patients and considerations around affordable options and access.
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Also covered is providing advice for patients who have missed doses or have additional exposures while on PEP and shared decision-making with patients about reducing on-going exposure risks.
“When someone presents to a healthcare service following potential exposure to HIV, it can be a stressful experience for them,” Ms Armishaw said.
“Utilising the latest HIV PEP guidelines, healthcare practitioners can help their patients to feel informed, safe, and involved in the decision-making of their care.
“And, importantly, a PEP presentation provides an opportunity to open up a conversation about ongoing HIV prevention strategies.”
The Decision Making in HIV PEP tool can be downloaded here.
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