HIV Postexposure Prophylaxis: Sexual Assault

HIV Postexposure Prophylaxis Algorithm: Sexual Assault

            Significant mucosal exposure?1
            Yes Yes         No  
  Survivor presents within 36 hours?  


    Yes             No  
  Perpetrator is known to be HIV−   Perpetrator is known to be HIV+
    No       Yes         Yes     No No  
  Survivor prepared to start PEP?


      Refer to HIV Specialist
Consider early treatment
    Yes   No                      
      Offer initial dose and reassess
in 24 hours
      Prepared to initiate PEP?              
        Yes     No No                
  Individual complicating factors?3


    Recommend return for
    No       Yes  
  Begin prophylaxis
and refer to
HIV Specialist
  Immediately consult with
HIV Specialist regarding
prophylaxis regimen.

1Defined by direct contact of the vagina, anus or mouth with the semen or blood of the perpetrator with or without physical injury, tissue damage, or presence of blood at the site of the assault.
2Prophylaxis should be initiated within 36 hours of the assault.
3Complicating factors: pregnancy; other medical conditions; drug interactions.
4If Specialist not available on site, 24-hour consultation information available at


Source: New York State Department of Health.
Available at:

(Rev. 11/2017)

This article originally appeared on MPR