A clinician can prescribe HIV prophylaxis without being told everything

Nonoccupational post-exposure prophylaxis (nPEP) is antiretroviral
treatment started after a possible HIV exposure outside a workplace setting.
The CDC's guidance sets out which exposures warrant it.

The instruction that governs all the others

**Persons with a recent HIV exposure might be concerned about disclosing all
details of the behaviors that might have exposed them to HIV.** Multiple
factors might contribute, including **trauma from sexual assault, concerns
about stigma, and medical mistrust**.
>
**Health care professionals can prescribe nPEP to persons who request it,
even if they are unable to elicit all details necessary to assess HIV
acquisition risk.**

That paragraph sits at the top of the exposure table, and it is the most
important thing on the page. Every row below it assumes a full account of what
happened. This one says: where you cannot get that account, prescribe anyway.

nPEP is time-critical. A clinician who withholds it pending a complete history
from someone who has just been assaulted has, in practice, withheld it.

For clinical consultation there is the NCCC PEPline: 888-448-4911.

When nPEP is not recommended

Four exceptions on PrEP

Even for someone on PrEP, nPEP may be considered if they:

1. Recently started PrEP and may not have reached maximum protection
2. Have missed doses
3. Are using an intermittent regimen outside current CDC guidance
4. Were exposed to a source **without sustained viral suppression and with
   resistance to PrEP components**

The pattern across the whole table: the "not recommended" answers all depend
on something having been done correctly and consistently, and every row
includes the exception for when it was not.

Source: Centers for Disease Control and Prevention.