Guide to Australian HIV Laws and Policies for Healthcare Professionals

Post-exposure prophylaxis

In some instances, post-exposure prophylaxis (PEP) will be appropriate to prevent HIV transmission within 72 hours of exposure to HIV. The National Guidelines for Post-Exposure Prophylaxis after Non-Occupational Exposure to HIV (2016) state:

“These guidelines outline the management of individuals who have been exposed (or suspect they have been exposed) to HIV in non-occupational and occupational settings. There are currently no data from randomised controlled trials of the use of post-exposure prophylaxis (PEP) and evidence for use has been extrapolated from animal data, mother to child transmission, occupational exposure and small prospective studies of PEP regimens in HIV-negative men. Accordingly, assumptions are made about the direction of management.

Every presentation for PEP should be assessed on a case-by-case basis, balancing the potential harms and benefits of treatment.”

The guidelines proceed to outline risk and treatment options. In short, PEP should be considered if the potential benefits of treatment are greater than the risks of treatment.

There are no Australian cases establishing a legal duty to offer PEP. However, a person who is not offered PEP and acquires HIV could argue that the clinician has been negligent. The clinician’s failure to follow the national guidelines could be taken into account by a court as evidence that the clinician has breached his or her duty of care in a particular case.

The current PEP Guidelines are available here.