FIGURE 1. Determining the need for HIV postexposure prophylaxis (PEP) after an occupational exposure*
STEP 1: Determine the Exposure Code (EC)
This algorithm is intended to guide initial decisions about PEP and should be used in conjunction with other guidance provided in this report.
Semen or vaginal secretions; cerebrospinal, synovial, pleural, peritoneal, pericardial, or amniotic fluids: or tissue.
Exposure to OPIM must be evaluated on a case by case basis. In general, these body substances are considered a low risk for transmission in health care settings. Any Unprotected contact to concentrated HIV in a research laboratory or production facility is considered an occupational exposure that requires clinical evaluation to determine the need for PEP.
Skin integrity is considered compromised if there is evidence of chapped skin, dermatitis, abrasion, or open wound.
Contact with intact skin is not normally considered a risk for HIV transmission, However, if the exposure was to blood, and the circumstance suggests a higher volume exposure (e.g., an extensive area of skin was exposed or there was prolonged contact with blood) the risk of HIV transmission should be considered.
The combination of these severity factors (e.g. large-bore hollow needle and deep puncture) contribute to an elevated risk for transmission if the source person is HIV-positive.