What should I do if I may have been exposed to HIV?
In countries and locations where you cannot be reasonably assured to get the necessary emergency medication in emergency rooms of hospitals, the UN system ensures that HIV Post-Exposure Prophylaxis (PEP) kits are available in UN system offices and are made available to all UN personnel and their eligible family members.
Post-Exposure Prophylaxis Kits
HIV Post-Exposure Prophylaxis (PEP) is an emergency medical response given to an individual who has been exposed to HIV to prevent possible HIV infection in the exposed person. HIV PEP services comprise first aid (depending on nature of exposure); counselling; assessment of risk of exposure to HIV; HIV testing; and, depending on the outcome of the exposure assessment, a 28-day course of anti-HIV medication, with appropriate support and follow-up.
The UN Medical Directors (UNMD) recommendations for HIV PEP are based on careful review of available studies and technical recommendation from World Health Organization HIV experts. For maximum efficacy, HIV PEP should be initiated as soon as possible after exposure - ideally within two hours or less and certainly not later than 72 hours following possible HIV exposure. Data suggests that the earlier the treatment is commenced, the greater the likelihood of success. Adherence to the full 28-day course of anti-retroviral (ARV) medicines is critical for the success of the treatment.
The United Nations through the Division of Healthcare Management and Occupational Safety and Health (DHMOSH) and the UNMD is facilitating rapid access to HIV PEP treatment in all field Duty Stations through provision of HIV PEP Kits and all technical support required for the administration of the kits.
The UN HIV PEP Kit contains enough anti-HIV medications to cover the full 28 days of antiretroviral treatment. Other contents of kit include:
- Pregnancy test kit: to identify if an exposed woman was already pregnant before potential exposure to the virus.
- Emergency oral contraception ("morning-after" pill): to prevent unwanted pregnancy after sexual assault.
- Patient Registry Form: to be filled and signed by the treating physician who will monitor the care.
Taking antiretroviral medicines as Post-Exposure Prophylaxis should be viewed very seriously; antiretroviral medicines should not be considered as an alternative to practicing safer sex.
If you believe you may have been exposed to HIV, as a result of an occupational exposure, sexual assault, criminal assault or security incident, or while giving first aid to an injured person who might be infected, contact the PEP Kit custodian at your duty station. You can get the information and location of PEP Custodian in your duty station from;
- The local office of UN Designated Official for Security (usually the Resident Coordinator's Office)
- The UN Medical Services if one exists at your duty station
- Your human resources officer
If you are living with HIV you should not take the antiretroviral medication in the PEP Kit, as it might harm you by increasing the risk of developing resistance towards these medications and therefore reducing future therapeutic options, when you need them. If you were the target of a sexual assault, and are female, you may want to follow the procedures for emergency contraception.
It is a good idea to enquire how PEP Kits may be accessed and to note the name of the Kit holder/custodian before a potential exposure occurs. We suggest that you write the name of the custodian on an "awareness card" and that you always carry the card with you. In some countries, such as in North America and parts of Europe, post-exposure prophylaxis is not available through the UN system since it can be obtained in the emergency room of any hospital.
In some cases, there is neither access to a PEP Kit nor a facility to provide one within your country. The Designated Official for Security (usually the Resident Coordinator) is required to ensure the establishment of a Post-Exposure Prophylaxis Emergency Protocol, which will identify the nearest regional medical evacuation centre where comprehensive follow-up can take place, including the quickest evacuation route(s) and method(s) for achieving this. Please contact your Designated Official if you find yourself in such a situation.
UN Personnel are expected to use all precautionary measures to avoid any possible exposure to HIV. PEP Kits are intended for use by HIV-negative persons in the event of accidental exposure to HIV. The PEP Kits are available to UN personnel and their immediate dependents who may have been accidentally exposed to HIV, irrespective of the means of exposure. Antiretroviral medications are a serious treatment taken under the supervision of a physician for an entire month that may cause various side-effects.
All information about the UN HIV PEP program, the role of the country team, PEP custodian, physician and the patient (exposed personnel /dependent) are contained in the UN HIV PEP Guidelines (See link)
- Further information on PEP is available on the WHO website.
- UN HIV PEP guideline: A document for UN country teams, PEP custodian, physician and patient with details of the HIV Post-Exposure Prophylaxis (PEP) Kits (updated January 2021)
For further information about HIV PEP, reach out to DHMOSH at firstname.lastname@example.org