Victorian NPEP Service
Management of people who have been exposed to HIV
The Victoria Non-Occupational Post Exposure Prophylaxis (NPEP) Service can assist people who have been exposed to HIV (either sexually or by injecting drugs) with the aim of reducing the risk of contracting HIV.
What we do
This service provides information and advice for people seeking PEP. It provides PEP across Victoria in partnership with GPs and hospital services and assists people to find their closest PEP provider.
The service is clinically overseen by Alfred Health, but can be accessed throughout Victoria from HIV-specialist GP's, emergency departments such as The Alfred’s Emergency & Trauma Centre (after hours and on weekends) and the Melbourne Sexual Health Centre.
Do I need to start PEP?
PEP is a 28 day course of tablets started within 72 hours (3 days) of a high risk HIV exposure. That is, an event where it is possible that you could catch HIV.
Whether or not you need PEP depends on how high the risk was.
To find out if you should take PEP, see the table below, and Commonly Asked Questions for further details. Please note that there may sometimes be exceptions to these general rules.
If you need to start PEP visit the PEP website to find your nearest PEP site.
| HIV exposure | PEP required? |
|---|---|
|
You had sex with someone on PrEP |
No |
| You had sex with someone with HIV who has a non- detectable viral load | No |
| Male to male sex - receptive anal sex (bottom) | YES |
| Male to male sex - insertive anal sex only if uncircumcised (top, uncut) | YES |
| Male to male sex - oral sex | No |
| Heterosexual sex | No |
| Community needle stick injury | No |
| Sharing needles (where HIV status is unknown) | No |
| Sharing needles (with an HIV-positive person, or a person at high risk of HIV) | YES |
Commonly asked questions
What does "HIV treatment" refer to?
HIV treatment (or anti-retroviral treatment) is medication taken by people who have HIV. The aim of HIV treatment is to reduce the amount of HIV in the body to a level that is so low that it can’t be detected on a viral load test – a non-detectable viral load.
What does it mean if someone has a Non-Detectable Viral Load (ND VL)?
Viral load is the amount of HIV in the body and is measured by a blood test. If someone with HIV has a ND VL it means that they have such a low amount of virus in their body that the test can’t detect it.
HIV positive people with a ND VL still have HIV but the level of the HIV virus is extremely low and transmission of HIV is very unlikely.
What if I was exposed to someone who is HIV positive with a non-detectable viral load (ND VL)?
If your exposure was with someone who is HIV positive and has been on treatment with a non-detectable viral load for at least 6 months you do not need PEP.
What if I was exposed to someone who is on PrEP?
If your exposure was to someone who has been reliably taking PrEP for at least 3 months and has had a negative HIV test 3 months after starting PREP they are unlikely to have HIV infection and you do not need PEP.
What should I consider with male to male sexual exposure?
If you had an exposure with someone whose HIV status is unknown or who is HIV positive and either not on treatment or has a high viral load you will need to start PEP in the following situations:
- Receptive anal sex (bottom partner) whether or not ejaculation occurred
- Insertive anal sex (top partner) if you are uncircumcised (uncut)
If you had oral sex your HIV risk is extremely low and PEP is generally not recommended. The only time PEP is considered for oral sex is if you had cuts in your mouth and were exposed to a partner who has HIV with a high viral load, or who is not on treatment.
There are some other sexual exposures that require assessment for PEP, such as getting semen in the eye or blood onto broken skin from someone who is HIV positive and either not on treatment, or on treatment with a high viral load. You may or may not be prescribed PEP depending on the particular circumstances of the exposure.
What should I consider with heterosexual sexual exposure?
Rates of HIV are very low in the heterosexual population in Australia and PEP is not generally required following sex between a man and a woman, including sex with female sex industry workers in Australia.
The only time PEP would be considered for sex without a condom between a man and a woman is where one partner is HIV positive and either not on treatment, or has a high viral load, or is at a high risk of having HIV, for example they are from a country that has high rates of HIV.
Do I need PEP for a needle stick injury?
Rates of HIV amongst people who inject drugs in Australia are very low. There have been no documented HIV transmissions from receiving a needle stick injury from a discarded needle in a public place.
You do not need to take PEP in this situation, however it is advised that you go to your GP within 72 hours to discuss hepatitis B vaccination. You will also need a test for Hepatitis C.
Do I need PEP if I share needles?
Rates of HIV amongst people who inject drugs in Australia are very low. If you have shared a needle with someone who’s HIV status you do not know, PEP is not generally recommended.
However it is advised that you see your GP within 72 hours to discuss hepatitis B vaccination. You will also need a test for Hepatitis C.
If you have shared a needle with a person who has HIV and is not on treatment or has a high viral load, or shared a needle with someone who has a high risk of having HIV, such as sharing with a man who has sex with other men, it is recommended that you start PEP.
I need to start PEP, what should i do?
Visit the PEP website to find your nearest PEP site.
How to access this service
Contact us directly
Family, carers, case managers and patients can contact us directly to access our services.