Once blood has dried, HIV becomes non-viable within 2 hours. In general HIV PEP is not recommended following an accidental community needlestick injury.

When needle sharing has occurred, a risk assessment considering the likelihood of the individual being HIV positive must be carried out. In the UK this would include:

  • Men who have sex with men.
  • Originally from sub-Saharan Africa.
  • Intravenous drug user from a country where there is a high prevalence of HIV among IVDUs.

The UNAIDS GAP Report considers how HIV prevalence among intravenous drug users varies from country to country. The prevalence is particularly high in Eastern Europe and Central Asia (17).

The BASHH HIV PEP guideline summarises recommendations for PEP use in needlestick injury in the community and needle sharing. These are adapted below (18):


HIV PEP prescription follows the same principles as those applied to healthcare workers. The prescription should consist of:

  • Truvada (245mg tenofovir and 200mg emtricitabine) once daily.
  • Raltegravir 400mg twice per day.


  • It must be prescribed within 72 hours of exposure.
  • A 3 day supply is common but enough must be given to cover the period until follow up will be accessed.
  • Provide sufficient written information, such as the HIV Pharmacy association leaflet.
  • It should not be taken with rifampicin.
  • It should be taken at least 4 hours after vitamin supplements, or calcium, iron, and magnesium supplements.
  • A pregnancy test should be performed when indicated but pregnancy should not preclude the use of HIV PEP.
  • Patients using oral contraception should be advised to use barrier contraception while taking PEP and awaiting results.