Effectiveness of PEP in Preventing Occupational HIV Infection

Since 1988, institutions have been offering antiretroviral postexposure prophylaxis (PEP) for occupational exposures to HIV (1,2). Although much has been accomplished since 1990, many important questions remain: What are the initiating events in the pathogenesis of occupational HIV infection associated with a percutaneous exposure? What evidence supports the effectiveness of PEP in preventing occupational HIV infection? How can the use of PEP be improved by eliminating overtreatment? How can access to and use of expert consultants be facilitated? How can adherence to PEP medication regimens be improved? What is the relevance of the source patient’s prior antiretroviral experience? How should occupational exposures be managed in pregnant health-care workers?